Both the public and health professionals will be surprised to hear of a confirmed case of leprosy in someone living in the Republic. After all, the World Health Organisation (WHO) stated that leprosy had been eliminated as a public health problem in 2000.
So how can you explain the occurrence of a case of leprosy in the southwest of Ireland in 2024?
Leprosy is an infectious disease caused by a bacterium called Mycobacterium leprae. Once feared as a devastating disease, the WHO made drug treatment for the disease available free of charge across the world in 1995. But the microbe has not been completely eradicated; it has a prevalence rate of 16.9 per million people, with most cases seen in Africa and Asia.
How contagious is leprosy?
By no means highly contagious, leprosy (which is also known as Hansen’s disease) can spread from person to person if there has been prolonged close contact with a person who has untreated leprosy. It is not fully understood how leprosy spreads, but it likely occurs through airborne droplets when an infected person coughs or sneezes. Apart from inhalation, spread may also occur if these droplets come into contact with broken skin.
Can it be treated?
Yes it can, using a multi-drug combination of antibacterial agents. Treatment is carried out by an infectious disease consultant. After three months of treatment, the patient will usually be unable to transmit the infection to others. While trials of a vaccine are ongoing, there is currently no way to immunise against leprosy.
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How might I know that I had leprosy?
Leprosy affects the skin, the peripheral nerves, the upper respiratory tract and the eyes. The main symptoms are:
- Skin patches that may be red or faded
- Reduced or absent sensation over the skin patches
- Numbness or tingling in the hands, feet, arms and leg
- Muscle weakness
- Loss of eyelashes or eyebrows
- Nasal congestion and nose bleeds
Symptoms of advanced disease include paralysis, vision loss, disfigurement of the nose and shortening of the fingers and toes. Because Mycobacterium leprae grows very slowly, it takes about five years for symptoms to occur after being infected.
How is leprosy diagnosed?
It is most often diagnosed with a biopsy of the affected area of skin. This is sent to a microbiology laboratory for analysis. Extensive contact tracing is carried out to identify close contacts of the person diagnosed with the disease. Household contacts of person with the most severe form of leprosy may be offered preventive treatment.
How much of a risk does a person with leprosy pose to me or my family?
Leprosy rarely occurs in Ireland, with most of the diagnosed cases being people who were infected outside the country. In fact, most of us face no risk at all. Research has shown that some 95 per cent of all adults are unable to get the disease, even if they’re exposed to the bacteria that cause it.
Although there is still a stigma associated with leprosy, part of the WHO’s strategy is to eliminate discrimination and marginalisation of those affected by the illness.
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