FAQ

A germ, or bacteria, called Mycobacterium leprae. It causes an infection that affects the skin, destroys nerves and can also cause problems in the eyes and nose.

The medical name for leprosy is Hansen’s disease. Norwegian doctor Armauer Hansen was the first to view the bacillus under a microscope in 1873.

No. The bacteria attack nerve endings and destroy the body’s ability to feel pain and injury. Without feeling pain, people injure themselves and the injuries can become infected, resulting in tissue loss. Fingers and toes become shortened and deformed as the cartilage is absorbed into the body. Repeated injury and infection of numb areas in the fingers or toes can cause the bones to shorten. The tissues around them shrink, making them short.

Early signs include spots on the skin that may be slightly red, darker or lighter than normal skin. The spots may also become numb and have lost hair. Often they appear on the arms, legs or back. Sometimes the only sign may be numbness in a finger or toe. If left untreated, hands can become numb and small muscles are paralyzed, leading to curling of the fingers and thumb. When leprosy attacks nerves in the legs, it interrupts communication of sensation in the feet. The feet can then be damaged by untended wounds and infection. If the facial nerve is affected, a person loses the blinking reflex of the eye, which can eventually lead to dryness, ulceration and blindness. Bacteria entering the mucous lining of the nose can lead to internal damage and scarring which in time causes the nose to collapse. Untreated, leprosy can cause deformity, crippling and blindness.

M. leprae is transmitted primarily through coughing and sneezing. In most cases, it is spread through long-term contact with a person who has the disease but has not been treated. Scientists don’t fully understand how leprosy is spread.

Most people will never develop the disease even if they are exposed to the bacteria. Approximately 95% of the world population has a natural immunity to leprosy.

Leprosy can be cured with multi-drug therapy (MDT), a combination of three antibiotics: rifampin, clofazimine and dapsone. Treatment can take from six months to a year, sometimes longer. People are no longer contagious after about one week of MDT.

Dapsone: Some people may have a mild anemia. Very rarely, other blood problems have been reported. Rifampin: Sometimes it will cause abnormal liver tests, but the problem clears when the medication is stopped. It may cause a harmless orange color in the urine, sweat or tears. Clofazimine: It has virtually no side effects except some darkening of the skin which slowly fades when the medication is stopped.

Most women with leprosy have normal pregnancies and deliver healthy babies. Patients on treatment do not transmit leprosy to their babies.

Leprosy can damage the peripheral nerves and nerves in the skin which can lead to: 1. Loss of sweat and oil gland function which causes dry and cracked skin on the hands and feet. 2. Loss of the ability to feel light touch or, with more severe damage, loss of protective sensation. Protective pain sensation prevents burns, cuts and exposure to destructive pressures to the hands and feet. 3. Weakness of the eyelids, preventing proper closure of the lid and protection of the eye, which can lead to blindness. 4. Loss of strength in the hands and feet. With severe nerve damage of the hands and feet, there is paralysis of the small muscles, leading to “clawing” of the fingers and toes.

Patients taking Multi-Drug Therapy do not spread the disease. When a person is placed on medication, most of the bacteria are killed within a few days. Within one week of starting the medicine, there is no risk of spreading the disease to anyone else. It is not necessary to isolate a person with leprosy at any time. Also, it is not transmitted through sexual contact or pregnancy.

A trained health worker diagnoses leprosy through a skin biopsy. In this test, a small piece of skin is taken and sent to a laboratory where it is examined for the bacteria. Skin smears are another test that can be used. This is done by making a small incision into the skin. A small amount of tissue fluid is obtained and examined in the laboratory for the bacteria. There are no blood tests for leprosy.

No. For centuries leprosy has been viewed with horror and the word leper has come to mean outcast. The word leper reinforces the already strong stigma against leprosy and contributes to the heartbreaking ostracism sufferers face. Using the word leper today is considered an offense to the hundreds of thousands affected by this disease. The terms “person affected by leprosy”.

Reaction is the body’s response to the dead bacteria in the body. When patients begin taking Multi-Drug Therapy (MDT) the bacteria are killed quite rapidly. Sometimes it takes years for the dead bacteria to be completely cleared from the body. During this time the body may react against these dead bacteria. This can cause pain and swelling in the skin and nerves and other parts of the body. Fever and muscle aches may also occur. The eyes could be red and painful. During reactions there is increased risk of damage to nerves in the eyes, hands and feet. Treating reaction quickly can prevent nerve damage. Up to half of all people with leprosy have reactions. A reaction does not mean the disease is getting worse or that the medication has stopped working. It is not an allergic reaction to the medication. It means that the body is reacting or fighting against the dead bacteria. These bacteria may have been killed by the body’s resistance to the bacteria or by the medication. This is why some persons develop reactions before they even start MDT.

If medications that kill bacteria were not given, the bacteria would begin growing again.

Some reactions can be treated with medicine such as aspirin or Tylenol. In some cases, medications such as prednisone or thalidomide may be required to prevent nerve damage during reaction. Episodes of reaction may occur off and on for a period of time.

There is no current leprosy vaccine that provides full protection against the disease. However, there is a leprosy vaccine called mycobacterium indicus pranii (MIP) which has been developed in India and is being used by the Indian government as part of its leprosy control programme. This vaccine is useful but offers limited protection. Currently, research to develop a more effective vaccine is taking place in the USA.

In addition to the physical effects of the late treatment of leprosy which can leave people unable to work or carry out everyday tasks, the disease also affects people’s mental health and general wellbeing. Many people affected by leprosy struggle with anxiety and depression. In countries where leprosy is prevalent, there are many myths and superstitions and a lack of understanding about the disease. This means that people affected by leprosy are often subjected to stigma and discrimination. They can be rejected by their families, friends and communities. Many people lose their jobs and struggle to find new employment. Others lose their homes or find themselves excluded from school.