Leprosy in Our Time – Medical and Social Challenges
TOWARD HUMAN SECURITY
A: Leprosy is a disease caused by a rod-shaped bacillus called Mycobacterium leprae, or M. leprae for short. It affects mainly the skin and the nerves.
A: Leprosy is thought to be transmitted through the air via droplets from the nose and mouth during close and frequent contact with untreated infectious individuals.
A: On the contrary, leprosy is sometimes called the least infectious of infectious diseases. More than 85% of cases of leprosy are non-infectious and do not spread the disease. Over 99% of people have a natural immunity or resistance to leprosy.
A: Yes. Leprosy is cured by multidrug therapy (MDT), a highly effective treatment that became available in the early 1980s. MDT is a combination of three drugs—dapsone, clofazimine, and rifampicin—administered over a 6- to 12-month period. The first dose of MDT kills 99.9% of the microorganisms in the body that cause leprosy.
A: The first sign of leprosy is usually the appearance of patches on the skin. These patches are accompanied by a loss of sensation in the areas affected.
A: Leprosy can be diagnosed and treated at the nearest health center or health post as leprosy services are being integrated into the general health services in every country.
A: Treatment costs nothing. Since 1995, the WHO has supplied MDT free to all patients in the world, initially with funding provided by The Nippon Foundation, and subsequently through MDT donated by Novartis and the Novartis Foundation for Sustainable Development.
A: Currently, less than 250,000 new cases of leprosy are diagnosed each year. Since the introduction of MDT in the early 1980s, some 16 million people around the world have been cured of the disease. Today, leprosy remains a public health problem in only one country.1 However, many countries continue to see new cases of the disease.
A: If untreated, leprosy causes nerve damage and other complications. Patients lose feeling in their hands and feet, and muscles become paralyzed because the nerves supplying them have been impaired. As a result, people with the disease are susceptible to injuries that can result in festering wounds or ulcers. These are secondary infections due to other organisms and are not caused by the leprosy germ.
A: Leprosy can be cured at any stage. To be cured of leprosy means to have no leprosy-causing bacteria remaining in the body. However, if leprosy is detected and treated only after permanent nerve damage has occurred, there will be residual disability and disfigurement. Disability is preventable with timely diagnosis and prompt treatment. Corrective surgery is also an option in some cases. Residual disability and disfigurement are not a source of leprosy infection.
A: No, but research is under way to find one.
A: No. Today, there is no medical or social justification for isolating people with leprosy. People can continue their normal way of life while receiving treatment. Any attempt to isolate persons affected by leprosy stigmatizes them and reinforces age-old prejudices about the disease.
A: Hansen’s disease is another name for leprosy. It is so called after Dr. G. H Armauer Hansen, the Norwegian doctor who discovered the M. leprae bacillus in 1873. In a number of countries, including Brazil, Japan and the United States, the term ‘Hansen’s disease’ is used instead of leprosy, because of the latter’s association with the derogatory term ‘leper’.
A: Leprosy has a long incubation period of between 5 and 20 years. New cases will continue to be diagnosed but in time the number of new cases should decline.
A: Recognize that leprosy is curable, treatment is free and that stigmatizing people with the disease is wrong—and pass on these messages to as many people as possible.
A: For a start, reject the use of derogatory terms such as ‘leper’ and its equivalent in other languages: a person should not be defined by his or her disease. Next, acknowledge that persons affected by leprosy, those cured of the disease and their families are full members of society. Finally, keep in mind these words: “Every person is born free and equal in dignity and rights.” (Universal Declaration of Human Rights, 1948)