Leprosy

Leprosy is a chronic infectious disease caused by the bacteria Mycobacterium M. leprae and M. lepromatosis. M. leprae was discovered in 1874 by the Norwegian physician Gerhard Armauer Hansen, which is why the disease is also known as Hansen's disease. M. lepromatosis is another bacterium identified in 2008 in the University of Texas.

The infection may start at any age, but most often it appears between the ages of 20 and 30. It mainly affects the skin, mucous membranes (nose) and the peripheral nervous system (extremities), but in severe cases it may affect other organs leading to severe impairment. The nerves most affected are the ones that are located in the limbs and face and may causing permanent disabilities. The advanced form of leprosy can produce facial disfigurement, which is why the social stigma of self-reporting this disease is a major obstacle to its treatment and results in inaccurate reports of infected cases.

Leprosy has affected mankind for at least 4,000 years. More than 5 million people worldwide are infected with M. leprae. The disease is more common in Asia, Africa, Latin America and the Pacific islands. In recent years the control of leprosy has greatly improved thanks to the national and local campaigns carried out in most of the countries where the disease is endemic, however it has yet not been completely eradicated.

Since the 1930s, as a Doctor, he joined one of the main leprosariums in Venezuela, where thousands of infected people where isolated from the rest of the society. During the time Dr. Convit worked intensively to find an effective therapeutic treatment with different drugs, which also included a poliquemotherapy or multi drug treatment that was then established as the conventional treatment by the WHO. As part of his proactive work, he developed a vaccine based on immunotherapy and inmunoprofilaxis to cure the disease, by stimulating the patient's own immune system to control the proliferation of the disease.

Additionally, Dr. Convit collaborated with numerous scientific publications with a bioquemical and microbiological focus of leprosy, proposing a differentiation between M. leprae and other mycobacteria which conducted to a 48 hour tuberculin type test for the diagnostic of leprosy. This test was used to determine immune-epidemiological aspects of the disease, which allowed to identify the population that was most sensitive in endemic areas. Therefore he contributed significantly regarding the transmission of the disease, which ended the popular myth that people thought the disease was contagious, putting an end to the stigma and the isolation of the people infected. This led to the forever closure of the leprosariums and the freedom of the infected people, which made Venezuela the first country in the world to close these type of centers and treat patients locally in their own living areas.

Our main objective is to support the efforts of authorized public institutions in treating the cases that are still being identified in our country. Additionally, it aims to serve as a center of information for the general public regarding the advancements of the epidemiological situation in our population and in the rest of the world.

¿How do people get Leprosy?

Anyone can get leprosy, but it is not so easily spread from person to person as previously believed. The disease is transmitted by contact between infected and healthy people but dose-dependent manner by two routes of infection, skin and mucosa. However, the disease is spread from a patient with the potential for transmitting the disease (not all patients with from leprosy eliminate bacilli from their bodies) and a healthy person (genetically predisposed, since most people have a natural resistance to M. leprae). This is why transmission of the disease is not always the case.

¿What are the signs and symptoms of Leprosy?

The progress of the disease is slow, and the first symptoms appear about a year after becoming infected, or even longer. Symptoms may vary depending on the part of the body affected. Some general symptoms include skin pain, numbness in hands and feet, muscle weakness, patches of skin that look paler than normal, nodules or skin rashes, and stuffy or runny nose. Abnormal sweat and sebaceous secretion as well as hair erection may also be observed.

¿How is Leprosy diagnosed?

On physical examination, symptoms such as the typical rash, loss of sense of touch and specific deformities due to muscle weakness allow the physician to diagnose leprosy. Microscopic examination of an infected tissue sample (lymphs, skin scraping / scarification of skin fissures or nasal septum) confirms the diagnosis when the stained smears show the presence of the bacteria. A skin biopsy of the affected thickened nerves is also performed.

¿How is Leprosy treated?

Leprosy is a curable disease, and disability can be averted if treated in the early stages. Generally, the type of leprosy allows the physician to determine a long-term prediction, the chances of complications and the need for antibiotic treatment.

Effective treatment for leprosy appeared in the early 30's with the introduction of dapsone and its derivatives, however due to its overuse leprosy bacilli showed resistance. In the 80's, a multidrug therapy was developed that kills the bacteria and cures the patient. Since 1985, the WHO provides free multidrug therapy (MDT) to leprosy-affected people around the world, which is a simple and very effective cure for all types of leprosy. So far there have been cases of resistance to TMM. In 1987, Venezuelan physician and researcher Jacinto Convit was honored for discovering the cure for this disease.

¿What should I do if I suspect I have leprosy?

Contact your physician in order to be referred to a specialized physician. If you live in the countryside you can ask for the nearest Sanitary Dermatology Service to be examined by their specialists. If you live close to the metropolitan area, you can go to the Institute of Biomedicine Dr. Jacinto Convit to get immediate assistance.

SERVICIOS DE DERMATOLOGÍA SANITARIA REGIONALES (ACTUALIZADO SEPTIEMBRE 2019)