Last week, we introduced ourselves to the current rampaging effects of leprosy, a disease we thought had become obsolescence. We mentioned that according to the latest research by World Health Organization(WHO), new cases(2,892) of leprosy, almost of epidemic proportions have been identified in 15 States and still counting.
Yes, leprosy has been in the news lately – but is it coming back? Or has the disease always been around and people just didn’t talk about it? That was what Prof Isaac Adewale the Minister of Health was trying to explain on January 29, 2017.
How do we explain leprosy?
According to Live-Science magazine, chances are the mention of leprosy brings to the mind, skin falling off from the bones, stump and stunted fingers and toes, and people cast away into quarantined leper colonies. Example Lagos and Uzuakoli leper colonies etc. These colonies were built by our colonial masters to prevent outbreaks and spread of leprosy to other labourers. While these colonies might have been useful in the past, now modern technology and treatment of leprosy has gone so digital, that it takes as little as four months to achieve a cure, instead of the former nine months to three years.
What is leprosy?
- Leprosy is a contagious, chronic disease, caused by Mycobacterium leprae, a rod shaped bacterium. The disease is also called Hansen’s disease, after a Norwegian doctor – Armauer Hansen. Hansen was the first to discover the bacterium that causes leprosy and published a paper on it in 1873.
- Leprosy affects not just the skin, but also the peripheral nerves, mucosa of the upper respiratory tract and the eyes. There are two common forms of leprosy. a) Tuberculoid leprosy and b) Lepromatous leprosy. Lepromatous is more severe and causes large lumps and bumps on the body
- Though it is contagious, Hansen’s disease isn’t highly infectious, especially if treatment is commenced early.
How do we contract leprosy?
- a) Leprosy disease is transmitted through droplets expelled by sneezes and coughs
- b) By coming in contact with nasal fluids on surfaces. Just touching someone with the disease, usually doesn’t cause infection as previously thought.
- c) Normally – a person’s immune system can prevent leprosy infection, but if for one reason or the other, one becomes immuno-compromised then leprosy infection will take hold. Children are more at risk for contracting leprosy than adults – according to the USA National Library of Medicine (NLM).
- d) Although leprosy was declared eliminated in United States in 2000, and some European countries in 2005, said Dr Paul Suderson the Medical Director of American Leprosy Mission it is beginning to surreptitiously creep back. However in 14 Countries of the World, Nigeria inclusive, leprosy is still highly endemic, and heading towards epidemic proportions. We still have pockets of leprosy which are highly endemic, and new infections still occur in about 100 Countries.
What are the symptoms of leprosy?
¤ The bacterium that causes leprosy grows very slowly, and can take two to 10 years before signs and symptoms appear. These symptoms include;
1) Growths in the skin – making it thick and folded.
2) Numbness or lack of feeling in the hands, arms, feet and leg.
3) Enlarged nerves especially around the elbow and knee.
4) Nosebleeds and or stuffy nose.
5) Lesions on the body that are not sensitive to touch, heat or pain. Remember our first patient who couldn’t differentiate hot and warm water in part one.
6) Skin lesion that are lighter than the person’s normal skin.
7) Lesions that do not heal after several weeks or months.
8) Ulcers on the soles of the feet.
9) Thick, stiff and dry skin.
10) Severe and generalized pain at onset of nerve attack, which later become numb.
11) Muscle weakness or paralysis, especially in the hands and feet, leading to abrasion and shortness of fingers and toes.
12) Eye problems that may lead to extrusion, bulging and blindness.
How do we diagnose leprosy?
- Early detection and treatment of leprosy is key. If it is caught and treated quickly enough, the disease is usually not debilitating.
- Diagnosis is by nerve biopsy or skin smear – the skin is firmly pinched to produce ischaemia, and a cut 3mm deep is made with a scalpel. Tissue and fluid are scrapped on to a slide, for Ziehl-Neelsen staining.
Treatment of leprosy.
¤ Surgery and physiotherapy may be needed, as well as chemotherapy.
¤ Chemotherapy include combination therapy with rifampicin, dapsone, fluoroquinolones, clofazimine, macrolides and minocycline.
¤ More than 16 million leprosy patients have been treated with multi-drug-therapy(MDT), over the past 20 years, and were all cured in 6 to 9 months.
What is our take this week?
If I must, let me raise the alarm, leprosy is gradually re surging, and the Minister of Health Prof Isaac Adewale has been shouting from the rooftops since January for us to take every precaution. We should err on the side of caution for our lives’ sake. If you notice any of the 12 symptoms I just enumerated above, in any of your house holds, please rush to your nearest leprosy centre. Treatment is absolutely free. Be medically guided.
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