Leprosy is a disease caused by bacteria called Mycobacterium Leprae. It affects mainly the skin and the nerves.
The first sign of leprosy is usually the appearance of white patches on the skin. These patches are accompanied by a loss of sensation in the affected areas. In untreated cases of leprosy, nerve damage and other complications occur as the disease progresses. The numbness and loss of sensation due to nerve damage often leads to neglected injuries progressing to infected ulcers on the hands and feet, and deformity like clawed finger, foot-drop and paralysis of eyelids.
Leprosy is curable with 6-12 months of treatment with Multidrug Therapy (MDT). The first dosage of MDT kills 99.9% of leprosy bacteria in the body.
Treatment for Leprosy is available free of cost in the Government Health facilities where the patient is registered. These are Sub-centers, Primary Health Centers (PHCs), Community Health Centers (CHCs), District & Sub-district Hospitals (DH & SDH), and Medical College Hospitals. Treatment of complications of leprosy is done at the secondary and tertiary referral centers run by the government as well as NGOs.
The exact mechanism of transmission of leprosy is not known. It is believed that it is transmitted through aerial route via droplets from the nose and mouth during close and frequent contact with untreated infectious individuals for a prolonged period.
Leprosy is mildly infectious if there is a prolonged exposure to untreated individual. Over 99% of people have a natural immunity or resistance to leprosy. Leprosy does not spread through touch and is also not a hereditary disease.
When the leprosy bacteria invade the body it causes one of two types of the disease either Paucibacillary (PB) leprosy or Multibacillary (MB) leprosy- which is more severe. In PB leprosy the body’s immune cells attempt to seal off the infection from the rest of the body. PB leprosy can cause the hair follicles, sweat glands, and nerves to be destroyed causing skin to become dry, discoloured and lose its sensation and the nerves become enlarged. MB leprosy is more contagious and severe as the body’s immune system is too weak to respond to the invading organism which multiplies freely resulting in large nodules or lesions across the body and face which can lead to severe disfigurement.
If diagnosed and treated at an early stage loss of sensation and disability can be prevented. As the disease progresses, patients lose sensation and strength in their fingers, toes and limbs making them susceptible to repeated burns and cuts which get infected resulting in severe ulcers. Deformities also occur on the face, hands or feet.
Leprosy reactions are the body’s immune system responding to the leprosy causing bacteria. It is important to manage reactions as they are sometimes severe and result in new lesions and new nerve damage leading to disabilities such as loss of sensation and deformities of hands, feet and eyes.
Reconstructive Surgery is a surgical procedure to correct deformities of hands, feet, eyes and face that occur due to leprosy. Reconstructive Surgery helps in improved function, restoration of cosmetic appearance, increased self confidence and self esteem.
(TLMTI has been at the forefront of reconstructive surgery for decades and performs over 1,400 reconstructive surgeries per year in its hospitals.)
Leprosy is curable but the nerve damage resulting from leprosy can be irreversible. Loss of sensation leaves fingers and toes susceptible to injury which can result in infection and further disabilities. People affected by leprosy must be taught techniques to care for themselves to prevent injuries such as regularly checking their hands and feet for cuts and taking action to prevent infection.
(Self care training is not provided by the general health care system in India. TLMTI provides self care training in all its hospitals and in villages.)