Leprosy, caused by Mycobacterium leprae, predominantly affects individuals in India, which runs a significant eradication program but still reports about 100,000 new cases annually. The disease primarily impacts skin and peripheral nerves, with symptoms ranging from mild skin patches to severe disfiguring conditions, and poses significant socio-economic challenges due to stigma and discrimination. While multidrug therapy is available, complications can include permanent disability, and existing laws in India further marginalize affected individuals.

1. Mycobacterium
leprae
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Leprosy currently affects
approximately a quarter of a
million people throughout the
world, with majority of these cases
being reported from India. India is
currently running one of the
largest leprosy eradication program
in the world, the National Leprosy
Eradication Program (NLEP). Still,
1.2 to 1.3 hundred thousand new
cases of leprosy reported every
year
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2. • an intracellular, pleomorphic, acid-fast, pathogenic bacterium
• an aerobic bacillus (rod-shaped) surrounded by the characteristic
waxy coating unique to mycobacteria.
• Optical microscopy shows M. leprae in clumps, rounded masses, or
in groups of bacilli side by side
• 1–8 μm in length and 0.2–0.5 μm in diameter

3. • The organism has never been successfully grown on an artificial cell
culture medium
• it has been grown in mouse foot pads and in nine-banded armadillos
because they are susceptible to leprosy
• difficulty in culturing the organism appears to be because it is an obligate
intracellular parasite

4. • Virulence factors include a waxy exterior coating, formed by the
production of mycolic acids unique to Mycobacterium.
• sensitive to dapsone (diaminodiphenylsulfone, the first effective
treatment which was discovered for leprosy in the 1940s)
• resistance against this antibiotic has developed over time.
• multidrug treatment (MDT) is recommended by the WHO, including
dapsone, rifampicin and clofazimine.

5. • Leprosy is one of the least infectious diseases as nearly everyone has some
measure of natural resistance against it.
• it continues to spread due to its extremely long incubation period, which may last
as long as 30 years,
• ignorance and misinformation about the symptoms and effects of the disease.
Stigma against the disease - causes its victims to be isolated and shunned.
• They may also isolate themselves out of fear of discrimination.
• Patients may be impacted in every area of their life, including interpersonal
relationships, economic security, and mental health and wellbeing.
• Leprosy is also the leading cause of permanent disability in the world
• is primarily a disease of the poor.
Leprosy

6. • primarily affects the skin and the nerves outside the brain and spinal cord, called
the peripheral nerves.
• also strike the eyes and the thin tissue lining the inside of the nose.
• disfiguring skin sores, lumps, or bumps that do not go away after several weeks or
months. The skin sores are pale-colored.
• Nerve damage can lead to:
• Loss of feeling in the arms and legs
• Muscle weakness
Symptoms

7. • usually takes about 3 to 5 years for symptoms to appear after coming into contact
with the bacteria. Some people do not develop symptoms until 20 years later.
• The time between contact with the bacteria and the appearance of symptoms is
called the incubation period.
• Leprosy's long incubation period makes it very difficult for doctors to determine
when and where a person with leprosy got infected.
Symptoms

8. Forms of Leprosy
The types are:
Tuberculoid. A mild, less severe form of leprosy. People with this type have only
one or a few patches of flat, pale-colored skin (paucibacillary leprosy). The affected
area of skin may feel numb because of nerve damage underneath. Tuberculoid
leprosy is less contagious than other forms.
Lepromatous. A more severe form of the disease. It has widespread skin bumps
and rashes (multibacillary leprosy), numbness, and muscle weakness. The nose,
kidneys, and male reproductive organs may also be affected. It is more contagious
than tuberculoid leprosy.
Borderline. People with this type of leprosy have symptoms of both the tuberculoid
and lepromatous forms.

9. Diagnosis
• a skin biopsy is taken.
• A skin smear test may also be done.
• With paucibacillary leprosy, no bacteria will be detected.
• bacteria are expected to be found on a skin smear test from a person
with multibacillary leprosy.
• detecting the DNA using polymerase chain reaction (PCR)
Early detection of the disease is important, since physical and neurological damage may be
irreversible even if cured. And can lead to permanent disability.

10. Treatment
• The Bacillus Calmette–Guérin (BCG) vaccine offers a variable amount of
protection against leprosy in addition to its target of tuberculosis.
• Multidrug therapy (MDT) remains highly effective
• people are no longer infectious after the first monthly dose
• Anti-inflammatory drugs are used to control nerve pain and damage
related to leprosy. This may include steroids
• Patients with leprosy may also be given thalidomide, a potent medication
that suppresses the body's immune system. It helps treat leprosy skin
nodules.

11. Complications of leprosy
• Blindness or glaucoma.
• Disfiguration of the face (including permanent swelling, bumps, and
lumps).
• infertility in men.
• Kidney failure.
• Muscle weakness that leads to claw-like hands or an inability to flex the
feet.
• Permanent damage to the inside of the nose, which can lead to
nosebleeds and a chronic, stuffy nose.
• Permanent damage to the nerves outside the brain and spinal cord,
including those in the arms, legs, and feet.

12. Discrimination In India
• Laws in the states of Chhattisgarh, Rajasthan, Madhya Pradesh, Andhra Pradesh,
and Orissa prohibit leprosy patients from running in local elections.
• the Motor Vehicle Act of 1939 which restricts leprosy patients from obtaining a
driving license
• the Indian Rail Act of 1990 which prohibits leprosy patients from traveling by
train.
• Section 13 of the Hindu Marriage Act, which permits leprosy as a justification for
divorce
• Section 70(3)(b) of the Orissa Municipal Corporation Act, which prevents leprosy
patients from running for the office of Corporator
Many of these laws were written before the development of multi-drug therapy (MDT), a
treatment that can make leprosy patients non-contagious and prevent further deterioration,
and they have not been updated since.

13. • National leprosy eradication programme (NLEP)
Central leprosy teaching & research institute (CLTRI) Tamil Nadu
regional institutes at Chhattisgargh, Orissa, west Bengal

14. It is nearly 11 years since
leprosy was officially
declared eliminated as a
public health concern in
India. India was officially
declared to have eliminated
leprosy in 2005 when new
cases fell to less than 1 per
10,000, yet India still
accounts for the largest
number of leprosy affected
people in the world (58 per
cent) with a registered
prevalence of 86,319 and
1,25,785 new detected
cases
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