Leprosy is a non-hereditary disease, wherein the virus attacks the skin and the nervous system. Doctor Gerhard Armauer Hansen from Norway discovered the leprosy bacterium (mycobacterium leprae) in 1872. The culture of this virus in culture medium has not been successful to date; therefore, there is also no vaccine against leprosy.
The path of transmission is not known precisely. Poverty-induced living conditions – particularly in the countries of the "Third World" – are conducive to the infection. For this reason, leprosy also often afflicts undernourished and malnutritioned people, who must live in poor and confined living conditions. Leprosy is a disease of poverty and must always be considered in the context of the general living conditions of the affected persons. In the Middle Ages, leprosy was a serious problem in Europe as well. With the improvement of general living conditions, however, this „disease of poverty“ disappeared. Incidentally: Out of 100 persons in the world, 95 have an innate defence against the leprosy virus.
In simple words, there are two main forms of leprosy: an uninfectious form and an infectious form. In the uninfectious form, the patients suffer primarily from skin damages and affliction of the nerves. Thus, crippling of the hand, the leg or certain nerves of the eyes can occur. The disintegration of the eye nerves can lead to blindness. In the infectious form of leprosy, the virus multiplies very fast. The leprosy patients are infectious for long before they even notice that they are afflicted by the disease. Once it breaks out, the disease leads to the formation of boils and lumps on the skin, and nerve damages occur. The ulcers and deformities, which one often sees in leprosy patients, are seldom caused directly by the disease, rather, they are caused by nerve disintegration and the loss of sensation caused by it. A leprosy patient, who, for instance, does not have any feeling in his hands, sustains injuries or burns on his hands easily. This easily leads to infections, which are not taken note of sufficiently by the patient due to the lack of the sensation of pain. The infection can progress unimpeded, if left untreated, which can even lead to loss of limbs.
Purely from the medical point of view, the loss of sensation is especially problematic: A limited sense of touch as well as the lack of sensation in hands and feet lead easily to injuries and burns, which are either not noted or noted (too) late. Then, inflammations occur, which can often progress unimpeded and lead to the loss of limbs in the final stage. The affliction of the eyes can result in blindness. Particularly serious for the leprosy patients are the social problems, which are associated with the disease: even today, persons affected by leprosy are segregated from their former social environment. One reason for this is the deep-seated, irrational dread of a disease, which can deform a person so terribly. In the Middle Ages, leprosy was regarded even in our part of the world as «God‘s Punishment». A focus of the work is, therefore, also an intensive health declaration in the countries affected by leprosy, in order to dispel the existing fears associated with the disease through information.
WHO estimates 2.5 to 3 million leprosy patients. Every hour, 30 new leprosy patients are discovered worldwide. On an average, out of these 30 persons, two already suffer from severe disabilities, another four face loss of sensation. 5 out of these are children under fourteen years. The number of new infections lies currently around 260 000 persons per year and has remaines constant after a reduction in the years 2002-2004.
Primarily in the poor countries of the Southern hemisphere, leprosy is still a big problem. India is the worst affected with over 50% of all leprosy patients, followed by Brazil that stands for app. 40'000 new cases every year. Over 90% of new cases worldwide are found in 17 countries with more then 1000 new cases pre year. In Asia this concerns Bangladesh, China, India, Indonesia, Myanmar (former Burma), Nepal, Philippines und Sri Lanka. In Africa these countries are Angola, Democratic Republic of Congo, Ethiopia, Madagascar, Mozambique, Nigeria, Sudan und Tansania.
Yes, leprosy is curable with a drug treatment lasting 6 to 12 months. During this period, the leprosy virus is killed totally with the help of effective drugs. Since 1982, there are different combination therapies.
Through operation, physiotherapy, orthopaedic shoes, prostheses and other measures of medical rehabilitation, corrective help can be rendered. Permanent nerve damages, however, cannot be reversed. The number of persons, who remain disabled for life due to a leprosy affliction, is estimated at about 2 to 3 million worldwide.
For contracting leprosy, long-term, close contact with the infected person is necessary. The disease is caused by a bacteria related with the tuberculosis virus and plays practically no role in travel medicine. If there is an infection among travellers (e.g. development workers), it is, as a rule, easily curable through drug treatment, as far as there are no severe damages.
