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In details

Leprosy


Brazil is the second country with the highest number of leprosy cases in the world, second only to India. To reverse this situation, you need to know more about the disease.

Leprosy is an infectious disease that mainly affects the skin and nerves (especially those of the face and extremities, such as arms and hands; legs and feet). It is caused by a bacterium called Mycobacterium leprae, discovered in 1873. This bacterium is better known as Hansen's Bacillus, named after its discoverer, Norwegian scientist Gehard Amauer Hansen.

There are records of leprosy since ancient times. The disease was known as Leprosy. Infected people were discriminated against and forced to live outside society and suffered the consequences of their own disease. At the time without cure and without treatment, Leprosy caused deformities.

Today the situation is very different. Leprosy is curable and, if treated in the early stages, leaves no sequelae. In addition, the leprosy patient, when treated early, stops transmitting the disease in the first doses of the drugs. For this very reason there is no more reason for stigma or social exclusion. In any case, it is advisable to avoid using the term Leprosy, due to its high prejudice burden.

It is important to emphasize that cases diagnosed and treated late may present irreversible neurological and systemic (whole body) damage.

Transmission Forms

Leprosy can be transmitted by physical contact, but is usually spread by the airways after frequent contact with the sick person. That is, it is not enough a conversation or an eventual meeting to catch the disease. Intimate and prolonged contact with the sick is really necessary. To give you an idea, a person is considered suspected of having leprosy after a minimum contact of 5 years with the sick individual. This usually happens when the patient is part of the family and lives in the same house.

This shows that not all people who come into contact with Hansen's Bacillus get the disease. The bacteria often penetrates the human body, but is eliminated as most individuals have some degree of resistance. With permanent contact, the bacteria overcomes the organism “by tiredness”. Thus, after being inhaled, it reaches the upper airway respiratory mucosa. getting into the bloodstream and spreading to the skin and nerves.

When to see the doctor

See a dermatologist or go to the nearest Health Center if you notice nodules in the body or light or reddish spots on your skin, which may even form higher layers. This does not mean that you have leprosy, as other skin conditions have similar characteristics. You should only suspect leprosy if, in addition to injuries, you have permanent contact with people with the disease. However, it is important to seek a dermatologist for the proper treatment of blemishes according to the diagnosis.

Leprosy also causes loss of sensation as it reaches the conductive nerves of sensation. So be aware if areas with stains respond to thermal, painful and tactile stimuli. That is, make sure you feel the difference between cold and hot, if you can feel pain or even if you feel someone's touch.

It is quite rare, but there are cases in which Hansen's Bacillus strikes only the nerve. That is, there are no lesions on the skin, but the person has loss of sensation, besides tingling in the body and pain in the nerves of the arms, hands, legs and feet. Having any of these symptoms, seek medical attention.

summing up, are common symptoms of leprosy: tingling, nerve pain and loss of sensitivity to temperature, pain and tactile stimuli, as well as white or reddish spots. Depending on the affected nerve, there are other symptoms: loss of vision due to corneal injury; paralysis of the hand, which becomes "claw", changes in sweat; impossibility of flexion of the foot (it is "fallen").

Types of Leprosy

There are different clinical forms of leprosy, some more severe than others, that develop according to the response of each person's immune system. You do not need to memorize the names, but it is important that you know the appearance of the lesions.

Undetermined leprosy: most benign way. Usually, there is only one spot, lighter in color than normal skin, with decreased sensitivity. Most common in children.

Paucibacillary Leprosy: also benign and localized, occurs in people with high resistance to the bacillus. It is characterized by few spots or just one, slightly reddish, slightly raised (like a plaque) and well-defined boundaries. There is absence of tenderness, pain, weakness and muscle atrophy.

Multibacillary Leprosy: In this case the bacillus multiplies a lot, leading to a more severe picture. There is muscle atrophy, swelling of the legs and lumps on the skin. The internal organs are also affected by the disease.

Diagnosis

When you are in consultation with a doctor or health agent, show the injuries. Diagnosis of leprosy requires careful clinical examination. The healthcare professional may also request additional tests, all quite simple. Among them are:

  1. Research of thermal sensitivity, painful and tactile.
  2. Histamine test - made to check if your nerves have been hit. A droplet will be dripped onto your skin, followed by a puncture prick.
  3. Pilocarpine Test - to check for changes in the innervation of the sweat glands. It is an intradermal injection (that tiny one that reaches only the superficial layers of the skin).
  4. Bacilloscopy - examination to detect the presence of Hansen's bacillus after analysis under the microscope.
  5. Skin biopsy

Treatment

Leprosy treatment includes specific medication, as well as physical and psychosocial rehabilitation in the most severe cases (more advanced stages of the disease, when there are deformities and, in some cases, limb loss). The important thing is not to let leprosy reach the stages where rehabilitation is needed. Remember that there are no sequelae when leprosy is detected and treated early.

There are different medicines used according to the degree and form of the disease. It is a cocktail of antibiotics, distributed free of charge in health posts. They are pills of different colors, in packs. All these medicines can be used by pregnant women and people with HIV.

The treatment lasts from six months to two years. What determines the duration is the stage and form of the disease. The person is healed. Those who begin treatment are quickly contagious and no longer a danger to those close to them. Therefore, there is no need for social isolation.

Attention: do not interrupt the treatment! Irregular use of drugs, or insufficient doses, increases the patient's chance of becoming drug resistant and increases the chance of disease progression to later stages.

Prevention

Leprosy is a disease typical of poor regions, where low socioeconomic status of families leads to domestic overcrowding, facilitating the spread of the bacteria. Add to this less hygiene and malnutrition conditions, which make the body more susceptible to disease. Thus, improving the quality of life of populations is a way to prevent leprosy.

Another way to prevent leprosy is to treat sick people quickly, avoiding transmission to other family members. In this case, it is very important for people to be informed about leprosy and its treatment so that they can quickly seek medical attention or encourage their acquaintances to do so.

There is a vaccine that helps protect against leprosy: it is the BCG, which is part of the childhood vaccination calendar. When a person in the household has leprosy, all residents should seek medical attention for clinical examination and vaccine application.