World Leprosy Day Brings International Focus To Ancient Disease

If you thought leprosy was a thing of the past, you’d be wrong.

More than 200,000 cases are diagnosed globally each year, according to the World Health Organisation’s 2015 update. That’s a lot but, fortunately, the numbers of new patients being diagnosed is decreasing every year, thanks to early intervention and successful multi-drug treatment.

Even so, there are currently 3 million people living with irreversible disabilities, including blindness, as a result of the late treatment of leprosy.

What is leprosy?

Leprosy is a mildly infectious disease caused by a tiny rod-like bacteria called Mycobacterium leprae – a relative of the tuberculosis bacteria.

Leprosy is also called Hansen’s Disease, after Armauer Hansen, the Norwegian who discovered the bacterium that cause this disease in 1873 in Norway. In fact, leprosy was the very first bacterium that causes a human disease to be discovered.

Leprosy is a disease of poverty in countries where fresh water is scarce and sanitation is poor or non-existent. The combination of dirty water, bad nutrition, and poor standards of living mean people’s immune systems are not strong and they are unable to ward off this infectious disease.

What are the symptoms of leprosy?

Leprosy starts with pale-coloured skin sores, lumps or bumps that don’t go away. It damages the small nerves on the skin’s surface, resulting in a loss of sensation in the hands, arms, legs, and feet. Sometimes the only signal may be numbness in one finger.

Without the ability to feel pain, everyday activities are fraught with danger. Unnoticed burns and ulcers can lead to permanent disability. Due to the inability to detect grit in the eye, blindness is a common consequence of leprosy.

Less than one-third of all patients go on to develop a deformity or lose a body part. The main cause of deformity in leprosy patients is nerve damage. This occurs because the leprosy bacteria have a peculiar liking for nerve tissue, and multiply freely between nerve fibers. When the bacteria die or are killed by medication, the resulting inflammation compresses and destroys these delicate fibers with more or less complete loss of function. So feeling is lost and muscles paralysed, thus paving the way for ulceration, damage through injury, and eventually the deformity or loss of a body part.

How does leprosy spread?

Leprosy is not hereditary, and it cannot be caught by touch. Scientists believe it is contracted through droplets of moisture passed through the air from someone who has leprosy but has not yet started treatment. A usual scenario would be when the infected person sneezes or coughs.

It takes years, however, of living in close proximity with an untreated leprosy patient to catch the disease.

Thankfully, around 95% of the world’s population are thought to be naturally immune to leprosy.

Is leprosy curable?

Yes, it is easily cured with multidrug therapy (MDT) – a combination of three drugs taken daily for 6 to 12 months, including simple antibiotics. MDT is available free of charge.

The sooner a person with leprosy is treated, the better, as they are less likely to suffer from irreversible disabilities as a result. While reconstructive surgery can correct a clawed hand, a ‘dropped’ foot, or restore the blinking mechanism to the eyes, it cannot bring feeling back to areas where there has been nerve damage.

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Which countries are affected by leprosy?

The countries with the highest number of new diagnoses are India, Brazil, and Indonesia, followed by some of the African nations. In 2015 there were 14 countries reporting more than 1,000 new cases of leprosy:

  1. Bangladesh
  2. Brazil
  3. DR Congo
  4. Ethiopia
  5. India
  6. Indonesia
  7. Madagascar
  8. Mozambique
  9. Myanmar
  10. Nepal
  11. Nigeria
  12. Philippines
  13. Sri Lanka
  14. Tanzania

More than half of all new cases of leprosy are diagnosed in India, which remains home to a third of the world’s poor. The WHO update for October 2016 for leprosy in India announced a massive leprosy detection campaign had screened 320 million people in the most hidden slums, finding and treating thousands of previously undiagnosed cases.

New cases of leprosy are resurfacing within some communities living in extreme poverty, such as pockets of Papua New Guinea.

Contrary to assumptions that the disease is extinct in the West, the National Notifiable Diseases Surveillance System records show 15 cases of leprosy in Australia in the 2016 year to date, compared to 9 cases in 2014.

Recent data from the Department of Health reveals there were 185 recorded cases in Australia over the past decade.

NSW Health Director of Communicable Diseases, Dr Vicky Sheppeard, said none of the cases in 2015 were locally acquired.

“It’s either been immigrants or Australians who’ve spent lengthy time in those parts of the world where there still is leprosy quite common,” she said.

History of leprosy around the world

In the 1980s, WHO estimates there were 5.4 million cases, which has been drastically reduced to compared to 388,000 existing and new cases at the end of 2015.

Leprosy has afflicted humans for a long, long time. It existed in ancient China, India and Egypt as far back as 6000 BC. It was probably brought back to Europe by Alexander the Great, around the 4th Century BC.

There is evidence of leprosy in Great Britain and France back to at least 500 AD. From Great Britain it is thought to have been spread to Scandinavia by the Vikings. The incidence of leprosy in Europe peaked in the 14th century. It was brought to the New World by explorers in the 16th century.

Leprosy was later introduced to Australia and the Pacific Islands and were regularly recorded from the 1800s onwards. In fact, between 1920 and 1929 on Nauru, 35 % of the entire population was infected with leprosy.

Why does leprosy get such a bad rap?

The disease was highly feared in ancient times, predominantly because of misunderstanding. The stigmatisation of sufferers and their families was appalling. Many people believed it a punishment or a curse for some alleged misdeed.

This stigma fuelled a vicious cycle that began with affected sufferers hiding their first suspect skin patches, in order to avoid being shunned by their families and becoming a social outcast, which in turn meant it went untreated for longer and was able to infect more people. The age-old stigma surrounding leprosy saw entire families robbed of their job opportunities, education, marriage prospects and their dreams shattered.

Even in Australia, the stigma meant that lepers were banished to specially set-up leper colonies, where the poor sufferers were forced to spend many years isolated from family and friends. The colonies were usually islands, such as Fantome Island (Eumilli Island) off the coast of Townsville.

The leprosy stigma still exists in many countries where the people are largely not educated. That’s why when Mother Teresa began serving the lepers of India in 1957, she focussed on fixed and mobile centres where lepers could come to receive treatment and rehabilitation. That way, people with leprosy could continue to work to provide for their families, retaining their dignity and worth as a member of society.

And it’s why today, the Leprosy Mission International works so hard to provide healthcare, rehabilitation, education, and vocational training to tens of thousands of people each year. The idea is to give renewed hope by breaking down stigma and empowering people affected by leprosy to stand up for their rights.

World Leprosy Day: How to get involved

World Leprosy Day is observed every year on the last Sunday of January. It was chosen in 1954 by French philanthropist and writer, Raoul Follereau, to commemorate the death of famous Indian nationalist leader, peace activist and celebrated global icon, Mahatma Gandhi.

ghandi “Eliminating leprosy is the only work I have not been able to complete in my lifetime.” (Gandhi)

Through World Leprosy Day, awareness of this ongoing disease adds to the hope that we can finish the work that Gandhi could not.

Although World Leprosy Day is not yet recognised by the United Nations, there are many charities globally that focus on the prevention, treatment, and cure of this ancient disease. Churches of all denominations are often involved in World Leprosy Day and, of course, you are always welcome to organise your own fund raising event through your workplace, school, or community club. To get involved through Leprosy Mission Australia, visit their website: http://www.leprosymission.org.au/TLM/Worldleprosyday

Leprosy Myths Debunked

People with leprosy should be segregated

Definitely not! They used to be, in the “old days” when nothing was known about the disease.

The fact is most patients are not highly contagious, and with the new drugs, all patients are rendered non-infectious within 48 hours.

Patients are now being diagnosed and treated in the community, while continuing their life and work. They are not admitted to hospital unless there is a complication of their illness or treatment.

Leprosy makes your arms, nose or head fall off

In short: no it doesn’t. Leprosy attacks the nerves in the cooler parts of the body, particularly those that relate to the hands, feet and face.

The result is a loss of sensation in these areas meaning a person is at much greater risk of injury as they cannot feel pain. A stone in a shoe may go unnoticed, or a burn while cooking may result in injury and infection that is sometimes severe enough to cause the bone to ‘shorten’. The feet of a leprosy-affected person are prone to ulcers and, if not treated properly, can lead to amputation.

Leprosy is a curse from a previous life

It certainly is not a punishment or curse for some perceived misdeed, whether in this life or a past one. Leprosy is simply a mildly infectious disease that can be easily cured.

Leprosy runs in the family

Another falsehood from ancient times. Leprosy is definitely not inherited. It’s an airborne disease that most people are actually immune to.

Leprosy causes deformities

Not in all cases. Less than one third of all patients develop a deformity due to nerve damage.

Clawing of the hands and toes is a common disability, but modern-day reconstructive surgery is working wonders with these conditions. The results can see a leprosy-affected person walk again without dragging their foot on the ground or use their hand to grip items.

For more information, go to: http://www.leprosymission.org.au/

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