Leprosy - surely a disease of the past ?

[Doc Alan]

Unfortunately not so . There are up to a quarter of a million new cases in tropics and subtropical areas of the world each year. Numbers HAVE fallen dramatically in the past 2 decades - from over 20 / 10,000 to less than 1 / 10,000 at global level. India, Brazil, Congo, Mozambique and Nepal have high case rates.


• NOT highly infectious, being transmitted by droplets from nose and mouth, during close contact with untreated cases.


• Mainly affects skin, nerves, upper air passages, and eyes.


• Diagnosed clinically ( with skin samples ).


• Curable with multidrug therapy ( dapsone, rifampicin, and clofazimine ). No known drug resistance ( so far ).


• Two main types – “ lepromatous “ ( commoner, many “ bugs “ present ); and “ tuberculoid “ ( few “ bugs “ present ). The “ bug “ causing leprosy is related to the tuberculosis “ bug “ and in fact BCG vaccination may give about 50% protection.


• There may be about 2000 new cases / year of leprosy in the Philippines.


• Free treatment is available in the Philippines, provided by the Swiss healthcare company Novartis, working with the Department of Health and World Health Organization. Novartis is committed to drug donation until 2020. Obviously cases need to be found and diagnosed – there is a " Kilatis Kutis ( skin screening ) Campaign " . Childhood / newborn BCG vaccination is also free.


• A leper colony was formed in 1904, on the island of Culion, in the northernmost chain of Palawan islands.



• In this more enlightened age, treatment is free at health centers, and :-
East Avenue Medical Center in Quezon City;
Jose Reyes Medical Center in Manila;
Makati Medical Center ;
Ospital ng Maynila ;
RITM in Muntinlupa ;
Quirino Memorial Med Center ;
St. Luke's Medical Center ;
Southern Philippines Medical Center in Davao ;
UST Manila ;
UE Ramon Magsaysay Memorial Medical Center ;
and Philippine General Hospital.


• Leprosy should be understood and not feared – if it’s diagnosed early and treated properly people affected should lead normal lives – including travel - without discrimination .


http://www.who.int/mediacentre/factsheets/fs101/en/


http://www.abs-cbnnews.com/lifestyle...e-wiped-out-ph


http://www.wpro.who.int/philippines/..._programme/en/

[les_taxi]

Good posts, always informative.

[Doc Alan]

Over 200,000 people worldwide - and 2,000 in the Philippines - are STILL diagnosed with leprosy each year. It’s completely curable through a course of multidrug therapy, lasting 6 months to a year. Treatment is free - but seemingly many are unaware it’s available. There is also still an associated stigma, with discrimination and even violence experienced by sufferers with the disease. It’s one of World Health Organization’s " neglected tropical diseases ".


The number of new cases diagnosed varies across the country - Ilocos Sur and southern Mindanao having a relatively high number - about a third are female and children account for less than a tenth.


For over 20 years World Health Organization has provided free worldwide treatment through an " agreement " with Novartis Foundation.


Novartis and the Department of Health has helped set up the country’s first mobile phone-based leprosy detection system, which allows frontline healthcare workers to send clinical images and histories of suspected leprosy patients to specialists. This should help accurate diagnosis and prompt treatment.


The diagnosis still relies on clinical signs and symptoms, but Novartis ( again ) is supporting research into immunological " biomarkers " for laboratory diagnosis.



Leprosy is NOT highly infectious - it’s thought to be transmitted by droplets from nose and mouth during close and frequent contact with untreated cases. There has been success in its treatment, with over 16 million patients treated and a dramatic decrease in numbers in the past 20 years.


Leprosy is an age-old disease, described in ancient civilizations, and throughout history sufferers have been ostracised by their communities and even families. The first breakthrough was with " Dapsone " in the 1940s, which required many years of treatment, before " multidrug " treatment became available in the past 50 years.



The Culion Leper Colony was located on an island in Palawan province and established by the US government, in an attempt to rid leprosy from the Philippines by the only known method at the time - isolating all known cases. During the last century Culion declined as a leprosarium, with better understanding and management of the disease at regional levels. World Health Organization declared it free of leprosy over 10 years ago and it’s now a tourist destination.


Leprosy has been known in the Philippines since the Spanish first " discovered " the country in the 16th century. The San Lazaro Hospital in Manila was founded and admitted leprosy patients at this time. It was made into a contagious diseases hospital by the Americans in 1898, and is now a referral centre for communicable diseases.


My iconic photo shows a protest over 80 years ago by around 300 leprosy patients at San Lazaro Hospital, in which a patient ( standing up, front row ) may be seen pointing out that leprosy was NOT highly contagious and there was no need for segregation. He was correct, well ahead of his time , but they were still " forcibly marched back to their quarters by police reserves " :-

[Arthur Little]

Having been "plagued" for many years now with unsightly, scaly *psoriasis on my knuckles, elbows & legs, I used to wonder ... whether *this disease was/is by - ANY (NOT so remote) chance - related to leprosy.

[Doc Alan]

Having been "plagued" for many years now with unsightly, scaly *psoriasis on my knuckles, elbows & legs, I used to wonder ... whether *this disease was/is by - ANY (NOT so remote) chance - related to leprosy.

Leprosy and psoriasis are unrelated conditions - apart from both affecting the skin.


Psoriasis is in fact a relatively common condition worldwide ( affecting at least 2% of males and females in UK and also the Philippines ). Psoriasis is not an infection, but a chronic overproduction of skin cells ( resulting in crusty and flaking patches often on elbows, knees, scalp and lower back ). It’s probably the result of over-production of " messenger " proteins by the immune system. It may be complicated by joint inflammation ( arthritis ). There’s a range of treatments, depending on areas affected and severity.