31^st January, 2008

Messala: “Look for them in the Valley of the Lepers, if you can recognize them”.

Judah: “I have just come from the Valley of Stone. My mother and sister live what's left of their lives. By Rome's will, lepers, outcasts without hope..”.

- ‘Ben-Hu’r (the movie, 1959)

On the fourth Sunday of each January, many pause to ponder on the scourge, that once haunted the world and, which continues to exist unshackled in certain parts of the globe  - leprosy. The day was set apart in honor of a Belgian priest, Father Damien, who gave his life ministering to the shunned lepers of Molokai, a Hawaiian Island.

Though eradicated in many nations, this neglected, tropical disease is still prevalent in several countries such as India, Mozambique, Brazil, Angola, Central African Republic, Democratic Republic of Congo, Madagascar, Nepal, Tanzania and China.

 The Disease

Leprosy, or Hansen’s disease, is one of the oldest recorded diseases in the world. It is a chronic, infectious ailment which targets the nervous system, particularly the nerves of the hands, feet and face.

 Leprosy is caused by the bacteria, Mycobacterium leprae, which is similar to the one causing tuberculosis. The disease spreads mainly through air-borne bacteria, expelled from an infected person or through long-term contact with an infected individual.

Other potential sources of Mycobacterium leprae include soil, bedbugs and mosquitoes.

Symptoms 

It is an established fact that about 95 percent of people who are exposed to Mycobacterium leprae do not develop leprosy. This is because their immune system fights off the infection.

Among those affected, the infection could vary from a milder form known as tuberculoid leprosy, which is not contagious, to a more severe form lepromatous leprosy.

Characteristic symptoms include-

• The presence of cuts on the body 
• Loss of sensation, beginning at the fingers and toes.
• External injuries result from loss of sensation which in turn get infected.
• In severe cases, gangrene may set in and the flesh may rot on the patient leading to loss of body parts.

It is in this manner that leprosy leaves its victims deformed, with severe disabilities. This happens mainly due to a lack of timely treatment. This disfiguring is probably one of the reasons that led leprosy victims to be shunned and feared by others, throughout the ages.

Disease symptoms are manifested at least a year after a person has been infected. This is because the bacteria that cause leprosy multiply very slowly.  The symptoms generally appear 5 to 7 years after infection as characteristic rashes and bumps. These could be without sensation and whitish in color. Facial skin infection can lead to areas of swelling and lumps, which disfigure the face. Some victims develop sores on the soles of the feet and suffer damage of the nasal passages, which could even lead to a complete loss of the nose.

Diagnosis

Even today it is difficult to diagnose the disease with precision. Diagnosis is usually made on the bases of -

• Distinctive and persistent skin rashes,
• Loss of the sense of touch and
• Deformities resulting from muscle weakness.