Understanding Leprosy: Symptom, treatment, and care for the Naga

DIPR
Dimapur, June 17

Leprosy is an infectious disease that causes severe disfiguring, skin sores and nerve damage in the arms and legs. The disease has been around since ancient times, often surrounded by terrifying and negative stigmas with tales of leprosy patients being shunned as outcasts. Outbreaks of leprosy have affected and panicked people on every continent.
The oldest civilizations of China, Egypt and India feared leprosy as an incurable, mutilating, and contagious disease. However, leprosy is actually not that contagious. One can catch it only if he or she comes into close and repeated contact with nose and mouth droplets from someone with untreated leprosy. Children are more likely to get leprosy than adults.Leprosy is a chronic infection caused by Bacteria, Mycobacterium leprae and Mycobacterium lepromatosis. It mainly affects the peripheral nerves and skin. Initially, infections are without symptoms and typically remain this way for five to as long as twenty years. Symptoms that develop include granulomas of the nerves, respiratory tract, skin and eyes. This may result in a lack of ability to feel pain and thus loss of parts of extremities due to repeated injuries. Weakness and poor eyesight may also be present.
Leprosy is spread between people and is believed to occur through cough or contact with fluid from the nose of an infected person. The two main types of disease are based on the number of bacteria present namely pauci bacillary and multi bacillary.
How to suspect Leprosy
The main symptom of leprosy is disfiguring skin sores, lumps or bumps that do not go away after several weeks or months. The skin sores are pale-colored.
The skin lesion can be single or multiple, usually less pigmented than the surrounding normal skin especially on ear lobes, face, trunk, arms and legs. Sometimes the lesion is reddish or copper-coloured. A variety of skin lesions may be seen but macules (flat), papules (raised), or nodules are common. Sensory loss is a typical feature of leprosy.
The skin lesion may show loss of sensation to pin pick and/or light touch. Thickened nerves, mainly peripheral nerve trunks constitute another feature of leprosy. A thickened nerve is often accompanied by other signs as a result of damage to the nerve. These may be loss of sensation in the skin and weakness of muscles supplied by the affected nerve.
If such symptoms are noticed in a person, he or she should be taken to the Primary Health Center for confirmation of leprosy by the Medical Officer.
Is leprosy curable?
Leprosy is curable and can be cured if complete treatment (MDT) is taken regularly by the patient. The treatment of Leprosy is free of cost and is available at all Government Health Facilities (Centers).
There are two group leprosy cases for treatment namely Pauci Bacillary (PB) – 1 to 5 skin patch and Multi Bacillary – more than 5 skin patch.
In the case of Pauci Bacillary, a 6 monthly doses (to be completed in 9 months) treatment is prescribed while the Multi Bacillary is a 12 monthly doses (to be completed in 18 months) treatment.
There can be some cases of reaction during the course of treatment. If the patches become red, swollen, warm and painful one should refer to the PHC Medical Officer.
How to Monitor
Visit the patient under treatment every month to ensure about the drugs taken by checking the MTD packet. If the treatment is taken irregular or discontinued, refer the patient to the Medical Officer PHC to restart the treatment and ascertain the reasons.

Self care practices
• Soak the hands/feet for about half an hour in lukewarm water
• Apply cooking oil when hands/feet are wet
• Protect hand against heat and friction
• Use MCR footwear for anesthetic feet and walk slowly with short steeps
• Clean the wound with soap and water. Dress with clean cloth
• Check eyes daily using mirror
People with leprosy who take medicines given to them at healthcare centers regularly have less chance of disability. Take medicine every day, even if the patches look better. Medicines for leprosy can cure the disease completely.