Leprosy is a disease caused by a bacillus, Mycobacterium leprae, also known as Hansen's bacillus. It multiplies very slowly and the incubation period can be on average about five years.
What are the symptoms?
For many people the first signs of leprosy are pale patches of skin or numbness in the fingers or toes. This is because the disease mainly affects the nerves and skin. If left untreated, it can lead to nerve damage, loss of feeling (sensation) and paralysis of muscles in the hands, feet and face.
How leprosy can be transmitted?
Leprosy is transmitted via droplets, from the nose and mouth. Prolonged, close contact with someone with untreated leprosy over many months is needed to catch the disease. You cannot get leprosy from a casual contact with a person who has Hansen's disease.
Can leprosy be cured?
Leprosy is curable with multidrug therapy (dapsone, rifampicin, and clofazimine), a combination that kills the pathogen, cures the patient, and halts transmission.
This therapy is free of cost in all the countries of the Americas. If untreated, the disease can cause progressive lesions, leading to disability and blindness.
Early diagnosis and multidrug therapy are key to eliminate the disease
How can it cause disabilities?
The bacteria attack nerve endings and destroy the body's ability to feel pain and injury. Without feeling pain, people don't realize when they injure themselves their injuries are often severe and can become infected. Changes to the skin also leave the person susceptible to ulcers, which if left untreated, can cause further damage, wounds and visible disfigurements to the face and limbs. If the facial nerve is affected, this can interfere with a person's ability to blink, which can eventually cause blindness.
How many children have leprosy?
In 2016, 23 countries in the Americas reported leprosy cases and 1.761 children were diagnosed with this disease. Of those, 38 had visible impairments.
What is the most common age for children to show signs of infection?
The most common age for children to show signs of leprosy is between 10 and 14.
What's the most likely source of transmission for children?
Household contact is the most likely source of leprosy transmission. But this isn't limited to just family, it can include anyone in regular and close contact with an untreated person.
What do the child rates of leprosy tell us?
Transmission to children is an epidemiological indicator that the disease is still actively being transmitted through communities. The fact that children are still contracting leprosy tells us that we need to improve the number and efficiency of public health initiatives to stop the spread of this disease.
Is multidrug therapy safe for children?
Yes, it is safe. There have not been significant reports of adverse effects from treatments in children; however, dosages should be adjusted for their weight and smaller size.
Are there likely to be hidden cases?
Yes. Beyond the new cases that are reported annually, there are likely to be many more adults and children living with undiagnosed leprosy. Further, there are about 6 million people who have been cured of the disease, but experience residual effects such as disability and discrimination. The majority, of all new cases (81%) occur in three countries: India, Brazil and Indonesia - which are the most highly endemic countries for leprosy.
Wasn't leprosy eliminated?
The World Health Organization declared leprosy 'eliminated as a public health problem' at a global level in 2005. This was based on a definition of less than one case per 10.000 people at the national level. This did not mean total eradication of the disease, and there were still many cases in pockets all over the world. However, once the target was reached, resources at the country level were often focused on other diseases and efforts to find and treat new cases diminished. The situation is that 27.356 new cases were diagnosed in the Americas in 2016.
Leprosy is closely linked to poverty. The stigma still associated with leprosy remains a barrier to ending transmission, as people are often reluctant to get diagnosed or seek help. It can also have a devastating impact on people's lives, long after they have been cured.
¿Cómo ayuda la OPS/OMS a la región de las Américas en la eliminación de esta enfermedad?
The Pan American Health Organization/World Health Organization is working in partnership with the Ministries of Health, National programs, the International Federation of Anti-Leprosy Associations (ILEP) and other organizations, governments and policymakers towards achieving zero leprosy. We want to stop the transmission of leprosy, prevent disabilities and promote social inclusion by ending discrimination.
In 1992, PAHO/WHO began to promote the Regional Plan of Action for the Elimination of Leprosy in the Americas for coverage with multidrug therapy.
Since then, a 42% treatment coverage rate has been achieved and, since 2001, coverage has been almost universal. The Organization provides medication free of charge to all people who need it, through donations from the Novartis Foundation for Sustainable Development.
In 2016, the PAHO/WHO Directing Council adopted Resolution CD55.R9, which includes implementation of the plan for the elimination of neglected infectious diseases, including leprosy.