LEPROSY (Hansen’s Disease)
The mere mention of the word leprosy strikes fear into most people – probably because of the images we have seen over the years of sufferers, stigmatised and restricted to colonies where many of them died before treatments became available.
There have been some recent cases in the UK and Ireland but all have been treated successfully and were diagnosed in patients who had lived abroad from several years in countries where the disease still exists. There were three cases reported in 2015 in Florida and two were linked to the nine-banded Armadillo, a native of South USA, that is suspected of carrying the bacteria.
WHAT IS LEPROSY?
Leprosy is a chronically infectious bacterial disease caused by Mycobacterium leprae, which was identified in 1873 by Leprosy also known as Hansen’s disease, after Armauer Hansen, the Norwegian physician who first identified the micro-organism. He was the first scientist to identify harmful bacteria to humans.
It is one of the oldest diseases to affect humans and could go back as far as 600 B.C as there are records of Romans bringing back the disease unwittingly from their various campaigns into Africa and Asia. Because the incubation period can be as long as four years it was very difficult during the diseases history to actually pinpoint the source and also it meant that it the disease was carried that long without symptoms. The bacillus actually multiplies very slowly and there has been recorded incubation periods as long as 40 years.
Thankfully about 90% of humans have a natural immunity to the bacteria but in the Middle Ages and in many warm, tropical countries in Africa and Asia the problem was widespread.
Although it can be a devastating disease it is one of the most difficult to catch and requires long-term contact with the carrier which is why family members tend to be at risk or people within very close knit communities where living conditions are very crowded.
When an infected person sneezes they release 100 million bacilli and even when these dry out they can still infect another person by being touched and then passed to the nose or to a break in the skin.
There are several forms of Leprosy which range from a mild form to a very severe lepromatous type. If the infected person has a strong immune system they may never show any symptoms but in cultures where there is famine or drought this type of disease easily overcomes the weakened defences.
WHERE IS LEPROSY MOST COMMON?
People all around the world could catch the disease, but it is most common in warm, wet areas in the tropics and sub-tropics. At the moment there around 5.5 million sufferers around the world but 80% of these live in India, Indonesia, Myanmar (Burma) Brazil and Nigeria. There are also cases in Pacific Islands such as Tahiti and the Cook Islands.
In Western countries the incidence is very low with around 200 cases being reported each year in the USA for example and only 6,000 have the disease.
Interestingly a French genetic company studying strains of leprosy causing bacteria has revealed some secrets of how the pathogen evolved and was spread. Their findings indicate that all the world’s existing leprosy infections are all caused by single bacteria that has barely mutated for centuries. They also show that the disease probably began in East Africa, not India as once thought and that it may well have been spread to other continents by European colonialism and later the slave trade.
HOW DOES THE DISEASE PROGRESS?
Once the bacteria is in the body it heads to the cooler parts of the body such as the mucous membranes in the nose, the skin and nerves near the surface of the body, and in men the testicles, which are always cooler being outside the body.
In most sufferers the first indications will be patches that are numb to the touch, and then skin lesions appear. Toes and fingertips are particularly vulnerable and lose their feeling which is what causes the terrific disfigurement of hands and feet, as sufferers cannot feel heat or cold or sharp objects and can easily injure themselves losing parts of the body without realising it.
The most severe Lepromatous type develops much quicker and affects facial features, sight, internal organ infection and death.
A couple of interesting facts. Babies do not present with leprosy because the bacilli multiply so slowly. The main infected times of persons life appears to be 10 – 14 and 35-44 years old.
THE GOOD NEWS.
Leprosy is treatable although treatment may continue for a number of years to ensure that the bacteria is completely killed off. There are three different classifications for dianosis from a patients who present with one lesion, two to five lesions and more than five.
Patients with an early diagnosis and only one lesion can expect to be cured with a single dose of the multi-drug therapy with children being given half the dose.
The multi-drug therapy uses the antibiotics dapsone, rifampicin or clofazamine in varying regimes using one or all three drugs depending on the severity of the infection. Sometimes the drugs may have to be taken for years to ensure that there is no reinfection as of course the bacteria is both slow to multiply and the symptoms may not reappear for years.
Oral corticosteroids are used to help prevent nerve damage by reducing swelling and in some cases reconstruction surgery may be needed.
Unfortunately despite the fact that there is a cure, the biggest problem facing the worldwide health authorities, is getting the cure to the people who need it.
In Africa for example there is poverty, starvation, civil unrest, AIDS causing a severe stretching of resources and a lack of education about the disease. It is still considered by many to be a curse and that the sufferers need to be kept as outcasts from the rest of the community.
Hopefully one day there will be a complete eradication of the disease.
There is a wonderful book by Victoria Hislop called ‘The Island’ that I recommend to anyone who would like to dispel the myths surrounding Leprosy.
It is about an Island of a Crete fishing village which was the home for Lepers from all over Greece. Not only does it vividly depict the life of a leper but also the effect on the families.
Read the reviews and buy The Island: https://www.amazon.com/Island-Victoria-Hislop-ebook/dp/B002TXZRV8
You can find out more about Leprosy here: http://www.webmd.com/skin-problems-and-treatments/guide/leprosy-symptoms-treatments-history#1
I hope that you have found the post interesting and I look forward to your feedback. Thanks Sally