Disease Review: Leprosy

Leprosy is an infectious disease caused by bacteria that troubled the world throughout history. The disease has been around since ancient times often accompanied by negative stigmas and tales of leprosy patients being outcasts. Until now, people afflicted are being ostracized by their communities and even families. This is due to the lack of information about the disease.

Leprosy was once feared as a highly contagious and devastating illness but breakthroughs of different scientists showed that it is not really the case. The disease is curable and is not easily transmitted. People who got treated from leprosy might still suffer PTSD due to the experience of being shunned as outcasts.  

History of Leprosy

Leprosy is pretty much an old disease described in the ancient civilization’s literature. Some think that the disease may have originated 40,000 years ago in Africa when the human population densities were small. Some believed it originated on the Indian subcontinent. 

A skeleton dating back 4,000 years ago was found in India. It bears the earliest archaeological evidence of leprosy. The skeleton was found to have similar erosion patterns similar to those in skeletons of leprosy patients in Europe in the Middle Ages. It is the first evidence of the disease in prehistoric India. 

The earliest written account on leprosy was said to be in an Egyptian Papyrus document written around 1550 B.C. An illness describing leprosy appears in medical writings around 600 B.C. There is a Chinese medical work around 400 B.C. describing an illness that resembles leprosy. 

Leprosy was thought to have reached Europe through the armies of Alexander the Great. After they invaded India in the 4th-century B.C.E., they carried the disease from India into the Middle East and then throughout the eastern Mediterranean. 

From the 11th to 13th centuries CE, leprosy spread along trade routes in Europe. People with leprosy were segregated, feared, and ostracized. They were condemned to wander the roads wearing bells and signs to warn healthy people. Leprosy was referred to as “living death” and the patients were treated as if they already died. They believed that leprosy was a form of divine punishment. 

Discovery of the Cause and Treatment

It was in Norway in 1873 that Dr. Armauer Hansen recognized under a microscope the bacteria that causes leprosy. At that time, 2.5% of the population of Bergen, where he did his research, was affected by leprosy. Because of the discovery, it was proven that the disease is not hereditary, punishment, or a curse. Leprosy was later called Hansen’s disease. 

In 1854, an English doctor Frederic John Mouat reported the use of chaulmoogra oil in treating leprosy. In the 1920s, its oil derivatives were used as the primary medication but later abandoned because of the side effects and low recovery rate. 

In the 1940s, sulfones or DDS were introduced as a treatment for leprosy. The most effective medicinal form of DDS was dapsone which quickly replaced chaulmoogra oil as the primary treatment for leprosy. 

In the next following decades, several bactericidal drugs, such as rifampicin and clofazimine, were invented and were found to be very effective against leprosy. 

In the early 1980s, WHO issued the recommendation that all leprosy patients receive combination multidrug therapy. The methods were successful and became the standard of treatment.  

Transmission and Symptoms

Leprosy or Hansen’s disease is caused by the bacteria Mycobacterium leprae. These bacteria are rod-shaped organisms with rounded ends.

The route of transmission of leprosy between people is still not known. Prolonged close contact with someone with untreated leprosy over many months is needed to catch the disease. Scientists think it may happen when a person with leprosy coughs or sneezes then the bacteria enters the healthy human body through the lining of the nose. 

People cannot get infected from casual contact with an infected person such as shaking hands, hugging, and sitting together. It is also not passed from mother to her unborn child during pregnancy. It cannot be spread through sexual contact. 

The risk of getting leprosy is very low. More than 95% of people around the world have a natural immunity to leprosy. 

Leprosy primarily affects the skin, the peripheral nerves or nerves on the brain and spinal cord, and mucous membranes or the moist inner lining of the body organs such as nose, mouth, and lungs.

The main clinical symptoms are easily recognizable and it usually takes 3 to 5 years for symptoms to appear after being infected. But it can take up to 20 years for symptoms to appear. 

Symptoms include disfiguring skin sores, lumps, loss of eyebrows, thick or stiff dry skin, and nosebleeds. 

If left untreated, signs of advanced leprosy include paralysis and crippling of hands and feet, blindness, nose disfigurement, and numbness. Leprosy patients can also develop unusual blood clots that can lead to stroke

Because the clinical symptoms take long to manifest if you suspect you are infected then be diagnosed. The doctor will take samples of your skin or nerve to look for the bacteria under the microscope. A skin smear test could also be done. 

Curing Leprosy

Leprosy is a curable disease. In the last two decades, around 16 million people with leprosy have been cured. A combination of antibiotics, typically 2 or 3 antibiotics, are used at the same time. This is called multidrug therapy. 

Long term treatment of multidrug therapy is recommended. Treatment is around six months to one year. People with severe leprosy would need to take antibiotics longer. 

Nerve damage caused by leprosy can’t be treated with antibiotics. Anti-inflammatory drugs are used to control nerve pain. This may include steroids. 

Treatment will prevent the disease from getting worse but does not reverse the nerve damage and physical misconfiguration that happened before the diagnosis. So it is very important that the disease will be diagnosed as early as possible. 

It is beneficial to know to some extent facts on certain diseases to prevent mistreatment of patients. Leprosy patients should not be outcast instead we should help them fight the dreadful disease.