The leprosyalso known as Hansen’s, is a pathology produced by the bacillus bacterium Mycobacterium leprae. It mainly affects the , peripheral nerves and can even reach the upper respiratory tract.
This infectious-contagious disease is one of the oldest recorded, and prevailed in Europe until the 16th century. However, today it is still endemic in many countries in Africa and Southeast Asia, where thousands of cases are reported each year.
Leprosy occurs in two distinct forms: tuberculoid and lepromatous. Skin lesions occur in both forms, although lepromatous leprosy is more serious. In this case, a systemic infection occurs that affects the skin, nerves and other organs.
According to the data of the World Health Organization (WHO), in 2020 127,558 new cases were detected worldwide, and more than 8,000 in children under 15 years of age. In our country, far from what many think, leprosy it is not eradicatedbut removed.
According to , in the last year 10 new cases have been reported:
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2 in the Principality of Asturias.
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2 in the Balearic Islands.
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1 in Andalusia.
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1 in Cantabria.
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1 in the Valencian Community.
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1 in Galicia.
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1 in La Rioja.
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1 in Murcia.
The doctor Rosa Maria DiazHead of Dermatology at the Infanta Sofía Hospital in San Sebastián de los Reyes (Madrid) explains to , coinciding with the World Leprosy Day, that at present there are no autochthonous infections in Spain. “The few cases that we see annually are the product of immigration, and are patients who have not been previously diagnosed or who have already been treated in their country of origin.”
Early diagnosis of leprosy is very important to avoid the sequelae of the disease. When diagnosed people are not treated at the onset of symptoms, it usually leaves sequelae that are progressive and permanent, such as deformities, mutilations, reduced mobility of the extremities, and blindness.
Because, the specialist points out, “the earlier, the less sequelae it leaves.” And, this disease presents both skin and neurological symptoms.
No, it’s such a contagious disease
The main problem is that the symptoms take time to appear, since the bacteria that cause this disease multiply very slowly and the incubation period can last up to five years. Thus, the symptoms can manifest in the first year or take up to 20 years or more.
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Muscular weakness.
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Tingling sensation in hands and feet.
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Lesions on the skin (light or dark spots).
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Loss of sensation in the affected area.
But it is not the only problem that patients diagnosed with leprosy have to face. Throughout the history of the disease, patients have been condemned to ostracism, being stigmatized by the population and discriminated against by their own environment.
Dr. Díaz points out that, even today, when a patient comes to the consultation “the health workers themselves get nervous when they hear the name of the disease, and that is why we often use the term Hansen’s disease (which refers to to the Norwegian doctor who discovered the causative agent)”.
What is clear is that it is not one of the most contagious pathologies. “It is very little contagious, and it is only more transmissible in the closest circle of the patient.” In addition, “the better the sanitary conditions of the patient, the less likely it is that the family itself will be infected.”
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“There is a belief that the leper patient is a highly contagious patient, but it is not true, and since before the Middle Ages they carry the stigma that they have to live in isolation to avoid infecting other people. But it is a much less contagious disease than syphilis, for example.”
Although we are talking about the route of transmission that has not yet been discovered, it is “supposed to be through direct contact and, especially, through nasal secretions.” And this preliminary conclusion has been reached after few infections have occurred within the same family, although it has been shown that for transmission to exist there must be direct and repetitive contact.
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“Close and prolonged contact is needed over time, which is why health personnel should not take any other measure to treat a patient with leprosy beyond what is usually taken. In fact, those infected are not isolated, since the treatment is outpatient.”
What is the treatment for leprosy?
The first breakthrough to fight this disease was discovered in 1940, when the first drug against leprosy was developed: dapsone. But the long duration of the treatment was one of the main handicaps (and could even become chronic throughout life).
Starting in the 1960s, the bacteria began to become resistant to this drug and, fortunately, other antileprosy drugs, rifampicin and clofazimine, were discovered.
And since 1981, the WHO recommends that the treatment be combined with these three drugs (PQT): dapsone, rifampicin and clofazimine, which has an estimated duration of six months in patients paucibacillary (with fewer skin lesions) and one year in multibacillary (with numerous skin lesions, nodules, thickening of the epidemic, congestion and nosebleeds).
“It is not an expensive treatment, the WHO provides it free of charge to all countries, and it is provided to patients for a total of three months. They are told how to take it and what side effects it may have”, says Dr. Díaz.
The World Health Organization estimates that in the last 20 years more than 16 million people have been treated with PQT, which has reduced the number of new cases. In addition, 45 countries have come to report zero cases of the disease.