Leprosy: Causes, Symptoms & Treatment By Alina Bradford, Live Science Contributor

Leprosy causes deformaties of the skull, seen in this medieval skull from Winchester, UK.
Credit: Image courtesy of University of Winchester
Chances are, the mention of leprosy brings to mind skin falling from the bone and people cast away into quarantined colonies to prevent outbreaks. While this may have been a reality for those in the past, modern technology and treatments have made this disease a little less scary.

Cause

Leprosy is a contagious, chronic disease caused by Mycobacterium leprae, a rod-shaped bacterium. The disease is also called Hansen's disease, after a Norwegian doctor, Armauer Hansen. Hansen was the first to discover the bacterium that causes leprosy and published a paper on it in 1873, according to an article in the Indian Journal of Dermatology.

Leprosy affects not just the skin, but also the peripheral nerves, mucosa of the upper respiratory tract and the eyes. If left untreated, the disease can be debilitating and cause muscle weakness, disfigurement, permanent nerve damage in the arms and legs and loss of sensation in the body.

There are two common forms of leprosy: tuberculoid and lepromatous. Lepromatous is more severe and can causes large lumps and bumps on the body.

Though it is contagious, Hansen's disease isn't highly infectious. This disease is transmitted through droplets expelled by sneezes and coughs or by coming in contact with nasal fluids on surfaces. Just touching someone with the disease usually doesn't cause infection, as previously thought.

Normally, a person's immune system can prevent infection. Children are more at risk for contracting leprosy than adults, according to the U.S. National Library of Medicine (NLM).

Leprosy has been in the news lately — but is it coming back, or has the disease always been around and people just didn't talk about it? "In 2000, it was declared 'eliminated as a public health problem' at a global level and by 2005 it was eliminated in many countries," said Dr. Paul Saunderson, medical director of American Leprosy Missions. "This is why leprosy may receive less news coverage and certainly that could be the case for developed countries. However, there are still 14 countries worldwide that are highly endemic for leprosy or have pockets which are highly endemic and new infections still occur in about 100 countries. There is some news flow from these countries and today, leprosy NGOs all over the world are supporting a final, increased commitment to rid the world of leprosy."

According to the World Health Organization (WHO), official figures from 121 countries showed 213,899 new cases of leprosy were reported in 2014. About 100 cases per year are diagnosed in the United States, usually in Hawaii, California, the U.S. Virgin Islands and Guam, according to the NLM.

Symptoms

The bacterium that causes leprosy grows very slowly and can take two to 10 years before signs and symptoms appear, according to the Centers for Disease Control and Prevention (CDC).

Some symptoms may include:

Growths on the skin
Numbness or lack of feeling in the hands, arms, feet and legs
Enlarged nerves (especially around the elbow and knee)
Nosebleeds and/or a stuffy nose
Lesions on the body that are not as sensitive to touch, heat or pain
Skin lesions that are lighter than the person's normal skin color
Lesions that do not heal after several weeks to months
Ulcers on the soles of feet
Thick, stiff or dry skin
Severe pain
Muscle weakness or paralysis (especially in the hands and feet)
Eye problems that may lead to blindness
Diagnosis & treatment

Early detection and treatment of leprosy is key. If it is caught and treated quickly enough, the disease usually is not debilitating. Typically, the medical professional will order a skin test, either a skin-lesion biopsy or a skin-scraping examination, to test for leprosy.

Once the diagnosis is made, antibiotics, such as rifampin, dapsone, fluoroquinolones, clofazimine, macrolides and minocycline, are used to kill the bacteria. The diagnosis may include more than one antibiotic. Prednisone, aspirin or thalidomide may be prescribed to control inflammation, according to the NLM. More than 16 million leprosy patients have been treated with multi-drug therapy (MDT) over the past 20 years, according to the CDC.

People once were isolated from the rest of the population to prevent the spread of leprosy. That isn't the case today. "This is because in 1980s multidrug therapy was introduced that provided a rapid and complete cure for leprosy," said Saunderson. "Until then, people who were diagnosed or who had symptoms of leprosy were often banished from their communities to live in leprosaria [leper asylums]. Despite this cure for leprosy, the stigma of leprosy, especially for those people who have been diagnosed late and have developed visible impairments, is still considerable. Although multidrug therapy is very good once it is started, the incubation period of leprosy is very long (several years), so transmission still continues before a person is diagnosed and put on treatment."

The dead bacteria may also stay in the body for several years, even after the treatment is finished. "It can take up to six years for the bacilli to be completely cleared from the body, although the bacilli will be dead after just a few doses of multidrug therapy," said Saunderson. "This explains why reactions can continue to occur long after multidrug therapy has been completed. We think the reason for this is the nature of the mycobacterial cell wall, which is very complex and constructed from various lipids, etc., which hang around and have to be removed bit by bit by the immune system."

Additional resources

Scientific American: Armadillos Likely Transmitting Leprosy to Humans in Southern U.S.
American Leprosy Missions
National Institute of Allery and Infectious Disease: Leprosy
Editor's Recommendations

6 Strange Facts About Leprosy
Leprosy: History of a Bacterial Scourge | Medieval Diseases
Armadillos Carrying Leprosy Bacteria Spreading in Southern US

Read More »

17-Year Old ‘Aminata’ tells her Heartbreaking Story of being Kidnapped & held for Two Years by Boko Haram

Two years ago a 15-year old ‘Aminata’ was taken by Boko Haram against her will and forced to marry an insurgent. She had no choice but to live with the insurgents, for two years, until she finally managed to escape. She is now an internally displaced person (IDP) living in one of many camps established in north-eastern Nigeria and in this interview with UNICEF’s Kent Page, ‘Aminata’ shares her heartbreaking story of suffering and fear while she was held captive.

According to UNICEF, more than 7,000 women and girls have been held and subjected to violence by Boko Haram. Most are believed to have been raped or forcibly ‘married’ to their captors, and many, like Aminata, became pregnant as a result.

Read the story of ‘Aminata’ below.

I came in contact with Boko Haram insurgents in my hometown in Borno State, north-eastern Nigeria. They saw me at my uncle’s house during their first attack on our town. I have lived with my uncle since I was two years old. My biological father and family live in Cameroon.

Boko Haram invaded the town and convinced my uncle to join them. They also asked if there were any girls in his compound. They offered 1,000 naira for each girl.

I was sitting next to my grandmother when they dragged me to a car. They took me to an unknown location outside my town. They had taken me and another 14 girls from my neighbourhood. I was held there for two months and then I was forced to marry one of the insurgents. Before you marry an insurgent, you are a maid. You wash plates and cook for the insurgents. But when you get married, you become a wife and also focus on only him.

The ‘wedding’ had nothing. There was no clothing, no lotions, no creams, no presents. It was just in my old clothes that I went to the house of my ‘husband’, which was just a hut with a room in it. That was where we lived. And every time he wanted to have sex I refused, and then he would rape me and beat me up. I cannot count the number of times he has beaten me.

I lived there with the armed group for two years. It was a very bad experience. I have witnessed terrible things, including the slaughtering of women in a town by the insurgents. They killed women who refused to marry them. Once they caught someone who had married another wife without telling them. They buried him up to his head in the ground. Then they stoned his head until he died. It was a public punishment that we were forced to watch.

In some villages, when they attack, they steal cattle and sell it off before feeding their wives and children. We didn’t ever have enough food. And any food we did get, didn’t have any condiments. The insurgents have to steal food from villages or attack villages before we eat. They don’t have any food.

My insurgent ‘husband’ had three wives before me who had become suicide bombers. But he decided he wanted me to remain as his ‘wife’. But two weeks later, he married another wife. I was very scared.

My ‘husband’ told me that if he decides or wants to, he will send me and my co-wife to town as suicide bombers. I was so scared. Three days after that, I told one of the women that I was going to a nearby village to visit my grandmother.  My ‘husband’ gave me three days for the visit.

I was with my grandmother in that village when the military arrived to fight the insurgents. After the fighting, the military took me with them to Bama. I was in Bama with the military for a month before I was brought here. My uncle and his brothers are still with the insurgents, and I have seen them carry out terrible acts, including killing people.

I really miss my family, and I wish I could see them again. We have been separated for too long. They live in Cameroon. I sincerely hope that everyone who has been taken like me can leave Boko Haram and be reintegrated back into society. My co-wife used to tell me to stop thinking about my parents, but she also said, “Don’t worry, you will find them one day.” I hope it is true.

I have been living as an IDP here in this camp for four months. I am pregnant. When I discovered I was pregnant, I was so unhappy, because it was my ‘husband’ who did it. The pregnancy is very difficult for me. But people here in the camp have been kind. People ask me how I escaped, and when I tell them, they say “Thank God you escaped!”

It is good, because although people know I was with the insurgents, so far no one has treated me badly. I live with people from my LGA [local government area] here in the camp, and they understand and treat me well. They have been very supportive. I only have a craving for certain foods which I cannot get here, and to see my family.

I hope to get married one day in the future. And to start a business. But, because I have never been in school, I cannot start doing that now, unfortunately. I also want villagers who had to flee the conflict to remain here for a little while and not rush back to their towns and villages to resettle. We suffered there tremendously.

But I am still happy. I am extremely happy I am no longer with the insurgents. I want to thank all the people who have helped me. All I want now is to see my family again.

***

UNICEF, in collaboration with International Alert, provides psychosocial support for girls and women who have experienced sexual violence, and for children born as a result. UNICEF also provides psychosocial support for children and families affected by conflict in Nigeria, including through child-friendly spaces, psychosocial training of teachers, and education, in protective and safe learning environments, for children like Aminata.

Read More »

High-Potency Pot Doubles Risk of Marijuana Dependence By Sara G. Miller, Staff Writer

 

The more potent the pot is, the more likely a person who uses it is to become dependent on it, a new study from the United Kingdom finds.

People in the study who used "high-potency" marijuana were twice as likely to become dependent as those who used lower-potency forms of the drug, according to new findings presented today (Oct. 21) at the International Early Psychosis Association meeting in Milan. The findings have not been published in a peer-reviewed journal.

People are considered to be dependent on marijuana if they experience withdrawal symptoms — such as irritability, mood and sleep problems, and decreased appetite — when they are not using the drug, according to the U.S. National Institute on Drug Abuse (NIDA).

The potency of marijuana refers to how much tetrahydrocannabinol (THC)is found in the plant. THC is the main psychoactive ingredient in marijuana. In the past decade, strains of marijuana that have higher amounts of THC have become more widely available, according to the study. [11 Odd Facts About Marijuana]

"Our findings suggest that people who prefer [high-potency marijuana] are around twice as likely to show problematic use," Tom Freeman, a research associate in clinical psychopharmacology at University College London and a co-author of the study, said in a statement. 

"The best way for people to reduce [their] risk [of dependency] is to quit or cut down their use," Freeman said. "If this is not possible, they should be encouraged to switch to low-potency cannabis."

In the study, the researchers looked at data from more than 400 adolescents and young adults in the U.K. who use marijuana. The ages of the participants ranged from 16 to 23.

The researchers found that 43 percent of the participants who preferred high-potency pot were dependent on the drug, compared with 22 percent of the participants who did not prefer high-potency pot. The researchers looked at a number of factors, including age, gender, marijuana and tobacco use, how much marijuana the user was exposed to, and how much THC was in the marijuana they used.

In an earlier study, published in 2015 in the journal Psychological Medicine, Freeman and his co-authors concluded that high-potency-marijuana use was associated with more severe dependency on the drug, compared with lower-potency-marijuana use. 

In the U.S., 4.2 million people abused or were dependent on marijuana in 2014, according to NIDA.

Read More »

‘The Ugliest man’ Contest Set To Hold In Zimbabwe Next Month? (Photos)

Despite difficulties in securing funds to sustain the pageant, organizers of Mr Ugly Zimbabwe have insisted that it will be held on November 25.

They say this year is exceptional because a lot of sponsors have come on board and preliminary contests are ongoing in other regions before the main event.

“Mr Ugly pageant is on. The sponsors are there. We have active sponsors, who have come on board … Harare is big and has a lot of people, hence we are having contests in a number of suburbs,” the founder of the pageant, David Machowa told local newspaper News Day.

 

Mison Sere, the 2015 champion caused a wild uproar after he was crowned for the first time with other participants complaining that he was too handsome for the title.

The contest which gained popularity in 2012 was won on multiple occasions and for the first time that year by William Masvinu, who is a porter and the runner up in last year’s competition.

The 2015 champion Mison Sere won $500 and the runner up took home $100. Both of them have joined the preliminary contest and hope to win this year.

Read More »