India has had a long-drawn battle with leprosy, which is, surprisingly, one of the least infectious diseases in the world. But the country’s association with leprosy goes back to 2000 BC where the first skeletal evidence of the disease was detected. For centuries, the disease has plagued and maimed sufferers in the subcontinent. They were ostracised by the society, quarantined and subjected to inhuman treatment, since leprosy or kushtaroga was believed to be a curse afflicted on those who sinned. Given the country’s long history with the disease, the government of India started the National Leprosy Control Programme (NELP) in 1955 and introduced Multi-Drug Therapy to cure the disease in the 1970s. The NELP operated with the World Bank Project in two phases, with the second phase ending in 2004. And as of December 2005, leprosy was considered “eliminated” with the prevalence rate of 0.95 cases in 10,000. But a few days before World Leprosy Day, WHO has revealed that disease in India may be far from eliminated. The country contributes to more than half the global cases every year.
WHO Regional Director for Southeast Asia Poonam Khatrepal Singh told IANS, “Leprosy-related discrimination, stigma and prejudice are the most powerful barriers to ending leprosy for good, especially given the disease is 100 per cent curable when detected early.” Types, Diagnosis, Treatment of Hansen's Disease.
She added that although leprosy causes severe deformities and disabilities, the percentage of patients with these symptoms is down to six percent, showing that the disease is being diagnosed earlier than ever. Khatrepal also assured that core public health interventions such as case finding, treatment regiments and surveillance have been improving.
What is Leprosy?
Leprosy is also known as Hansen’s disease, which is a chronic infectious disease caused by Mycobacterium leprae. The bacteria affects the skin, the peripheral nerves, mucosal surfaces, the eyes and the upper respiratory tract. The bacteria grow slowly, and it could take up to 20 years for the symptoms to show. The affected area on the skin becomes discoloured and impervious to pain or any sensation. Know More About the Diagnosis and How to Eradicate the Disease.
What Are The Symptoms of Leprosy?
Leprosy primarily affects the skin, nerves, mucous membranes, etc. Following are some of the symptoms according to the Center for Diseases Prevention and Control (CDC):
• Skin discolouration in patches
• Growth or lesions
• Thick, dry skin
• Painless ulcers on the soles of the feet
• Painless swellings on face or earlobes
• Loss of eyelashes and eyebrows
• Numbness on the skin
• Muscle weakness or paralysis
• Enlarged nerves
• Eye problems
• Stuffy noses
If left untreated, leprosy can lead to complications like:
• Painful or tender nerves
• Burning sensation on the skin
• Redness and pain in the affected area
The nerve damage in the hands and feet can result in irreversible deformity. In its advanced stages, leprosy can cause the “reabsorption” of the digits, causing loss of toes and fingers. Corneal ulcers caused by the disease can also lead to blindness.
What Causes Leprosy?
Science has not decoded the exact mechanism of the spread of leprosy. It is believed that the bacteria is spread through the air when someone with the infection coughs or sneezes.
Contrary to what people believe, leprosy is a very contagious disease, and it may take years for someone to contract it through touch. According to CDC, 95 percent of adults can fight off the bacteria that causes leprosy. It’s one of the least contagious diseases in the world. Shaking hands, hugging or sitting next to each other cannot spread the disease.
Who is At Risk?
Most people are protected against the disease since they have natural immunity against the bacteria. A person may be at a heightened risk of contracting the disease if they live in countries like Congo, Ethiopia, Madagascar, Mozambique, Nigeria, Tanzania, Bangladesh, India, Indonesia, Myanmar, Nepal, Philippines, Sri Lanka and Brazil where the disease is rampant.
How is Leprosy Treated?
Leprosy is treated with a combination of two to three antibiotics, called multidrug treatment. In the forties, the medicine dapsone became a breakthrough in the treatment of leprosy. But the treatment was often lifelong, which made sticking to the regimen difficult. When the bacteria began to gain resistance to dapsone, other medicines such as rifampicin and Clofazimine were introduced.
How to Prevent Leprosy
Most people have natural defences built into their immune system against the disease. And contrary to popular myths, leprosy is not highly contagious. It is also highly-curable if treatment is sought at the right time. Early diagnosis is key. Infants, especially those belonging to endemic countries, should be vaccinated with the BCG vaccine.