Leprosy: all you need to know about this infectious disease

Leprosy Caused by the Mycobacterium leprae bacillus, leprosy is a chronic infectious disease that mainly affects the skin, the peripheral nerves, the mucous membrane of the upper respiratory tract and the eyes.

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"Already present in ancient civilizations in China, Egypt and India, leprosy has always been a scourge marked by stigma and exclusion," according to the Pasteur Institute. And for good reason, it has caused -and continues to cause- havoc in many countries in Africa, Asia and Latin America. The WHO estimates that there are still 2.8 million lepers in the world today.

What is leprosy?

Induced by the Myobacterium leprae bacteria, leprosy is a chronic infectious disease that mainly attacks the skin, the peripheral nerves, the upper respiratory mucous membranes and the eyes.

It can cause severe skin mutilations and nerve damage that can lead to muscle atrophy and therefore disability.

What are the symptoms of leprosy?

The incubation period of leprosy is long and silent and lasts about 5 years. Sometimes the symptoms may not appear until after 20 years, but what are they?

• Painful, depigmented or reddened skin lesions.
• anesthesia or paresthesia (tingling) of the extremities
• lumps
• Loss of sensation in the extremities (especially in the hands and feet)
• Muscle weakness
• paralysis of the hands and feet
• eye disorders
• oozing skin that is dry to the touch

These symptoms are used to determine the stages of the disease.

Depending on these factors, physicians can prescribe appropriate treatment. Leprosy progresses in successive relapses and can lead to death after 10 to 20 years if left untreated.

How is leprosy diagnosed?

The diagnosis of leprosy is confirmed with a skin smear to detect bacilli.

Two types of leprosy can be distinguished: paucibacillary (from one to five insensitive skin lesions) and multibacillary (more than five insensitive skin lesions).

Who can be affected by leprosy?

Leprosy can affect people of any age or sex, including children.

Transmission: how does leprosy contract?

As explained above, leprosy is caused by the Myobacterium leprae bacteria.

"The latter seems to be transmitted by droplets of nasal origin during close and frequent contact with infected and untreated people," reports the Pasteur Institute website.

Contrary to popular belief, it is not very contagious and is only transmitted during close and prolonged contact with an infected person. Therefore, the risk of contracting it during a trip to an endemic area is low.

Another point to note is that a person who has leprosy but has been treated is no longer contagious.

Because of the incubation time of the infection, which lasts several years, asymptomatic carriers of Mycobacterium leprae can transmit the disease, making it difficult to eliminate it on a global scale," continues the Pasteur Institute.

Lack of hygiene and the use of infected objects or utensils (towels, cutlery, glasses, etc.) are also known to encourage the spread of the disease.

What are the treatments for leprosy?

There are two types of leprosy. Less severe paucibacillary leprosy (one to five insensitive skin lesions) can be cured with a combination of two drugs for six months.

Other patients may be more severely affected. This is known as multibacillary or leprosy (more than five insensitive skin lesions). This type of leprosy is contagious.

It can be cured by treating the patient with three drugs for twelve months. It is called multidrug therapy (MDT) and combines three antibiotics: dapsone, rifampin, and clofazimine. Patients are no longer infectious after the first dose of drugs and their ability to transmit leprosy stops immediately.

The World Health Organization (WHO) has committed to making this treatment available to all people in the world at no cost. Towards eradication then? Not entirely. Patients have yet to be identified and have access to treatment.

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