What is Leprosy Diseases?

Leprosy is a chronic infectious diseases caused by a bacterium: the mycobacterium leprae . It belongs to the large family of Mycobacteriaceae, which among other things cause tuberculosis in humans. Leprosy is also known as "leprosy" . The name comes from the fact that lepers used to have to live outside the city like lepers in order not to infect other people.

People with leprosy develop tissue damage all over their bodies if they don't receive therapy in a timely manner. Leprosy raged in Germany especially in the Middle Ages. Today it is hardly to be found in this country. However, around 220,000 new infections with leprosy occur worldwide every year - children in particular are susceptible to it.

So far, the World Health Organization (WHO) has not achieved its goal, namely to make the leprosy disease disappear from the planet: Around four million people are currently infected all over the world. Most often, the disease occurs in tropical and subtropical countries , where hygiene standards leave something to be desired.

Leprosy occurs mainly in the following countries: India, Indonesia, Sri Lanka, Myanmar, the Philippines, Nepal, Brazil, Mexico, Angola, Cameroon, Kenya, Sierra Leone, Uganda, Tanzania, Sudan, the Democratic Republic of the Congo, Ethiopia and Mozambique. According to the Infection Protection Act, leprosy is a reportable disease in Germany .

Leprosy: Symptoms affect the skin and nervous system

Leprosy bacteria preferentially attack the nerves that run through the body (peripheral nerves), as well as the skin and mucous membrane cells. Bacteria can infect these tissues particularly well and multiply there. The leprosy pathogens prefer body parts that are slightly cooler than the core body temperature: the nose on the face , hands or feet. Leprosy is therefore associated with severe skin changes . Sometimes the pathogens also attack the eyes, airways, testicles or nerve cells. Even the bone marrow can be affected.

The first signs of a leprosy infection are:

• individual, indistinctly demarcated skin damage (skin lesions) . Due to the lower pigmentation, these appear light in dark skin and more reddish in light skin. At this early stage, doctors speak of “indeterminate leprosy”.
• Sensory disturbances often occur in the affected parts of the body because the bacterium destroys the nerve cells. The spots on the skin feel numb to those affected.

An indeterminate leprosy infection can heal spontaneously or continue to progress. If there is no therapy to stop the disease, pronounced tissue damage will gradually develop . The patients are often optically disfigured; the leprosy is particularly recognizable on the face. In many countries, people with leprosy are still stigmatized and discriminated against. For people with weakened immune systems, leprosy can be fatal without treatment.

Leprosy: how contagious is the disease?

The way in which leprosy is contagious is not yet fully understood. However, the most important role is played by the transmission of leprosy from person to person. The pathogens are mainly found in the nasal secretions and in the skin ulcers. In close, long-term contact , for example with the skin wounds of infected people, others can become infected with the leprosy bacteria. There is an increased risk of infection when leprosy sufferers have a high concentration of pathogens.

Researchers are increasingly discussing the transmission of leprosy via droplet infection . The bacteria distribute themselves through the air through the finest droplets that an infected person emits when coughing, sneezing or speaking. A transmission through insects include researchers did not thoroughly. However, these routes of infection have not yet been actually proven.

During pregnancy, the pathogens causing leprosy can probably pass through the placenta to the unborn child. Doctors call this form of infection "transplacental transmission".

Compared to other infectious diseases, however, the risk of infection with leprosy is rather low: Statistically, it is around five percent. Those who do not maintain close contact with infected people without adequate protective measures are unlikely to be able to contract leprosy.

 

Leprosy: incubation period is years

The incubation period in leprosy is very long. Doctors understand this to be the time span between infection with the bacterium and the onset of the disease . On average, it takes three to seven years between first contact with the pathogen and the appearance of the first symptoms . Incubation times of 20 years are also known. The reason for this is that the mycobacterium leprae reproduces comparatively slowly and is considered to be less aggressive. In addition, a healthy immune system can keep the pathogen under control for a long time.

Leprosy: the course of the disease varies

Doctors differentiate between three forms of leprosy: tuberculoid leprosy, lepromatous leprosy and borderline leprosy. The latter is an intermediate form in which symptoms of both forms occur. Depending on the type, the disease progresses differently:

• Tuberculoid leprosy: It is slower and more belt-like. It develops when the immune system can keep the pathogens in check. The disease then resembles tuberculosis and manifests itself as localized spots on the skin. If the pathogen attacks the nerve cells, it leads to abnormal sensations and paralysis in the affected areas. Tuberculoid leprosy sometimes heals on its own. Because of the lower density of pathogens, this form is also called paucibacillary leprosy .
• Lepromatous leprosy: This form is the most severe form of leprosy. It occurs when the immune system cannot do much to counteract the pathogen. The bacterium then multiplies almost unchecked, which leads to skin changes all over the body, especially on the face. Due to the high density of pathogens, this form is also called multibacillary leprosy . Sick people also lose their eyelashes and eyebrows. If they do not die of the infection because the pathogen eventually attacks the organs, noticeable scars and mutilations remain. It is typical that the face of the person affected at some point resembles a lion's head - doctors call this characteristic of the disease "Facies leontina".

Leprosy is curable if treatment is timely.

Leprosy: treatment with antibiotics

There is an effective therapy for leprosy: antibiotics . These drugs can be used to cure the disease. The World Health Organization (WHO) has simplified the treatment regime in its current guidelines (6/2018). Doctors should now use the same three active ingredients in combination for both forms of leprosy, but for different durations:

• Tuberculoid Leprosy : Dapsone (daily), rifampicin (once a month), and clofapicin (once a month) for six months
• Lepromatous leprosy : dapsone (daily), rifampicin (once a month) and clofapicin (once a month) for twelve months

The antibiotics kill the bacteria and prevent them from multiplying further. If the pathogens develop resistance, these recommended antibiotics are no longer effective. If there is resistance to rifampicin, there are other alternatives, for example clarithromycin, monocylcline or quinolones such as ofloxacin, levofloxacin or moxifloxacin.

Sometimes it is helpful to surgically remove the infected tissue as well.

Doctors recommend leprosy sufferers to have the therapy carried out in specialized centers . Because so-called "leprosy reactions" of the immune system can occur during antibiotic treatment. This is inflammation that can leave permanent nerve damage. Doctors treat these with anti-inflammatory drugs (corticosteroids, "cortisone") and the active ingredient thalidomide (known from the Contergan scandal).

Additionally, doctors treat the symptoms of the leprosy infection. For example, those who are sick receive exercise therapy to combat the paralysis. In addition, good wound treatment is an important component of leprosy therapy.

 technologyify          worldbeautytips          technologyford        techiesin    blog4techies