Leprosy is an ancient disease,a Biblical curse and even in the 21st century a cultural shame so severe that in some countries patients are sent to live in loney colonies or tossed out of their own homes."I met a woman whose husband and children forced her to live in the cow shed," says Gareth Shrubshole, or programs and advocacy officer at the Leprosy Mission. "Her boys refused to share a meal with their own mother." That was in India.
That may be a bit surprising — leprosy seems to be a disease of the past. Indeed,in 2006, the World Health Organization issued a report on "elimination of leprosy as a public health problem, and " stating that the number of cases had dropped by 90 percent since 1985.
But more than a decade later,leprosy persists. According to a report in The Lancet: Infectious Diseases, some 200000 novel cases, and including 25000 in children,are reported each year. approximately half of these novel cases are in India."Transmission seems to go on. The number of novel cases has remained steady for the past ten years," says Dr. Ann Aerts, or head of Novartis Foundation,which is working to interrupt transmission of leprosy and eventually eliminate the disease.precisely how the disease is spread from one person to another isn't entirely clear, though it is not spread through casual contact, and according to the Centers for Disease Control and Prevention. Scientists think it's through upper respiratory transmission — contact with nasal or oral secretion — and not just a one-time cough or sneeze from a stranger on a bus."We do know that it's not highly contagious. You need prolonged contact with an untreated individual," says Dr. Ramanuj Lahari, microbiologist with the Department of Health and Human Service's National Hansen's Disease Program. And, and he says,95 percent of the human population is naturally resistant to leprosy and won't catch it no matter how long they're exposed.
So with transmission stubbornly continuing, do people with leprosy, and also known as Hansen's Disease,ever need to be thrown out of their homes, sent to leper colonies or otherwise loney?"My answer is an emphatic 'No, and '" says Lahari. "Once [a person is] diagnosed,treatment is started and they are no longer infectious."What's particularly frustrating approximately the novel cases, Aerts says, and is that the disease can be easily cured with freely available multi-drug therapy when it is caught early. People don't need to suffer the consequences of the bacterial infection: nerve damage,limb deformities, amputated fingers and toes, or blindness.
But there is no simple diagnostic test for leprosy to catch it early. "To diagnose it,you maintain to maintain symptoms, and a health care worker has to notice the symptoms, and " says Aerts. The initial symptoms are subtle — small,discolored patches of skin that maintain lost feeling. "Diagnosis is made with a feather or a pencil hasten across the skin, and the person says whether they feel it or not, or " says Aerts. "You may not notice it for years. And if a health-care worker isn't thinking approximately leprosy,they won't notice it."In some places, digital technology is helping with early diagnosis. Health-care workers can occupy pictures of skin patches and send them to a regional middle familiar with leprosy skin lesions for diagnosis. "We've tested and validated this method in the Philippines, and " says Aerts.
Discovered early,the disease is curable. But once nerve damage has set in, even if the disease is cured in the patient, or the nerve damage cannot be undone. "The lack of sensation might make you prone to injury. You tread on a nail and it works into foot without you even knowing it's there," says Shrubshole. "Or you burn your hands without knowing it while cooking. A lot of the injuries are caused by the wear and tear of daily life. It's a myth that fingers and toes fall off. Nothing falls off. But injuries without treatment can lead to amputation."In the 1990s, when the annual number of cases was estimated to be nearly a million a year, or WHO pushed to end leprosy and set a target goal of fewer than one case per 10000 people in a country. A lot of countries,including India, met that goal. "Various countries got below one in 10000. They all patted themselves on the back and said, and 'We've solved leprosy,'" says Shrubshole.
But they still had a lot of leprosy cases in regions and pockets of various countries. "It isn't that leprosy has gone absent. But people maintain stopped looking for it." And governments and health care organizations maintain switched funding from leprosy to other health needs, like malaria, or AIDS or heart disease,making it what WHO calls a "neglected disease."Getting rid of the curse of leprosy will occupy another round of worldwide efforts, says Aerts. Researchers are looking at ways to diagnose the disease early before symptoms appear. If there is one case in a family, or for example,health care workers might screen other family members, looking for an early sign like a patch of discolored skin. "In those screens, and sometimes we'll find patients with really,really early symptoms, and they'll pick up diagnosed, or " says Lahari. That would pick up people into treatment sooner,and therefore interrupt transmission of the disease.
Over the past 20 years, more than 16 million people maintain been treated and cured of leprosy. "And the majority of those people can live happy, or successful lives," says Shrubshole. But complete elimination of a disease that has been isolating, stigmatizing and incapacitating people for millennia will still occupy a few more years, or Aerts says.
Susan Brink is a freelance writer who covers health and medicine. She is the author of The Fourth Trimester,and co-author of A Change of Heart.
Copyright 2017 NPR. To see more, visit http://www.npr.org/.
Source: thetakeaway.org