Leprosy forgotten but not gone

Nov 9 2008

According to scientists in the U.S. leprosy is a disease which may be forgotten, but it is still around.

Leprosy which is usually associated with biblical times, is also known as Hansen's disease, and the scientists say approximately 150 cases are diagnosed each year.

Dr. James Krahenbuhl, director of the Health Resources Service Administration's National Hansen's Disease Program (NHDP) in Baton Rouge, says 3,000 people in the U.S. are currently being treated for leprosy.

Dr. Krahenbuhl says they suspect there are other cases of leprosy which not identified due to the lack of awareness about the disease among doctors and this is leading to misdiagnosis and wrong treatments for patients who are left to suffer with the debilitating damage caused by the disease.

Although it remains unclear how leprosy is transmitted, it is known to be a slow, chronic disease that attacks the peripheral nervous system and motor skills, often leading to disability and disfigurement.

According to the NHDP, the onset of infection and symptoms can take anywhere from three to 10 years, which makes it difficult to trace the origin of the disease or how people acquire it.

As the disease progresses, patients lose their sense of touch in their fingers and toes leaving them open to repeated burns and cuts which then get infected and the effects of repeated damage initiates bone absorption and motor nerve deterioration, causing fingers to shorten and curve, resulting in a claw-like appearance.

Although leprosy can be fully treated with medicine when diagnosed in early stages, once the disease has advanced nerve damage cannot be reversed.

The NHDP says because many of the population in the U.S. affected by leprosy are immigrants living in poor communities, who seek treatment in free clinics or emergency rooms, many of those doctors are not familiar with the disease and unable to make an accurate diagnosis.

Many doctors mistake the skin lesions of leprosy for a fungus or ringworm and treat it with a topical cream and, because leprosy is a slow-progressing disease, it can take months, if not longer, before the doctor or the patient realises that the treatment isn't working - by which time the disease may have started to destroy the nervous system

Leprosy is most prevalent in the tropics and third world countries where living conditions are poor and access to medical care limited and the NHDP says because of changes in immigrant relocation, leprosy is now being diagnosed throughout the States.

However the NHDP also says there are approximately 30 cases each year in southern Louisiana and the Gulf Coast of Texas in people born in the U.S. who have never visited an endemic country and Dr. Krahenbuhl says as leprosy moves toward internal regions of the States, it becomes more urgent to reach those doctors and let them know about the symptoms of this disease.

Dr. Krahenbuhl is leading a symposium at the American Society of Tropical Medicine and Hygiene meeting to raise awareness among physicians that leprosy is in the U.S. and assistance and treatments are available.

Nearly 2,800 physicians and scientists from institutions around the world, plan to meet at the ASTMH meeting in December in New Orleans, to discuss the latest research on infectious diseases and global health threats, where new research and treatment options will be presented.

In Australia there were 13 cases of leprosy last year and there have been 7 reported this year - it occurs mainly in indigenous groups living in remote areas.