Leprosy

Introduction

Leprosy is an infectious bacterial disease caused by Mycobacterium leprae. It mainly affects the nerves, skin, eyes, and the upper respiratory tract. Another name for leprosy is Hansen’s disease. Gerhard Armauer Hansen discovered Mycobacterium leprae in 1873 and hence the name Hansen’s disease. If it is not treated on time it causes ulcers in the skin and can damage muscles and nerves that lead to physical disability in the affected individuals. Leprosy mainly occurs in tropical and subtropical climates.

Causes of Leprosy

Leprosy is an infectious bacterial disease caused by the Mycobacterium leprae. The bacterium is rod-shaped and proliferates at a slow rate. The incubation period of leprosy diseases is on an average of 5 years. Symptoms may occur at the earliest like in one year or it may take 20 years or more.

Types of Leprosy

Leprosy can be categorised based on symptoms and that are described below −

• Tuberculoid − This type of leprosy is less severe and has mild symptoms. The affected individuals have only a few lesions. As the nerves present below the affected skin become damaged, the particular area may become numb. It is less contagious in comparison to others.

• Lepromatous − It is a severe and more contagious Hansen’s disease. It is a condition of widespread skin bumps and rashes followed by numbness and weakness in the affected patient. This type can affect the kidneys, nose, and male reproductive organs in its severe form.

• Borderline − The individuals which are affected by this type have symptoms of both tuberculoid and lepromatous forms.

Leprosy can be categorised into five types based on Ridley-Jopling classification −

• Tuberculoid Hansen’s disease − Very few flat lesions are present and nerve involvement is less.

• Borderline tuberculoid Hansen’s disease− More lesions are present and nerve involvement is more.

• Mid borderline Hansen’s disease −Nerve involvement is more followed by inflammation in the lymph nodes, reddish plaque, and moderate numbness.

• Borderline lepromatous Hansen’s disease − Occurrence of many flat lesions, bumps, plaques, and nodules.

• Lepromatous Hansen’s disease −Occurrence of many lesions followed by severe nerve involvement, limb weakness, and disfigurement.

Apart from these two classifications, the World Health Organization has classified leprosy into the following two types −

• Paucibacillary − In this type, the bacterium is not detected in the skin samples and has few lesions.

• Multibacillary − In this type, the bacterium can be detected in the skin and have multiple lesions.

Apart from these types, intermediate leprosy is considered to be the very early form of leprosy. The affected individual has only one skin lesion that is slightly numb in nature.

Signs and Symptoms

The primary symptom of leprosy is skin lesions in addition to this it affects the nervous system. The common symptoms of leprosy are listed below −

• Lesions in the skin lead to reduced sensation.

• Weakness in the muscles.

• Numbness in arms, feet, hands, and legs.

The effect of leprosy in the nervous system are as follows −

• Leprosy damages the sensory nerves that are able to register pain. That results in hands and feet being vulnerable to injuries and burns that lead to loss of fingers, toes, hands, and feet.

• It can also damage the eyes which leads to loss of vision. Also, it causes glaucoma.

• As leprosy affects motor nerves it causes paralysis in the body parts. That includes dropped wrist and foot and clawed hand.

• Leprosy affects the ANS which leads to affected individuals' hair loss, dry and cracked skin, and very much vulnerable to secondary infections.

Diagnosis

Leprosy is a communicable disease. It is generally transmitted from one individual to another with the help of droplets from the mouth and nose and close and frequent contact with patients who are untreated. The untreated leprosy patient may suffer from permanent and progressive damage to their nerves, limbs, eyes, and skin. The diagnosis of leprosy is as follows −

• Physical examination of the affected areas.

• Biopsy test, in which small skin of the affected area is removed and sent to the laboratory for examination.

• Lepromin skin test, in which the health care professional would inject a small amount of the disease-causing bacteria.

Treatment

The first effective treatment against leprosy was the use of Dapsone medicine in the year 1940. The treatment with Dapsone lasted for a longer period of time. And then the Mycobacterium leprae started to develop resistance to Dapsone which was the only leprosy medicine at that time. The drugs rifampicin and clofazimine were discovered in the early 1960 and used in the treatment of leprosy.

The World Health Organisation recommended multidrug therapy for the treatment of leprosy in the year 1981. In the present-day, MDT is used for the treatment of leprosy which consists of medicines Dapsone, rifampicin, and clofazimine. With the discovery of MDT leprosy is curable. In addition to these antibiotics, minocycline and ofloxacin are also used in the treatment of leprosy. Sometimes anti-inflammatory medications like aspirin, prednisone, or thalidomide are also used in leprosy patients. The treatment will last for 6 months to 12 months. Leprosy can be prevented by giving BCG vaccines. The treatment for leprosy is free of cost worldwide.

Conclusion

Leprosy is a bacterial disease caused by Mycobacterium leprae. It mainly affects the nerves, the skin, the eyes, and the upper respiratory tract. It is generally transmitted from one individual to another with the help of droplets from the mouth and nose and close and frequent contact with patients who are untreated. The untreated leprosy patient may suffer from permanent and progressive damage to their nerves, limbs, eyes, and skin. The World Health Organization recommended multidrug therapy in the year 1981 for the treatment of leprosy.

FAQs

Q1. What are the organs present in the upper respiratory tract?

Ans. The nose, nasal cavity, mouth, pharynx, and larynx are parts of the respiratory tract. The mucous membrane lines the respiratory system.

Q2. How BCG is effective against leprosy?

Ans. The full form of BCG is Bacile Calmette-Guerin. Leprosy can be prevented by giving the vaccine that is used against tuberculosis (BCG). This is because the disease causing bacteria for tuberculosis and leprosy are closely related to each other.

Q3. What is tuberculosis?

Ans. It is a respiratory disease caused by the bacterium Mycobacterium tuberculosis. The individuals suffering from this have chest pain, weight loss, fever, and cough with blood.

Q4. What do you understand by ANS?

Ans. The autonomic nervous system (ANS) controls and regulates the involuntary function of the internal organs. This function is done without a person's conscious effort. The ANS is segregated into sympathetic and parasympathetic systems.

Q.5. What is paralysis?

Ans. In paralysis, parts of the body fail to do any muscular movements. The main causes of paralysis are stroke, injury to spinal cord, and nervous system disorder. Paralysis can be partial or complete.