Leprosy is one of the oldest known diseases and continues to be a challenge despite a substantial fall in its prevalence in the last few decades. In spite of straightforward clinical diagnosis in most cases and availability of effective drugs, various factors contribute to a delay in diagnosis leading to increased nerve damage and disability.
Given the high incidence being reported even among children globally, transmission rate is still very high and Leprosy continues to be the leading infectious cause of disability.
Surprising announcement
Given the number of new cases, India's announcement of having eliminated leprosy in 2005 may seem surprising. According to a WHO target, countries can announce ‘elimination' when there are fewer than one case for every 10,000 people.
Therefore, the Government of India announced in December 2005 that leprosy is no more a public health problem and channelled the services (and funding) dedicated to leprosy back into general health programmes.
When the WHO Strategic Plan for Leprosy Elimination was renewed, the word ‘elimination' was replaced by the phrase ‘reducing leprosy burden'. This term encompasses the direct burden of disease and related burden of disability. But there is no denying that, in the last six decades, India has made a lot of progress towards achieving leprosy control.
To commemorate Mahatma Gandhi's service to those affected by leprosy and his scientific approach to the disease, January 30 (the day of his martyrdom) is observed as Anti-Leprosy Day.
But the prevalence of myths about leprosy leads to stigma and delayed detection of cases. Much needs to be done to spread the awareness about the disease and change people's attitudes.
Leprosy is caused by M leprae bacteria. It has a long incubation period of 2-10 years (before symptoms appear). Most people infected with this organism are thought not to develop clinical disease depending on their immunity.
The mode of transmission is still not conclusively proven, although person-to-person spread via nasal droplets is believed to be the main route with the majority contracting it through close long-term contact with an untreated infected person.
Casual and short-term contact does not seem to spread the disease. Leprosy cannot be contacted by touching someone with the disease, as is commonly believed. Health care workers often work for many years with people who have leprosy without getting the disease.
What it does
Leprosy attacks nerve endings destroying the ability to feel pain and injury, which makes patients susceptible to ulcers and infections leading to disabilities in hands, feet, and eyes like blindness, facial disfigurement and the ‘clawing' of hands and feet. Leprosy is not very contagious and approximately 95 per cent of people have natural immunity. The earliest sign is a spot on the skin with loss of sensation and thinning of hair. If left untreated, leprosy can progress to cause disabilities.
The good news is that leprosy is curable and drugs are provided by WHO free of charge to all leprosy patients worldwide. Good self-care will prevent the disease from destroying the body
The most effective way to prevent disabilities as well as further transmission lies in early diagnosis and treatment. Much needs to be done to spread awareness about the disease and change people's attitudes towards the affected.
Author: Dr. Srinivas, National Med Advisor, India
Published in: The Hindu
