Leprosy, also known as Hansen’s disease, is a disease that is caused by a bacteria known as Mycobacterium leprae. This disease is often a chronic and progressive disease that affects the nerves that supply the hands and legs, the lining of the nose, the skin, as well as the parts of the body system, which is often referred to as the upper respiratory tract.
The upper respiratory tract is made up of the nose, the nasal cavity, the mouth, the larynx(often referred to as the voice box), and the pharynx. Leprosy causes sores on the skin, damages to the nerves, as well as resultant muscle weakness and sometimes, atrophy of the underlying muscles.
Leprosy can also cause severe body disfigurement as well as significant muscle disabilities. Leprosy is one of the oldest diseases that has been seen to plague man. This disease was first recorded in ancient times around 600BC; however, some records show that Leprosy may have been affecting men even before this time.
Leprosy is a common disease in the world, and it is particularly prevalent in countries found within the tropical and subtropical regions. According to the American Centre for Disease Control, about 150 to 250 cases of people who are inflicted with Leprosy are recorded each year in the United States.
Little or no knowledge made people consider most victims who suffer Leprosy in the olden days to be outcasts and forbidden. In the ancient days, China, Egypt, as well as India feared that Leprosy was a contagious disease that is incurable and disfiguring.
However, this school of thought can be considered as a false one as Leprosy isn’t so contagious to everyone. The only way one can develop the infection is if you are a close member of the family, and you have been exposed repeatedly to the disease.
According to the World Health Organisation(W.H.O), about 180,000 people are infected with Leprosy worldwide. However, the countries with the largest population of people suffering from Leprosy can be found the majority in Africa and Asia.
Causes of Leprosy
Leprosy is caused by a bacteria named Mycobacterium leprae, which is a slow-growing bacteria. This disease was caused by a scientist named Hansen. He discovered this bacteria in 1873, and eventually, this disease was named after him.
Types of Leprosy
There are three different classes doctors use in classifying Leprosy. They include:
1. The tuberculoid/lepromatous/borderline classification
This classification divides Leprosy into three different types, and this classification is based on the body’s immune response to the disease.
- If a person has Tuberculoid Leprosy, the person’s immune system is still functional and useful. A person who has tuberculoid Leprosy has only mild symptoms, with only a dew sores or lesions appearing on the skin. Also, a person who has this kind of Leprosy is considered to be less or mildly contagious.
- A person who has Lepromatous Leprosy, on the other hand, is considered to have a very weak and dysfunctional immune system. A person who has this kind of Leprosy will experience skin lesions, a damaged nervous system, as well as the infection of other organs.
There will be the presence of nodules(which are large bumps and lumps) on the skin as well as sores. Once a person has lepromatous Leprosy, he or she is extremely contagious.
- Borderline Leprosy
Borderline Leprosy is said to occur when a person has symptoms of both Tuberculoid Leprosy and Lepromatous Leprosy. This kind of Leprosy is not as severe as Lepromatous Leprosy, but it is worse than tuberculoid Leprosy; hence the patient is considered to be in between the two types of Leprosy under this classification.
2. The World Health Organisation (W.H.O) classification
The World Health Organisation classifies Leprosy based on the number of places affected on the body as well as the type of areas affected. Based on this classification, Leprosy is divided into two types, namely:
Paucibacillary Leprosy
There are less than five lesions that are seen on the skin, and on the skin, samples collected, there is no bacterium detected.
Multibacillary Leprosy
In this kind of Leprosy, there are more than five lesions or sores that can be seen on the skin. Also, bacteria are often detected on the collected skin samples or the skin smear or both.
3. The Ridley-Jopling Classification
This classification is often used in the clinical studies of Leprosy. This classification depends on the signs and symptoms experienced by the patient as well as the system response of the disease. There are five types of Leprosy based on this classification, and they are:
Tuberculoid Leprosy
Its symptoms include some flat and a few numb lesions, as well as the probable damage of some nerves. However, tuberculoid Leprosy has the ability to heal on its own. Sometimes, the disease may persist or progress to a more severe type of Leprosy.
Borderline Tuberculoid Leprosy
This type is similar to the tuberculoid Leprosy. However, a patient who suffers from borderline tuberculoid Leprosy will experience more body lesions like that which is seen in tuberculoid Leprosy, and more nerves are also affected.
The response of the disease involves the tendency for the condition to revert to being tuberculoid Leprosy, it may persist in the same way, or it may also progress to a more severe type of Leprosy.
Mid-borderline Tuberculoid Leprosy
In this type of Leprosy, the patient will experience plaques that are reddish or brownish, numbness in moderate forms, and severely swollen lymph nodes. In this form of Leprosy, more nerves are affected, and the patient will experience some kind of muscle weakness.
This form has the tendency to regress, relapse, persist, or even progress to more persistent types depending on the extent of damage and infestation.
Borderline Lepromatous Leprosy
A patient who has borderline Lepromatous Leprosy will experience several lesions that may be flat or raised. These lesions may come in the form of plaques, nodules, or bumps, and the patient will continue to experience numbness in his or her hands and feet.
The response of this disease may be to resolve itself, persist or progress to Lepromatous Leprosy proper.
Lepromatous Leprosy (Proper)
This Leprosy is considered to be the worst form of Leprosy there is. A person who has this Leprosy will experience several skin lesions that are filled with bacteria and hair loss. In this form of Leprosy, several nerves are affected, and the peripheral nerves become thickened.
Also, the patient will experience severe muscle weakness as well as body disfigurement. This form of Leprosy doesn’t regress.
Another form of Leprosy that isn’t included in the Ridley-Jopling classification is Intermediate Leprosy. Mostly, this type is considered to be the early manifestations of Leprosy in which the patient may have only one skin lesion that feels numb to touch.
This form of Leprosy may, in most cases, regress; however, it also has the tendency to progress to any of the other five types of Leprosy that are listed in the Ridley-Jopling classifications.
Symptoms of Leprosy
Generally, Leprosy mostly affects the skin as well as the nerves that are found outside the Central Nervous System (brain and the spinal cord). These nerves are collectively known as the Peripheral Nervous system.
Asides the nerves, Leprosy also tends to affect the eyes, the lining of the nose, and sometimes the eyes.
The primary symptoms a person who is suffering from Leprosy will experience include:
- Severe muscle weakness
- Numbness that mostly occurs in the hands, legs, arms, and feet.
- Skin lesions which may be small, numerous, flat, or slightly raised. Because of the wounds that are found on the skin, the person will have a decreased feeling to pain, touch, or sensation. These lesions often don’t heal even after several weeks. The injuries are usually lighter than the skin, and when they get inflamed, they become reddened.
- Loss of feeling in both the legs and arms.
Once a person comes in contact with the bacteria that causes Leprosy, it takes about three to five years for symptoms to begin to show. In some cases, the symptoms often don’t manifest until twenty years later.
The time taken for the symptoms to manifest after the person has come in contact initially with the bacteria is known as the incubation period. Due to the fact that Leprosy has a long incubation period, doctors often find it difficult to determine when the person got infected.
Treatment
Due to the severity of the disease, in 1995, the World Health Organisation developed multidrug therapy to treat all forms of Leprosy, and it is available for free worldwide. Also, there are several antibiotics that are used to treat Leprosy.
These antibiotics help in killing the bacteria that cause the disease and, as such, treating the disease.
These antibiotics include:
- Aczone (also known as dapsone)
- Rifadin (also known as rifampin)
- Clofazimine (also called as Lamprene)
- Minocin (also known as Minocycline)
- Ocuflux (also known as ofloxacin)
All these drugs are effective; however, one or more of these antibiotics may be prescribed by your doctor to help treat this disease.
Sometimes, anti-inflammatory medication such as prednisone or aspirin may be prescribed, and these treatments can last for more months or years depending on how severe the inflammation is as well as the body’s response to the drugs.
Complications
If this disease is not treated on time or appropriately, it may lead to several complications, such as:
- Body disfigurement
- Severe hair loss which is especially seen on the eyebrows as well as the eyelashes.
- Severe muscle weakness
- Permanent damages in the nerves of both the arms and the legs.
- Inability to use one’s limbs
- Chronic nasal blockage, severe nose bleeds, as well as a collapse of the nasal septum
- Inflammation of the iris of the eye which is medically known as iritis
- Glaucoma which is an eye disease that is characterized by the damage of the optic nerve.
- Total blindness
- Infertility
- Erectile dysfunction
- Failure of either one or both kidneys.
To prevent Leprosy, one must avoid any long-term contact with someone who has an already untreated infection. If you are a family member, it is better to take drugs and supplements that will help strengthen your immune system.
References;
- Leprosy; Webmd
- What is Leprosy?; Healthline
