Bacterial infections are a very real and sometimes terrifying thing. Mycobacterium Leprae, commonly known as Leprosy, is one of the oldest, and scariest, bacterial infections known to humankind. Most commonly found in warm, subtropical climates, 80% of all Leprosy cases are found in 5 countries (Myanmar, India, Indonesia, Nigeria, Brazil). While the infection causes nearly 144,000 cases per year, 5.5 million people in the world are estimated to be infected at any given time with the disease, which has 3 notable strains, namely Lepromatous (seen below), Indeterminate, and Tuberculoid Leprosy.
Leprosy can [and probably will] affect the skin, mucosal membranes (nose), peripheral nervous system (nerve function), eyes, and testes by way of lesions and inflammation. The form, the strain, will affect each subject differently according to the way his or her immune system responds to the initial infection. Regardless of the strain, if Leprosy goes untreated, it can lead to severe deformities.
While the early form of Leprosy may be cured using prescription strength steroids and antibiotics. Steroids such as Prednisone, an anti-inflammatory prescription strength steroid, has been proven to help prohibit inflammation and in some cases will cure patients entirely. Antibiotics like Clarithromycin and Minocycline, strong antibiotics work to prevent infections in affected areas; these drugs are very important for the areas that are strongly affected by Leprosy. Antibiotics, when taken properly, will create helpful immune antibodies that can target Leprosy before it takes hold of an individual patient, as well as helping to treat infections like Leprosy.
Leprosy is an infection that multiplies very slowly, as the incubation period may take up to five years, and may not show symptoms for up to 20 years. Leprosy also is not highly infectious; the bacteria is transferred via droplets from the nose and mouth during very close contact between patients with untreated infections. The ages between 10-14 and 35-44 are the two most common ranges where Leprosy is found. The first symptom is normally numbness in the affected area, which may precede skin lesions by years. Temperature is the first sensation lost, followed by light touch, pain and then deep pressure. Sensory loss usually begins in the extremities (toes and fingertips), however in more severe cases, can begin in the lips or ears (depending on where leprosy has taken hold).
Leprosy has very individually characteristic clinical features, making it easy to diagnose when observed in a patient, however the need for confirmation is important because the treatment with antibiotics is a long one. Normal patients will be tested via skin biopsy, which may show characteristic histopathology (the study of the changes skin will undergo as a result of bacterial infectious disease), with granulomas (a reaction to inflammatory infectious diseases in the form of a skin ulcer) and involvement of the nerves. Mycobacterium Leprae exhibits a very tricky evolutionary characteristic called acid-fastness. It is a physical property of certain bacteria, specifically their resistance to decolorization by acids during staining procedures. Special staining of the tissue may show acid fast bacilli, the number visible depending on the type of leprosy. The bacteria may also be found in lepromatous leprosy (mentioned and seen above) on swabs taken from skin slits made in the ears and ear lobes, but they will be negative in the tuberculoid or borderline forms of the disease.
According to an NGDO Article, “Leprosy control and prevention has improved significantly due to national and subnational campaigns in most endemic countries. Integration of primary leprosy services into existing general health services has made diagnosis and treatment of the disease easy. The implementation of the global leprosy strategy 2011–2015 national leprosy programmes now focus more on underserved populations and inaccessible areas to improve access and coverage. Since control strategies are limited, national programmes actively improve case holding, contact tracing, monitoring, referrals and record management. According to official reports received from 105 countries and territories, the global registered prevalence of leprosy at the beginning of 2012 stood at 181, 941 cases. The number of cases detected during 2011 was 219, 075 compared with 228, 474 in 2010. In 2016, 144,453 cases were reported.”
When attempting to treat and prevent Leprosy, as with most if not all other Neglected Tropical Diseases, patient education is an absolute necessity. Leprosy can be cured, however it is essential to take the full course of either the steroid or antibiotic, as hard as it may be. Leprosy is rendered absolutely no longer infectious once treatment has begun, so patients need to be instructed how to deal with existing nerve damage for example protecting numb feet from injury once symptoms have appeared. Physical, social and psychological rehabilitation is important also for those who Leprosy has affected.