What is Leprosy?
Leprosy, also known as Hansen's disease or HD is caused by a bacterial infection. It is considered a granulamatous syndrome located in the peripheral nerves, upper respiratory tract and the mucosa. Untreated it can result in permanent damage to the limbs, nerves, skin and eyes.
Causes of Leprosy
Hansen's disease is caused by a bacteria called Mycobacterium lebrae and Mycobacterium lepromatosis. This bacteria is rod-shaped and aerobic and is surrounded by cell membrane that is considered waxy. It is impossible to culture and grow this bacteria in the lab because it lacks the genes needed to grow independently of the body. As a result, it was difficult at first to actually identify the bacteria as the cause of leprosy.
Medications for Leprosy
The treatment for the 12 month multibacillary type leprosy includes using the antibiotics Rifampicin, Dapsone DDS and Clofazimine(Lamprene). The six month regiment for the paucibacillary type of leprosy involves rifampicin and dapsone. Clofazimine has the advantage of also being anti-inflammatory. Other anti-inflammatory drugs that are used include Aspirin, Chloroquin and Prednisolone. Thalidomide can be used treat clients with sever symptoms as long as the patient cannot bear children.
An individual must be exposed to an HD patient for a lengthy period of time to actually catch the disease. Even then, only 5 % of individuals exposed actually become HD positive. To prevent catching Hansen's disease it is best to avoid contact with individuals while they are going through the contagious state of the disease. Infected individuals should remain in isolation until the contagious period has passed (usually three weeks after treatment has begun). Avoid travel to those areas of the world that are considered unsanitary and underdeveloped.
Risk Factors for Leprosy
Those who live in under developed areas with unsanitary conditions are more prone to Hansen's disease. This is also true of individuals who elect to travel to third world countries. In addition, patients who are immunosupressed such as those individuals with HIV are more susceptible to this disease. There has also been some recent genetic similarities found in those more likely to get HD.
Symptoms of HD
It can take 3 to 5 years after infection with the bacteria for leprosy symptoms to appear. The symptoms do vary based on the type of leprosy that has infected the host. In general skin lesions from light rashes to harsh ulcerations can occur. Because the bacteria attacks the peripheral nerves individuals can feel muscle weakness in the extremities, stiff and dry skin, swollen nerves usually visible around the knee or elbow and vision problems. Once again, depending on the type of leprosy the facial skin can thicken, the nose may collapse or feel stuffy and often bleed. The patient may suffer from laryngitis or swollen lymph glands. The testes can become so scarred they render the patient infertile. Men may also experience breast growth. Afflicted individuals may also suffer from amyloidosis and arthritis. It is not uncommon to lose toes or fingers.
Treatments of Hansen's Disease
In 1993 a study done by the World Health Organization put forward two preferred treatments. The first, a 24 month treatment is used on multibacillary leprosy. The second treatment lasts for 6 months and is to be used on paucibacillary leprosy. By using these treatments, individuals who have contacted HD are not infectious after maintaining the prescribed regiment for 30 days. Studies have shown that the original 24 month treatment can now be shortened to 12 months.
Types of Leprosy
There are several different types of HD and each has several names depending on the institution classifying the disease. Ridley Jopline, ICD-10, MeSH and the World Health Organization (WHO) all have different systems of classification but they do parallel each other.
- Paucibacillary (WHO) also know as TT or BT by Ridley-Jopling or A30.1 and A30.2 (ICD-10) and Tuberculoid(MeSH) damages peripheral nerves.
- Mutlibacillary (WHO) or BB (Ridley-Jopling), A30.3(ICD-10) or Borderline (MeSH) is the most common form characterized by numerous skin lesions that can cover one whole limb.
- Multibacillary(WHO), or BL and LL (Ridley-Jopling), A30.4 and A30.5(ICD-10) or Lepromatous (MeSH) manifests as symmetrical lesions and usually involves the mucosa of the nose.
- There are other types of HD including Tuberculoid, Borderline tuberculoid, borderline, borderline lepromatous, lepromatous, histoid leprosy and diffuse leprosy of Lucio and Latapi.
- The term Hansen's disease well commonly used to refer to leprosy is actually a manifestation of the disease without skin lesions. In this type of leprosy only the nerves are involved.