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Leprosy is a mildly infectious disease caused by a bacillus called Mycobacterium leprae (a relative of TB). It is most common in places of poverty – overcrowding and poor nutrition mean people’s immune systems are not strong and they are less able to fight the disease.
The first signs of leprosy are patches of skin which look paler than normal or sometimes nodules on the skin. It can be difficult to diagnose and sometimes people are misdiagnosed.
If leprosy is not treated it will attack the nerves that supply feeling to the hands, feet, eyes and parts of the face. This means that when people injure themselves they do not feel pain so don’t notice their injury. Untreated leprosy can also cause muscle weakness and paralysis.
Scientists are not 100% sure how leprosy is passed on, and research is ongoing. Most scientists believe that leprosy is caught through droplets of moisture passing through the air from someone who has untreated leprosy. Symptoms can be slow to appear and it may be five or ten years before the disease appears after initial exposure. There is a higher likelihood of transmission where people have close and ongoing contact – for example, living in the same house. Leprosy is also more prevalent where overall nutrition and hygiene is lower. However, around 95% of the world’s population are naturally immune to leprosy.
Multi-drug therapy (MDT), the WHO recommended treatment for leprosy, emerged in the early 1980s and is highly effective and freely available. This combination of antibiotics includes rifampicin, dapsone and clofazamine and is currently made available free of charge by Novartis through the World Health Organization. Within two days of a patient starting MDT treatment there is no risk of the disease spreading to anyone else. These drugs need to be taken every day for either six or twelve months.
There have been amazing medical breakthroughs that enable us to help people who have been disabled due to leprosy in a variety of ways. A clawed hand or foot-drop can often be restored with surgery and physiotherapy, though they can’t restore feeling. Surgery can also restore eyelid muscles so a person can blink again. To protect insensate feet and hands, people are encouraged to look after themselves by soaking their feet regularly, oiling their skin to make it softer and checking daily for any wounds. By following these self-care exercises, injury and further disability can be avoided. Customised mobility aids and special protective shoes are also available for people that need them.