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HANSEN'S DISEASE/LEPROSY

By Dr. Chinda

18:01:00

Saturday, 18 June 2016

Leprosy, also known as Hansen's disease (HD), is a long term infection caused by bacteria called Mycobacterium leprae and Mycobacterium lepromatosis.

Leprosy has affected humanity for thousands of years. The disease takes its name from the Latin word lepra, which means "scaly", while
the term "Hansen's disease" is named after the physician Gerhard Armauer Hansen. Separating people by placing them in leper colonies still occurs in places such as India, China and Africa. However, most colonies have closed since leprosy is not very contagious. Social stigma has been associated with leprosy for much of history, which continues to be a barrier to self-reporting and early treatment. Some consider the word leper offensive, preferring the phrase "persons affected with leprosy". World Leprosy Day was started in 1954 to draw awareness to those affected by leprosy.

Initially, infections are without symptoms and typically remain this way from 5 to as long as 20 years. Symptoms that develop include development of abnormal tissues called granulomas, from the nerves, respiratory tract, skin, and eyes. This may result in a lack of ability to feel pain and thus loss of parts of extremities due to repeated injuries or infection due to unnoticed wounds. Weakness and poor eyesight may also be present.

Leprosy is spread between people. It is believed to occur through a cough or contact with fluid from the nose of an infected person. Leprosy occurs more commonly among those living in poverty and is believed to be transmitted by respiratory droplets. Contrary to popular belief, it is not highly contagious.

Leprosy is not known to be sexually transmitted. People are no longer infectious after as little as two weeks of treatment.

Leprosy may also be transmitted to humans by armadillos and may be present in three species of non-human primates.

Two exit routes of M. leprae from the human body often described are the skin and the nasal mucosa, although their relative importance is not clear.

The skin and the upper respiratory tract are most likely entry route. While older research dealt with the skin route, recent research has increasingly favored the respiratory route.

The two main types of disease are based on the number of bacteria present: paucibacillary and multibacillary. The two types are differentiated by the number of poorly pigmented (not as dark as surrounding skin), numb skin patches present, with paucibacillary having five or fewer and multibacillary having more than five.

Leprosy is curable with a treatment known as multidrug therapy (MDT). Treatment for paucibacillary leprosy is with the medications dapsone and rifampicin for six months.

Treatment for multibacillary leprosy consists of rifampicin, dapsone, and clofazimine for 12 months. These treatments are provided free of charge by the World Health Organization. A number of other antibiotics may also be used. Globally in 2012, the number of chronic cases of leprosy was 189,000, down from some 5.2 million in the 1980s. The number of new cases was 230,000. Most new cases occur in 16 countries, with India accounting for more than half. In the past 20 years, 16 million people worldwide have been cured of leprosy.

POWERFUL GUIDE TO LEPROSY PREVENTION

Early detection of the disease is important, since physical and brain damage may be irreversible even if cured. Medications can decrease the risk of those living with people with leprosy from acquiring the disease and likely those with who people with leprosy come into contact outside the home. However, concerns are known of resistance, cost, and disclosure of a person's infection status when doing follow-up of contacts. Therefore, the WHO recommends that people who live in the same household be examined for leprosy and only be treated if symptoms are present.

World Leprosy Day is observed internationally on January 30 or its nearest Sunday to increase the public awareness of the Leprosy or Hansen's Disease. This day was chosen in commemoration of the death of Gandhi, the leader of India who understood the importance of leprosy. Leprosy is one of the oldest recorded diseases in the world. It is an infectious chronic disease that targets the nervous system, especially the nerves in the cooler parts of the body - the hands, feet, and face.

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