Description of leprosy
Hansen’s disease (leprosy) is a chronic infectious disease that affects the skin, mucous membranes and nerves, especially on the legs and face.
It is also called Hansen’s disease, in honor of the Norwegian physician Hansen, who in 1873 isolated the originator onemocnění- bacterium Mycobacterium leprae (also known as Hansen bacillus). It is the bacteria living and reproducing inside cells (intracellular) of the affected organism. Leprosy has become one of the first diseases where shown originator.
The disease is known since time immemorial, has been described in ancient Egypt and India. In Europe came at the beginning of our era, and most were extended for the Crusades. Later, the Spaniards also been introduced to America. In the Middle Ages the church was ordered mandatory labeling of leprosy – had to wear special clothing with a hood and a rattle that on his arrival warned. They also had to wear gloves and were forbidden to reach a healthy population.
Currently, leprosy infected about 1.2 million people worldwide. It is increasing annually around 700 000 to 790 000 new cases. Of these, the majority are lepers in India, as the disease often occurs in Brazil, Bangladesh, Myanmar, Nigeria, and many people in developing countries.
For us it is sporadic evidence of disease by foreigners, or people who have long lived in areas where leprosy and have been in close contact with sick people.
Risk factors for leprosy
Mycobacterium leprae is best multiplies at temperatures around 33C, therefore primarily affects the peripheral parts of the body, especially the fingers and toes, face and eyes and skin all over the body.
Despite the fact that leprosy is examined for more than a century, the route of transmission of disease is not always fully understood. It is known that the incidence is significantly higher in areas with poor sanitation and dirty drinking water. She suffers more people malnourished and living in cramped conditions, according to current research, there is even a certain genetic predispositionfor the disease of leprosy.
The disease is very little infectious transmits only prolonged close contact with the patient, the transmission is most likely droplet infection (the transmission of air tiny droplets that are released during coughing and sneezing) from nasal secretions leprous, which contains large amounts of mycobacteria. The transmission can also occur through the graze on the body in direct contact with the skin of the patient or injuries infected animal (monkey).
It also can infect the child from the mother during feeding breast milk, so breastfeeding among mothers lepers strictly prohibited!
It is also possible for other, yet unproven higher risk of infection, considering a lot of transmission by insects.
leprosy prevention
Most people (95%) has a natural immunity to the disease. The disease can be transmitted only people in whom the disease exploded there, and only to people with poor immune systems.
Leprosy infection is also staying at the areas where leprosy is endemic (prevalent throughout the territory), is highly unlikely. Therefore, healthy people are virtually no limits used to minimize the risk of infection.
Vaccination against leprosy still exists, and in the near future probably will not. The reason for this is the impossibility to cultivate Mycobacterium that causes it in the lab. In some countries, however, it appears to be to some extent protective vaccination against tuberculosis so-called BCG. It is the affinity agent of tuberculosis (Mycobacterium tuberculosis), leprosy with the originator.
In areas with occurrence of leprosy among population in the prevention of applied programs in schools aimed at early detection of disease symptoms.
With early by catching the disease and initiation of treatment increases the success of treatment and the disease does not develop until late, devastating stages.
symptoms of leprosy
tubercular form
lepromatous form
borderline form
Leprosy occurs in three forms.
tubercular form
The first is called tuberculoid form. This is manifested spots on the skin that are typically white, sometimes red. Stain is a small amount, which may cause difficulties with the revelation of the disease.
Bacteria are hit nerves which can be palpable as swollen painful site. Affected nerves soon die and the area is innervated by them loses sensitivity. Due to the death of the nerves and muscles stop working, which then begin to wane (atrophy).
With progressive disease occurs in the affected area to gradually vznikům deep ulcers, which are not, due to necrosis of nerves, painful. Created open wounds joints are gradually spontaneously amputated body parts (mostly phalanges).
Patients with this form of leprosy is not contagious, mycobacteria are closed in the affected nerves, and do not spread around.
In most patients there is spontaneous healing.
lepromatous form
A more severe form of lepromatous leprosy, which tend to suffer from people with impaired cellular immunity. It manifests with the formation of nodes and stains brown or puce color that are placed throughout the body. Nodes can absorb, but they can also break down in the devastating sores and heal scars (white or yellowish spots alternating rough areas of space). Spots look as tuberculoid form of the disease.
Usually, it hit his face, which gradually emergence of nodes, sores and scars deformed. Resulting deformity is called a lion’s face (facies Leontina). Nose when it overflows, it looks eyebrows.
Is lost blink reflex, eye cornea to dry and therefore is more susceptible to infections that can lead to blindness.
Also present is impaired nasal mucosa with fever and nosebleeds. Sick excreted in nasal secretions large quantities of mycobacteria, which can infect susceptible humans in their immediate surroundings.
In the late stage of untreated leprosy they are hit bones and internal organs.
Mycobacteria proliferate throughout the body including the lymph nodes, testes, spleen, liver and bone marrow.
borderline form
The third form of the disease is called borderline form, which is manifested as symptoms tuberculoid, and lepromatous forms.
treatment of leprosy
Leprosy is treated generally to two-year administration of combinations vícerých potent antibiotics: rifampicin, chlofamizinu (lamprena) and dapsone (DDS). The combination is used because the properties of mycobacteria quickly develop resistance (resistance) against one drug.
To prevent paralýzám and atrofiím muscles is also used supportive movement therapy.
Only physical cure the disease but not nearly enough. Very important is the after-care of the patient’s mental and emotional state. In rehabilitation after antecedent disease plays an important role in reconstructive plastic surgery. Perform a facial reconstruction, operate eyelids to restore the blink reflex, they can be transplanted tendon to correct the deformation of limbs.Once the disease has affected a larger part of the body, they are available prosthesis and replace missing body parts.
How can I help myself
Important in this disease is mainly early detection of disease symptoms and initiation of effective treatment. Timeliness initiation of therapy and increases its efficiency, but also reduces the infectiousness of patients, what is important in terms of further spread of leprosy.
complications of leprosy
Death occurs after several decades of disease. Leprosy itself is not the cause of death that occurs as a result of complications, or else associate disease (leprosy affects only people with a malfunctioning immune system, which are also susceptible to other infections, due to which the die).
Other names: leprosy, Hansen’s disease Hansen’s disease
