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Undoubtedly
no disease has cast such an intense social stigma over its sufferers
as Hansen's Disease - commonly known as Leprosy. Leprosy
has afflicted humanity since time immemorial. It once affected every
continent and it has left behind a terrifying image in history and human
memory - of mutilation, rejection and exclusion from society. Leprosy
has struck fear into human beings for thousands of years, and was well
recognized in the oldest civilizations of China, Egypt and India. A
cumulative total of the number of individuals who, over the millennia,
have suffered its chronic course of incurable disfigurement (see images
below) and physical disabilities can never be calculated.
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Appalling Images courtesy the National Library Of Medicine
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Bacterial
Leprosy is a chronic infectious disease caused by Mycobacterium
leprae, an acid-fast, rod-shaped bacillus. The disease mainly affects
the skin, the peripheral nerves, mucosa of the upper respiratory tract
and also the eyes, apart from some other structures. When M.leprae
was discovered by G.A. Hansen in 1873, it was the first bacterium to
be identified as causing disease in man. Although Leprosy is contagious,
it is not widespread because 95% of the population have immune systems
able to cope with the bacteria.
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Leprosy
usually starts as a slightly light colored patch desensitized to pain,
touch or temperature. The patch can be found anywhere in the body. Nerves
near to these patches and at the joints are swollen when affected. In
the majority of patients, the disease progresses without any deformity.
In a few patients the involved nerves become damaged. When improperly
treated, the nerve damage is severe and may lead to deformities of hands,
feet and eyes. These deformities occur due to loss of sensation and
a break in the communication between nerves and muscles. Loss of sensation
results in unusual injuries and ulcers. The eyes are affected in a few
patients with prolonged disease.
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Treatment
for leprosy only appeared in the late 1940s with the introduction of
dapsone, and its derivatives. Leprosy bacilli resistant to dapsone gradually
appeared and became widespread. In 1997, there were an estimated 1.2
million cases in the world, most of them concentrated in South-East
Asia, Africa and the Americas. It is estimated that there are between
one and two million people visibly and irreversibly disabled due to
past and present leprosy who require to be cared for by the community
in which they live.
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Turn of the century
leprosarium in Jerusalem
