Leprosy
Leprosy is an infection caused by the bacteria, Mycobacterium leprae.
The bacteria looks similar to Mycobacterium tuberculosis but leprosy is different from tuberculosis.
Mycobacterium leprae often affects the nerves of the hands, feet and face, and also the skin.
There is often much fear and misunderstanding about leprosy because it can cause disabilities.
However, it is not very contagious and it is easily treatable with antibiotics.
Treatment provided in the early stages prevents or minimises permanent damage to the skin, nerves, limbs and eyes.
Types of leprosy
Manifestations of leprosy are determined by a person’s immune response to the disease.
If the infected person has:
- little resistance, the bacteria multiplies - this is called multibacillary leprosy (previously referred to as lepromatous leprosy)
- a high level of resistance, most of the bacteria are destroyed - this is called paucibacillary leprosy (previously referred to as tuberculoid leprosy).
Where it's found
In 2011, approximately 219,000 new cases of leprosy were reported worldwide.
This occurred mainly in Africa, Asia and South America.
Over the last 20 years, control of leprosy has improved significantly due to national campaigns in many countries.
In Australia, leprosy is rare and found mainly in:
- Northern Australian Aboriginal people
- migrants from overseas countries in Asia, the Pacific and Africa where leprosy is more common.
How it spreads
Leprosy is not a very contagious infection.
It is probably transmitted by droplets from the nose and mouth when people are in close and frequent contact with an infectious person.
The majority of people who come in contact with untreated leprosy are unlikely to become infected.
In fact, it is close family contacts who are most at risk of catching the infection.
Infectious cases become non-infectious soon after starting regular treatment.
Diagnosis
The diagnosis of leprosy is often delayed because it is not considered, especially in countries like Australia where it is rare.
A discoloured skin patch, often, but not always without sensation, may be the first sign of leprosy.
A doctor or nurse will check for:
- numbness in the hands or feet
- swollen nerves
- eye problems
- wounds
- deformities on the hands or feet
- skin changes.
They may make a tiny cut in the skin to take a small sample of fluid under the skin to send to a laboratory for testing.
If the leprosy bacteria is detected in the sample or other biopsy specimen, then leprosy is diagnosed.
If you suspect you have leprosy, seek advice from your nearest Centre for Disease Control on the NT Health website.
People who live remotely may consult the remote medical officers who regularly visit rural community care centres in the NT.
Discussion with general practitioners (GPs) or infectious disease physicians may also be appropriate.
Treatment
Leprosy can be completely cured with free multidrug therapy (MDT). They do not need to stay in hospital for treatment.
MDT means taking 2 or 3 special antibiotics for 6 months to 2 years, depending on the type of leprosy.
These antibiotics include rifampicin, dapsone and sometimes clofazamine.
After only a few doses of MDT, people with leprosy are no longer infectious to others.
But to cure leprosy they need to take all the antibiotics as prescribed by their doctor.
Deformities and disabilities
Leprosy can often damage nerves and cause deformities, especially if the diagnosis of the disease is delayed.
Unfortunately, these deformities cannot be cured with antibiotics. These are the scars of leprosy.
To avoid developing further problems, occupational therapists and physiotherapists can help.
Reconstructive surgery can also be done for people making it possible for them to live independent and productive lives.
Control measures
Leprosy is becoming less common around the world. Screening programs in the past have resulted in early detection of leprosy.
Effective treatment programs with MDT therapy have reduced transmission of the disease.
People living in the same house as a person with leprosy should be examined and followed up by a doctor or nurse.
Information for health professionals
To find out more, go to the NT Health website.
Contact
For more information, contact the TB Clinic in your region.