Leprosy is a chronic, mildly infectious disease caused by a slow growing bacillus, Mycobacterium leprae.
Since the introduction of an effective cure for leprosy using multidrug therapy in 1982, over 16 million patients have been cured and new cases detected reduced in number. This means that today, the disease can be mistakenly viewed as a minor health problem, leading to reduced political commitment, lower priority and reduced resources to deal with it and its resulting disabilities effectively.
We believe that the number of cases is under-reported and active case finding has stopped in many countries so several million new cases may be undetected, especially among women and children. In addition, delays in detection are leading to avoidable disability. Research has been underfunded; it does not attract health professionals and skills are disappearing.
Several million people have completed treatment but need treatment reaction management and self-care education if disabilities are to be prevented and effective rehabilitation achieved. Leprosy remains endemic so early detection is key.Children, women and men affected by leprosy are discriminated against and too often stigmatised, their rights ignored.
The provision of directly delivered services by ILEP Members fills the underfunding gap left by many governments who have no future plans for tackling leprosy and its related issues.
What is leprosy?
Leprosy affects the skin and nerves of infected individuals. Numb patches on the skin are usually the first sign of the disease. They are painless and do not itch, so are often ignored by the patient.
As the disease progresses it can lead to nerve damage and other complications. Numbness and lack of feelings in the limbs, especially the hands and feet, can lead to injury and wounds that become infected. Changes to the skin leave the patient susceptible to ulcers, which, if also left untreated, can cause further damage, wounds and visible disfigurements such as collapsed noses or shortened limbs. Blindness can also occur. In turn this can lead to stigma towards those affected and their families, causing them to be shunned and even excluded from everyday life.
Is there any cure?
Fortunately, leprosy is curable and can be treated with a course of multidrug therapy (MDT) that is antibiotic based and can quickly kill the bacteria that cause leprosy.
If treatment starts at an early stage, most patients won’t suffer the terrible complications and disabilities that used to be common. Nerve damage does still occur in some patients and in some cases it can be reversed with other medical treatments.
When nerve damage cannot be reversed and the person remains with some disability, there are many different strategies of rehabilitation to help them live as rewarding a life as possible.
How is leprosy transmitted?
It is transmitted by droplets from the nose and mouth during close and frequent contact with untreated patients. As such it is thought that leprosy is spread like the common cold, but is much less infectious.
In a study of new cases being put on treatment in the United Kingdom, it was found that all people affected had lived abroad in a country with leprosy for at least eight years.
Wasn’t leprosy common in Europe at one time?
Evidence of leprosy has been found in skeletons from the ancient Near East and it became a common disease in Europe in medieval times. The last case of indigenous leprosy in the UK was diagnosed in 1798. The disease died out in most of Europe for reasons that are not clear, more than 200 years ago, although there were significant numbers of new cases in Norway until the early years of the 20th century. People affected by leprosy from Crete and the rest of Greece were quarantined on the Greek island of Spinalonga until as recently as 1957.
The severe stigma attached to leprosy usually meant that people affected were driven into segregated settlements know as “leper colonies.” In more recent times, however, most such settlements have either been closed or developed into supportive communities.
Where does leprosy occur today?
Leprosy is a disease of poverty and remains endemic in poorer parts of the world. At the end of 2015, there were 210,758 new cases of leprosy reported worldwide.
The majority, i.e. 81%, of all new cases occur in three countries; India, Brazil and Indonesia – which are the most highly endemic countries for leprosy.
In considering the impact of leprosy it is not only the numbers of new cases being detected and treated that has to be taken into account. Many of those cured of the disease will have to live with the consequences of leprosy. It is estimated that probably at least three million people are living with some permanent disability due to leprosy, although the exact figure is unknown.