What Is Leprosy?
Leprosy, also called Hansen's disease, is an infectious disease that causes severe, disfiguring skin sores and nerve damage in the arms, legs, and skin areas around the body. Leprosy is caused by close contact with nose and mouth droplets from an infected person. Leprosy has been discovered in animals in different locations across the world. On the American continent, armadillos are naturally infected with the bacteria that cause leprosy. Leprosy can spread from these infected armadillos to humans. The United Kingdom's red squirrel population is also known to carry leprosy, but there are no instances of transmission from these squirrels to humans.
How Many Cases of Leprosy per Year?
It is estimated that about 250,000 new cases of leprosy are diagnosed worldwide every year. The condition is most common in India, Brazil, and other areas with warm climates. Children have a higher risk of getting leprosy than adults.
What Causes Leprosy and How It Is Spread?
The disease leprosy is caused by a slow-growing bacteria called Mycobacterium leprae (M. leprae). It may happen when a person has leprosy, coughs, or sneezes, and a healthy person gets infected through the droplets containing the bacteria. The infection can spread through long-term contact with an infected person.
Leprosy is not caused by the following:
-
Shaking hands or hugging.
-
Sitting next to each other.
-
Eating meals.
-
Mother to her unborn baby during pregnancy.
-
Sexual contact.
What Does Leprosy Look Like?
Leprosy mainly affects the skin, nerves, and mucous membranes (the soft, moist areas inside the body's openings). It usually takes three to five years for symptoms to appear after contact with the leprosy bacillus.
The disease may cause skin symptoms such as:
-
A large, discolored lesion on a person's chest with leprosy.
-
Skin patches that are discolored, flat, numb, and faded.
-
Skin growths.
-
Thick and dry skin.
-
Painless ulcers on the soles of feet.
-
Painless swelling.
-
Lumps on the face or earlobes.
-
Loss of eyebrows or eyelashes.
Leprosy also causes nerve damage; symptoms may include:
-
Numbness in the affected areas of skin.
-
Enlarged nerves.
-
Muscle weakness or paralysis.
-
Eye problems that may lead to blindness.
-
Enlarged nerves below the skin.
Symptoms when leprosy affects the mucous membranes:
-
Stuffy nose.
-
Nose bleeding.
What Are the Types of Leprosy?
The number and type of skin sores classify leprosy.
-
Tuberculoid Leprosy: It is a less severe and mild form of leprosy. Tuberculoid leprosy is less infectious than other types. People with this type of leprosy have only one or a few flat and pale skin (paucibacillary leprosy). The affected skin area gets numb because of nerve damage below the skin.
-
Lepromatous Leprosy: It is more severe and causes bumps and rashes (multibacillary leprosy), numbness, and muscle weakness. It affects the nose, kidneys, and male reproductive organs.
-
Borderline Leprosy: People with this form of leprosy have tuberculoid and lepromatous leprosy symptoms.
The World Health Organization (WHO) Classification:
-
Single Lesion Paucibacillary (SLPB): There is only one skin lesion.
-
Paucibacillary (PB): There are two to five lesions. There is generally a loss of sensation in these areas.
-
Multibacillary (MB): Six or more lesions. Multibacillary leprosy usually involves many cutaneous lesions, including damage and lumps under the skin (nodules). In addition, the moist tissues lining the body openings, such as the eyelids and the inside of the nose and mouth (mucous membranes), can also be affected, leading to vision loss, destruction of nasal tissue, or impaired speech.
How Is Leprosy Diagnosed?
In the case of a skin sore that might be leprosy, the healthcare provider removes a small sample and sends it to a lab for examination (a skin biopsy). The health care provider may also do a skin smear test. In the case of paucibacillary leprosy, no bacteria will be in the test results. A lepromin skin test is done to see which type of leprosy someone has. In this test, the provider injects a small amount of inactive leprosy-causing bacteria under the skin of the forearm. Then, the provider checks the spot where the person got the shot three days later and then again 28 days later to see if there is any reaction. People who respond to this test may have tuberculoid or borderline tuberculoid leprosy, while those who do not respond may have leprosy or lepromatous leprosy.
How Is Leprosy Cured?
Leprosy is curable. Treatment depends on the type of leprosy someone has. Leprosy medication usually includes antibiotics. Doctors recommend long-term treatment, usually for six months to a year. Severe forms of leprosy may need to take antibiotics longer than the other forms.
-
Leprosy medication includes multidrug therapy (MDT), the most common leprosy treatment that combines antibiotics.
-
Anti-inflammatory drugs are taken to control nerve pain and damage related to leprosy. These drugs include steroids like Prednisone.
-
Leprosy medication also includes Thalidomide. It suppresses the immune system and helps treat skin nodules. Thalidomide is never taken in pregnancy as it is known to cause severe, life-threatening congenital disabilities.
What Is Armadillo Leprosy?
In the southern United States, armadillos carry the bacteria that causes leprosy. There are many chances for the occurrence of armadillo leprosy. However, the risk of armadillo leprosy is low, and there are fewer chances for people to get infected. If the people decide to have the meat, it should be undercooked. Through cooking, the armadillo, which carries the bacteria, will destroy the bacteria.
What Are the Complications of Leprosy?
Leprosy can permanently damage the skin, nerves, arms, legs, feet, and eyes if left untreated.
The complications of Leprosy may include
-
Blindness or glaucoma.
-
Iritis.
-
Hair loss.
-
Infertility.
-
Face disfiguration.
-
Kidney failure.
-
Muscle weakness that leads to claw-like hands.
-
Nosebleeds and a chronic stuffy nose due to permanent damage to the nose.
-
Permanent nerve damage outside the brain and spinal cord leads to loss of feeling.
How Is Leprosy Prevented?
The most effective way to avoid leprosy is to prevent contact with droplets from the nasal and other secretions from people with untreated leprosy. The WHO recommends the prevention of leprosy through a single dose of Rifampicin for eligible familial and social contacts.
What Are the Risk Factors Associated With Leprosy?
The most common risk of leprosy is getting in contact with someone who is already infected with leprosy. Compared to the normal population, people who have encountered the infected person have a five to eight times higher risk of leprosy. Certain conditions can increase the risk of leprosy, such as malnutrition, genetic mutations, or other illnesses. Some genetic factors are seen to develop leprosy in a person. Certain genetic conditions can cause tuberculosis or lepromatous leprosy.
Conclusion
Leprosy is an infection caused by a slow-growing bacteria called Mycobacterium leprae. It can affect the nerves, skin, eyes, and nasal mucosa. Leprosy was once considered a highly contagious and devastating disease, but now it does not spread easily, and treatment is very effective. However, leprosy can permanently damage the skin, nerves, arms, legs, feet, and eyes if left untreated. However, with early diagnosis and treatment, it is possible to cure the disease completely. People affected by leprosy can have a normal lifestyle during and post-treatment.