What Is Leprosy?
Leprosy is a chronic infectious disease that occurs as a result of an infection with Mycobacterium leprae. The disease develops over a long period of time causing skin and nerve damage. Its form of transmission is through the contact of human beings, although it may be transferred by other species such as nine-banded monkeys, chimpanzees and mangabey monkeys. Leprosy is also referred to as granulomatous disease and it is similar to tuberculosis because it damages the skin and peripheral nerves (Thompson et al., 2009).
Research has shown that leprosy exists since 4000BC and it was first recognized in Egypt, Ancient China, and India. People considered it a curse because it runs family, and they also considered it as a genetic problem. Due to this belief, it was left to be cured by spiritual leaders. Dr. Hansen found bacteria in leprosy lesions, concluding that it is a communicable disease and not genetic (CDC, 2009).
General Characteristics of Leprosy
Mycobacterium leprae is a rod-shape bacillus bacterium that can only grow in the cells and it is therefore referred to as an obligate intracellular bacterium. It is also an acid-fast bacterium because it contains acid in its endothelial cells. When it is placed for microscopic study, it stains red on a blue background (Thompson et al., 2009). The Mycobacterium leprae multiplies slowly in the cells and it requires the low temperature to grow which is between 80.9F to 86F. Due to this, it grows in cooler parts of the bodies such as feet (Gould, 2005).
It causes sensory and motor loss leading to nerve damage. The Mycobacterium is also known to infect Schwann cells. Mycobacterium leprae is biologically related to Mycobacterium tuberculosis. Leprosy generates antibodies inside the human cell walls. A new species of Mycobacterium that is Mycobacterium lepromatosis that causes lepromatous leprosies was discovered among people in the Caribbean Islands and Mexico (Gould, 2005).
Symptoms of Leprosy
Due to the long period of time leprosy reproduces inside the cells; the symptoms and signs occur gradually and slightly. The first symptom a patient experiences is a loss of sensory; the patient loses temperature perception, pain, tactile and pressure senses as the disease progress. Signs include skin lesions characterized by flat and whitish skin, painless ulcers, clawed hands, eye damage which is characterized by eye dryness and reduced blinking.
As the disease progress, signs such as large ulcerations, facial disfigurement, and drop foot are evident. The disease spreads constantly to other body parts such as hands, feet, knees, and face (Gould, 2005). Though leprosy has been associated with sensory loss, studies have shown that patients treated with WHO multi-drug regimen report to have pain and seek relief. This is because there is tissue inflammation in leprosy which occurs during episodes of immune activation.
Forms of Leprosy
Leprosy is classified in different forms which are determined by the individual’s ability to resist Mycobacterium leprae. Tuberculoid form of leprosy affects people whose body is able to resist the bacterium properly, and it is characterized by partial skin damage. People with reduced immunity develop a lepromatous form of leprosy, which is characterized by a wide range of skin damage. However other people may develop the two forms of leprosy. Leprosy is classified into two forms by the World Health Organization depending on the number of skin lesions (Thompson et al., 2009).
WHO classifications are widely used, and they are paucibacillary and multibacillary leprosy. Paucibacillary leprosy is characterized by the severity of skin damage with the absence of Mycobacterium leprae on a skin smear, while Multibacillary leprosy is characterized by severity of skin damage with the presence of the bacterium in a skin smear. The World Health Organization then classifies these forms depending on the number of skin lesions for the purposes of treatment (Thompson et al., 2009).
Leprosy is mostly diagnosed through clinical findings because it is mostly detected in remote areas with no laboratory equipment. Signs and symptoms are considered when conducting a clinical diagnosis that is damaged skin and nerves (CDC, 2009). Laboratory tests which include skin smears are also used. If the bacteria are present, it is concluded to be multibacillary leprosy and when the bacteria are absent, it is considered to be paucibacillary leprosy (Gould, 2005).
Treating of Leprosy
Leprosy is treated with multi-drug therapy which consists of antibiotics. The WHO treatment regimen includes dapsone plus rifampicin antibiotics. The treatment is prescribed form half a year to one year. The disease is completely cured but the harm caused before drug therapy is irreversible. Each patient is treated individually depending on the classification of the condition. The lost sensory is reactivated due to nerve activation and the patients’ complaints of pain. The common nerve affected in leprosy is the ulnar nerve (Thompson et al., 2009).
Surgery may be conducted after drug therapy if skin smear results are negative of Mycobacterium leprae. This is usually done for cosmetic improvements and body parts functions restorations in the case they are lost in severe cases of leprosy. It has been shown that the relapse rate after completion of short course multi-drug therapy may rise (CDC, 2009).
Leprosy is believed to be transmitted through contact with nasal droplets and secretions from infected people, so avoiding contact with this is the most recommended way of preventing leprosy (Gould, 2005). It has also been found that those people, who are under treatment with antibiotics, do not transmit the disease and that staying with untreated people is at high risk of contracting leprosy. A vaccine to prevent leprosy has not yet been discovered (CDC, 2009).