:: [ What is Leprosy? ] :: Last updated 21 Nov 97

Leprosy is a mildly infectious disease caused by a bacteria, Mycobacterium Leprae. The disease mainly affects the skin and peripheral nerves. This disease is known since ancient times and fears and myths surrounding the disease have persisted to the present time. Over the past fifty years we have made considerable progress in the understanding and treatment of the desease.

Where is Leprosy found?

The disease is prevalent in many of the tropical and subtropical regions of the world. There may be as many as 15 to 20 million cases of leprosy world wide. The number of new cases of leprosy in Singapore is steadily declining and we get about 30 new cases a year.

How is the disease is transmitted?

The germs are transmitted by droplets when an infectious leprosy patient coughs or sneezes as in tuberclosis. Not everyone exposed to the bacteria develop the disease. Most people have natural immunity and are completely immune to the infection. A few who have some or no immunity to leprosy develop clinical disease after an incubation period varying from 3 to 20 years.

Signs of Leprosy

Leprosy may present with:-

• One or more slightly whitish hypopigmented or reddish patches which may have loss of sensation.
• Impairment of sensation (numbness) with or without paralysis of fingers, toes, limbs or legs
• Thickened nerves which may be painful.
• Thickened patches which are flat or raised over face and body

Types of Leprosy

There are two main types of leprosy:

1. Where the patient shows no immunity to the germs

2. Where the patient shows some immunity. Those who have no immunity develop multi-bacillary (many germs) or lepromatous leprosy. Those who have some immunity develop paucibacillary (few geerms) or tuberculoid leprosy.

Treatment of Leprosy

Leprosy is curable. We now have effective drugs to treat the disease. The paucibacillary leprosy is treated with two drugs (Rifampicin and Dapsone) for 6 months. Multibacillary disease is treated with 3 dugs (Rifampicin, Dapsone and Clofazimide or Ethionamide) for 24 months or more. Rifampicin rapidly kills the bacteria within days so that patients on treatment rapidly become non infectious, although the body take some time to clear the dead germs. New and effective drugs like Oflozacin, Minocin and Clarithromycine are being introduced and may further shorten the length of treatment. Early treatment can prevent defomities from nerve damage.

Where is Leprosy treated?

Leprosy patients are treated as out-patients at the National Skin Centre In Mandalay Road. Those who develop foot-ulcers or other medical complications that need admission are treated in the Communicable Disease Centre, Moulmein Road.

Rehabilitation in Leprosy

Nerve damage may be prevented if the disease is treated early. patients have to be taught to protect their limbs from injuries like burns or scalds id they have sessory loss. Reconstruction surgery like tendon transfers can restore motor function to paralysed limbs. The community should accept these patients and support them in every way.