World Leprosy Day

World Leprosy Day is observed internationally on January 30 or its nearest Sunday to increase the public awareness of the Leprosy or Hansen’s Disease. This day was chosen in commemoration of the death of Gandhi, the leader of India who understood the importance of leprosy.

Leprosy is one of the oldest recorded diseases in the world. It is an infectious chronic disease that targets the nervous system, especially the nerves in the cooler parts of the body – the hands, feet, and face.

 

What is Leprosy?

Leprosy is an infectious disease of the skin and nerves which, if not diagnosed and treated quickly, can result in debilitating disabilities. The effects of leprosy are exacerbated by the negative stigma surrounding the disease.

In 2015, over 210,000 people were diagnosed and it is estimated that millions more go undiagnosed. Leprosy manifests in different ways in different people.

Today, it is not just the disease that is forgotten, but the people too.

 

Leprosy History

In 1873 G. H. Armauer Hansen in Norway discovered the causative agent of leprosy, Mycobacterium leprae. This was the first bacterium to be identified as causing disease in humans.

From the 19th century, European nations adopted some practices of India and China, administering naturally occurring oils. They were given by injection and orally, and were believed to cure some people, but results were often disputed. It was not until the 1940s that the first effective treatment, promin, became available. The search for additional anti-leprosy drugs led to the use of clofazimine and rifampicin in the 1960s and 1970s.

Later, Indian scientist Shantaram Yawalkar and his colleagues formulated a combined therapy using rifampicin and dapsone, intended to mitigate bacterial resistance. Multidrug therapy (MDT) combining all three drugs was first recommended by the World Health Organization (WHO) of the United Nations in 1981. These three anti-leprosy drugs are still used in the standard MDT regimens.

 

How is Leprosy Transmitted ?

Researchers suggest that M. leprae are spread person to person by nasal secretions or droplets. However, the disease is not highly contagious like the flu. They speculate that infected droplets reach other peoples’ nasal passages and begin the infection there.

Some investigators suggest the infected droplets can infect others by entering breaks in the skin. M. leprae apparently cannot infect intact skin. Rarely, humans get leprosy from the few animal species. Occurrence in animals makes it difficult to eradicate leprosy from endemic sources. Routes of transmission are still being researched for leprosy.

Recent genetic studies have demonstrated that several genes (about seven) are associated with an increased susceptibility to leprosy. Some researchers now conclude that susceptibility to leprosy may be partially inheritable.

 

Leprosy Symptoms And Signs

A person with leprosy may have symptoms across a spectrum ranging from a form of leprosy where:

  • There are many symmetrical lumps (nodules, papules and macules) on both sides of the body
  • Involvement of the lining of the nose causing crusting and difficulty in breathing
  • Bleeding and inflammation of the eye (keratitis and iritis).

To a form of leprosy where:

  • There are a few skin lesions with loss of feeling that are clearly marked (loss of pigment or reddish colour)
  • There is symmetrical thickening of the nerves of the arms, legs and face on both sides of the body with loss of feeling.

Complications of leprosy include permanent deformity and disability, especially of the hands, feet and face; most of which can be prevented by early treatment. Special reconstructive surgery can correct many deformities that develop.

 

Treatment Of Leprosy

Multi-drug therapy has significantly improved treatment for people with leprosy. Most people with leprosy can be cured and do not need to be treated in hospital. The duration of therapy is usually 6 to 24 months, depending on the type of leprosy. Treatment is free.

 

Leprosy Prevention

  • Exclude people with leprosy from childcare, preschool, school and work until approval to return has been given by an infectious diseases physician, dermatologist, or a SA Health Communicable Disease Control Branch doctor
  • Control is best achieved by the rapid elimination of infectivity in people with leprosy using multi-drug therapy
  • Because close and prolonged contact is required for transmission, travellers to areas where leprosy is present have a very low risk of contracting the disease.

 

Leprosy Colony

A leper colony, leprosarium, or lazar house is a place to quarantine people with leprosy (Hansen’s disease). The term lazaretto can refer to quarantine sites, which were at some time also leper colonies.

 

Leper Colony Louisiana

Although leprosy, or Hansen’s Disease, was never an epidemic in The United States, cases of leprosy have been reported in Louisiana as early as the 18th century. The first leprosarium in the continental United States existed in Carville, Louisiana from 1894-1999 and Baton Rouge, Louisiana is the home of the only institution in the United States that is exclusively devoted to leprosy consulting, research, and training.

 

Leper Colony Hawaii

Kalaupapa is a small unincorporated community on the island of Molokai, within Kalawao County in the U.S. state of Hawaii. In 1866, during the reign of Kamehameha V, the Hawaii legislature passed a law that resulted in the designation of Molokai as the site for a leper colony, where seriously affected patients could be quarantined, to prevent them from infecting others. At the time, the disease was little understood: it was believed to be highly contagious and incurable. The communities where persons with leprosy lived and were treated were under the administration of the Board of Health, which appointed superintendents on the island.

Kalaupapa is located on the Kalaupapa Peninsula at the base of some of the highest sea cliffs in the world; they rise 2,000 feet (610 m) above the Pacific Ocean. In the 1870s a community to support the leper colony was established here; the legislature required people with severe cases to be quarantined on this island in the hope of preventing contagious transmission of the disease. The area has been preserved as the Kalaupapa Leprosy Settlement and National Historical Park, which takes in the entire county.

Despite the declining population, the post office is still active, having a zip code of 96742.


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