LEPROSY

What is Leprosy?

  • • Leprosy is a bacterial disease caused by a slow growing bacteria (Mycobacterium leprae).
  • • It affects mainly skin and peripheral nerves. Sometimes eyes and other parts of the body may be involved.

How can one get Leprosy?

  • • Leprosy is an infectious disease and a person is affected based on the immune response elicited by the body towards the infectious organism.
  • • The transmission of the bacteria is through the respiratory tract (through nose/pharynx) and in few cases through direct prolonged contact with an open/ untreated case of leprosy.
  • • One is unlikely to get leprosy from a patient who has taken treatment for leprosy with multi-drug therapy(MDT) adequately. A leprosy patient becomes noninfectious within one week after receiving first dose of treatment.

Is Leprosy hereditary? Is Leprosy transmissible to family members or contacts?

  • • No. Leprosy is not hereditary.
  • • Yes, leprosy can be transmissible to family members or contacts. However all cases of leprosy are not transmissible. Patients who have a poor immune response to the leprosy organism and have increased number of leprosy bacilli are more likely to transmit the disease.

What factors can aggravate the disease?

  • • Poor nutrition/protein energy malnutrition may aggravate the disease due to low immunity.
  • • Incomplete/inadequate treatment may also aggravate the disease.

How does Leprosy look? Which areas of body are affected with Leprosy?

  • • There is a broad spectrum of presentation in leprosy.
  • • Leprosy may have hypo pigmented or reddish skin lesions which show loss of sensations or decreased sensations. The skin lesions may be single or multiple in number.
  • • Leprosy may present with a localized loss of sensation or tingling/numbness of the upper and lower limbs.
  • • It may manifest as deformities in the form of bending (claw hand) of fingers, shortening of fingers, foot drop, recurrent blisters in hands or feet, foot ulcer, loss of eyebrows, thickening of ear lobules.
  • • High grade fever, joint pains, recurrent painful swellings, or pain along a particular peripheral nerve can occur in lepra reactions.
  • • Besides skin, peripheral superficial nerves, parts of anterior chamber of the eyes, testes, maxillary bones(loosening /loss of upper incisors teeth), nasal bone/ cartilage (saddle nose) etc may be affected.
  • • In Leprosy, cooler parts of the body are affected and the warmer areas like hairy scalp, axilla, etc are not affected.

What should one do if he/she gets Leprosy?

  • • If one gets leprosy he/she should consult a qualified dermatologist/ leprologist as early as possible.
  • • Early treatment is very important because patient may develop permanent deformities. There should be no discontinuation of the treatment and treatment should be strictly followed as per the dermatologist's advice.

Are there any tests to confirm Leprosy?

  • • Diagnosis is usually made on the basis of clinical signs and symptoms.
  • • Slit skin examination (Acid Fast Bacilli staining) and skin biopsies can be done to confirm the diagnosis of leprosy.

How can leprosy be treated?

  • • Leprosy is treated with MDT (Multi drug therapy).
  • • Depending up on the type of Leprosy, MDT can be given for 6- 12 months.
  • • The dosage regimens include single dose (ROM therapy for single lesion pauci-bacillary leprosy), for six months (two drugs for pauci-bacillary) and for one year (three drugs for multi-bacillary).
  • • Treatment for leprosy can also be availed free of charge at public hospitals.

What are the measures to prevent spread of Leprosy?

  • • The most effective way of prevention is by early detection and initiation of treatment.
  • • A leprosy patient should cover his/her mouth duringcoughing or sneezing and he/she should avoid to gocrowded area during initial months of starting MDT. Thismay help prevent spread of the disease.

How can one prevent deformities in Leprosy patients?

  • • Deformities in leprosy can be prevented by early detection, prompt treatment and proper advice to the patient
  • • Appropriate counseling about self - care to the patient and his family members should be done,
  • • Contact with hot objects and trivial trauma or friction may lead to blister formation in anesthetic area. Hence he/she should avoid trauma/ friction and touching hot objects.
  • • The patient should not walk barefooted and should be provided with proper footwear to prevent blistering and ulcer formation in the feet.
  • • In case of problems suggestive of lepra reactions (fever, headache, recurrent swellings, skin rash, joint pains, pain in hands/feet), prompt treatment should be started after consultation with a dermatologist and MDT should not be stopped.

Can Leprosy be cured? Can Leprosy recur?

  • • Yes. Leprosy can be cured. However deformities caused by leprosy may persist if treatment is not initiated early or appropriate care is not taken to prevent deformities.
  • • Generally after taking full course of MDT, leprosy does not recur. Relapses may be seen, especially in multi bacillary cases, however these can be effectively treated by MDT.
  • Even after full treatment hypopigmentation and mild loss of sensation might persist.

Can a person with Leprosy marry?

  • • Yes. A person with leprosy can marry and have children. After taking MDT for few months person becomes non-infectious so, there is minimal chance of infection to spouse.

What are the misconceptions and stigma associated with Leprosy?

  • • All white lesions are believed to be leprosy.
  • • Leprosy is believed to be a curse by Gods.
  • • It is believed to be a hereditary disease associated withlow social status.
  • • There is a misconception that there is no treatment forthis disease.
  • • The deformities and disabilities due to leprosycontribute further to the social stigma.

How can misconceptions and stigma associated with leprosy be corrected?

  • • Providing proper information and educating the publicabout the disease can help in reducing the stigma.
  • • There is no need to treat leprosy patients in specialhospitals, leprosy patients should not be isolated orsegregated from the general public.
  • • Leprosy patients can share household items or rooms.They can go to schools or be employed.
  • • It is important to educate the patients to take completetreatment and take appropriate measures to prevent deformities.