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| Dr. Winsome Christie |
Hansen's disease (also known as leprosy) is an infection caused by slow-growing bacteria called Mycobacterium leprae (M. leprae) or M. lepromatosis. It can affect the nerves, skin, eyes, and lining of the nose (nasal mucosa) resulting in extreme damage to the skin and nervous system. With early diagnosis and treatment, the disease can be cured.[1,2]
Signs of leprosy are painless ulcers, skin lesions of hypopigmented macules (flat, pale areas of skin), and eye damage (dryness, reduced blinking). Later, large ulcerations, loss of digits, skin nodules, and facial disfigurement may develop. The infection spreads from person to person by nasal secretions or droplets. The disease is termed a chronic granulomatous disease, similar to tuberculosis, because it produces inflammatory nodules (granulomas) in the skin and peripheral nerves over time.[1,2]
There is rarely transmission from other animals like monkeys, and nine-branded armadillos to humans by droplets or direct contact.[1,2]
The susceptibility to getting leprosy may be due to certain human genes hence the reason why it usually appeared in families over the centuries and was believed to be a family trait. Due to its highly contagious nature persons suffering from the disease were isolated on colonies.[1,2]
Antibiotics can be used to treat leprosy. Due to the increased development of resistance to antibiotics used to treat the disease such as dapsone, The World Health Organisation (WHO) introduced a multidrug regimen in 1981 that includes rifampicin, dapsone, and clofazimine. Some clinical studies have also shown that certain quinolones, minocycline, and azithromycin have activity against M leprae. WHO recommends the use of the long-term multidrug regimens for both paucibacillary and multibacillary leprosy.
The Multidrug therapy still does not alter the disfiguring effects of the disease which has occurred to the patient.[1,2]
Vaccines against leprosy including those using Mycobacterium leprae, as well as other mycobacteria, are under investigation. Leprosy vaccines are being studied both to prevent infection with M. leprae as an immunoprophylactic approach to prevent disease in infected individuals and as a therapeutic approach via the immune system (immunotherapeutic). The investigation into the creation of a vaccine against leprosy is based on the theory that once the cell-mediated immune response is triggered then this will result in protection against the agent causing leprosy (Mycobacterium leprae). [3]
A killed vaccine has been developed in India for use as an adjunct to standard multidrug therapy in the treatment of leprosy. Although studies of new vaccines are continuing, quite a few vaccines have been studied including,
Bacillus Calmette-Guerin (BCG), plus heat -killed Mycobacterium leprae. The findings point to the fact that BCG vaccine, which is inexpensive and widely available, is effective against leprosy and this has important implications for leprosy control.[3] BCG presently is referenced as a preventative treatment approach for leprosy in areas with high incidences and may be given to infants, children and adolescents.[4] Our Jamaican population is quite familiar with the inoculation of new-borns at six week clinics.
In Jamaica presently, we as a nation will be pleased to know that cases have gone from nine in 2005 to zero in 2020 according to the statistics obtained from our local reports and displayed by the Global Health Observatory[5] (see fig 1)
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| Figure 1 |
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As i read this piece i cant help but to think how there is nothing new under the sun, there is something about us human being,we are facinated by things abnormal,in biblical times leprosy was abnormal, no one did have a clue as to its,causes except to know that it was a plague, and those who was infected would cry out from a safe distant," unclean unclean!!!" So that those pasing could keep their distance,today we refer to same as social distancing,again nothing new under the sun.
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