Chronic Infectious Disease
Leprosy is a chronic infectious disease, which is attracted to, and attacks primarily the skin and peripheral nerves. Caused by the bacterium Mycobacterium leprae, it thrives mostly in body extremities such as feet, hands, testes, nose, ears, etc., where because of less circulation body temperatures are lower.
Also known as Hansen’s disease after Norwegian Dr. Armauer Hansen, who in 1873 discovered the bacteria, leprosy can be very destructive, sometimes settling into the upper respiratory tract, as well as other additional structures. Untreated, it can result in grotesque disfigurement of the feet, hands, and face, and can even cause blindness. However, it is rarely fatal.
There are as yet a number of unknowns concerning leprosy. It is believed to be transmitted by nasal discharges and open sores. Because of inherent immunity in most humans, only 5% of those exposed acquire the disease. As the result of intermittent and gradual growth, leprosy usually takes several years to manifest itself.
Early diagnosis and treatment with MDT (Multi Drug Therapy) can give a complete cure. MDT also eliminates the contagious aspect of the disease. However, if left untreated, loss of feeling occurs, and such things as unnoticed cuts, burns, stone bruises, etc. can complicate conditions adversely. Also, muscle weakness and paralysis can occur, resulting in deformities, even the loss of fingers and toes.
Although treatment can produce a complete arresting of the disease, damage already done remains. That is why early detection and treatment are so important. Today many thousands of cured, but handicapped, lepers serve as mute testimony of this fact. They remain isolated, cast out by an ignorant or uncaring society, living a pitiful life of poverty, devoid of hope and human dignity.
History of Leprosy
Leprosy has historically been a feared and dreaded disease, carrying with it shock waves of alarm because of the grotesqueness of lepers, and ignorance concerning its prevention and cure. Lepers were believed to be cursed by God, and were forced to live lives of banishment and isolation from society.
Mentioned in the Old Testament of the Bible, leprosy is thought to have existed in Egypt as early as 4,000 BC, and in India and Japan earlier than 1,000 BC. Reliable descriptions of leprosy, dating to 600 BC, have been found in documents from India.
Leprosy spreads throughout the world until in some places it reaches epidemic proportions. Historians believe that it was carried by travelers, like the soldiers of Alexander the Great, Roman Legionnaires, Crusaders, slave traders, and seafarers, who unknowingly transmitted the bacteria from leprosy-endemic regions.
Becoming rampant in Europe, Britain, and Scandinavia, leprosy finally peaked in the Middle Ages, around 1100-1300 AD. Its regression came about as the result of improved living conditions through better housing, hygiene, nutrition, water, etc.
Today, leprosy is construed as being the “disease of the poor”, as it is particularly endemic to tropical, densely populated, and impoverished third world and emerging countries. There, poverty, ignorance, unsanitary conditions, and poor governmental and societal conditions abound. Under such circumstances, leprosy thrives, and is much more difficult to eliminate.
Incidence of Leprosy
It is impossible to measure the incidence of leprosy in ancient times, although we know from biblical stories and other methods that it existed then. We also know that it existed at the time of Christ, and that there were severe social stigmas attached to it.
Further, we know that it peaked in Europe in the Middle Ages, then gradually subsided because of better hygiene and standards of living. However, it continued as a major disease worldwide, in many places reaching epidemic proportions.
Leprosy tends to favor warmer, tropical-type climates, and is most prevalent where there are the highest concentrations of people and the least sanitation.
Measurement of numbers is difficult, as there are several distinctions that must be considered. First, there is the “incubation” period of about 4 or 5 years, during which those infected with the bacterium offer no signs of its presence.
Second, there are those with obvious manifestations of the disease, who thereby can be counted. However, this is not all-conclusive, as embarrassment and fear of social repercussions frequently prevent these lepers from coming forward.
Then, third, there are the millions who are cured of leprosy, but remain lifelong cripples, either unable to walk, to see, to feed themselves, to tend to personal hygiene, to work, etc. These are leprosy victims who deserve to be counted, at least in some category. They are totally dependent on others if they are to survive.
Since the preponderance of data is approximate, exact data is mostly nonexistent. Yet there is enough to give us important information. Various organizations- political, public, and private- have worked diligently on the leprosy problem. Through their efforts, meaningful insights into the incidence of this dreaded disease have been collected.
Leprosy Statistical Information
Reasonably valid statistical information has become available only in recent years, and it has been very encouraging. WHO (World Health Organization) has set its sights on the elimination of leprosy as a major worldwide threat, and it has made very meaningful strides toward that goal.
In 1985, 5.4 million known cases existed, with the total estimated cases in the 10-12 million range. By 1997, known cases were reduced to 900,000, and total estimated worldwide cases were only about 1.2 million. In the year 1985, 550,000 new cases were detected, and in 1997, this figure was 675,000. Importantly, consider that the more cases detected, the more cases available for cure.
Males become infected at about a 2 to 1 ratio over females. Race is not a factor in susceptibility. However, children are at higher risk than adults are. In fact, the number of children’s cases detected per year went from 61,000 in 1985 to 97,000 in 1997. It is not known how many children’s cases are undetected worldwide.
Leprosy is being assaulted by treatment with MTD (Multi Drug Therapy), which consists primarily of dapsone, rifampin, and clofazimine. The theory is that if the disease should develop an immune resistance to one of the drugs, then one of the others can and will still overcome it. This has worked extremely well.
Despite the positive strides, leprosy remains a large worldwide problem. India, Myanmar, and Indonesia account for about 70% of all cases. It is also endemic to Mexico, South America, China, Australia, and the Caribbean area, among others.
America does not escape unscathed. Although active numbers have been reduced, there are still about 7,000 active cases in the U.S. Leprosy is endemic to Texas, Louisiana, Hawaii, and Southern California. Many of these cases are believed to have been brought in by travelers and immigrants.
As impressive as the cure-rate is, it is important to remember that for every leper cured, there remains a cripple – either mentally, physically, psychologically, or socially – or any combination of these. It is estimated that 10 million or more such people exist. That is the number of patients cured in the past 15 years; it presents a gigantic challenge to a caring world.
Wounds of leprosy
The pain of the cure
Lepers need help
Children of lepers need help