Leprosy is an infectious disease that has affected people throughout history and one which is marked by painful and disfiguring symptoms. Throughout history, people with leprosy have been treated with fear and disdain with many cultures banning or shunning the victims of this disease. That stigma has slowed the study of the disease, since, throughout much of history, treatment was a low priority for some cultures. The ancient civilizations of China, Egypt, and India feared the disease, presuming it to be incurable and highly contagious.
In truth, leprosy isn’t as contagious as the myths suggest. The disease can’t be transferred from person to person, unless there’s repeated close contact with leakage from the nose and mouth of a leper. Additionally, the disease most often affects children, so it’s rare for an adult to contract the disease. The World Health Organization reports that there are 180,000 cases of leprosy worldwide today with most cases occurring in Africa and Asia. In the United States, approximately 100 individuals are diagnosed with leprosy each year. Most incidences occur in the southern states, California, Hawaii, and outlaying U.S. territories.
The disease is caused by exposure to Mycobacterium leprae (M. leprae), a bacteria that grows slowly in the body, once a person has been exposed. The condition may also be called Hansen’s disease, named after the scientist credited for discovering M. leprae in 1873. Since the bacteria grows slowly, it can take three to five years for symptoms to develop, after a person has been exposed. In some cases, it can even take up to 20 years for symptoms to present. For that reason, it can be nearly impossible to know where or when exposure to the M. leprae bacteria occurred. This slow incubation period is also the reason it’s important to be aware of the following early signs of infection.
1. Numbness
One major symptom of leprosy is a feeling of numbness in the affected areas. This primarily begins in the hands and feet, spreading to the arms and legs. It’s characterized by a loss of feeling or a loss of sensation in those parts of the body. The numbness may vary in feeling from area to area, since just one nerve may be affected or multiple nerves may go numb.
The sensation of numbness can be more significant, affecting an entire side of the body at once. In more extreme cases, it can affect both sides of the body at the same time. It will vary, because the bacteria may attack different nerves at different times, causing damage or irritation to the individual nerves. The nerves affected are called the peripheral nerves, because they’re the nerve branches located away from the brain and spinal cord. As a primary symptom, numbness plays a part in causing many of the other symptoms to manifest. For this reason, prolonged numbness should be reported to your doctor as soon as possible. Additionally, if the numbness affects an entire limb or larger area of the body, you should seek medical attention immediately. As with any disease, early diagnosis is the key to more efficient treatment of the underlying disease.
[nextpage title=“Next” ]2. Loss Of Temperature Sensation
Another early sign that you may have contracted leprosy is the inability to sense changes in temperature. Again, this is tied to the nerve damage that the bacteria has on the body. The loss of temperature sensation often begins in the hands and feet, where the nerves are normally most sensitive and may spread from there. An inability to sense temperatures, especially extreme changes, is a warning sign that you need immediate medical attention. In addition to it being a symptom of leprosy or another serious condition, it may cause you to unknowingly expose your skin to damage from burns or frostbite.
[nextpage title=“Next” ]3. Pins And Needles Sensation
The pins and needles sensation, also known as paresthesia, often accompanies feelings of numbness in people infected with the Mycobacterium leprae bacteria. It’s characterized by tingling or prickling of the skin, but may also cause one to feel itchy or can create a crawling sensation in the skin. Most people are familiar with the feeling from having had an arm “fall asleep,” since the pins and needles sensation can result from laying on one’s arm for too long. In that case, the compression of the nerves causes the sensation. In leprosy, however, it’s caused by damage to the nerves and will be longer lasting.
[nextpage title=“Next” ]4. Pain
The nerve damage that marks the onset of leprosy may lead one to assume there’s no pain associated with the disease, but this isn’t true. As the nerves are affected by the bacteria, a condition called neuritis occurs, which causes the inflammation of the peripheral nerves. This condition in combination with the development of nerve hypertrophy can cause chronic pain for the patient. Nerve hypertrophy is a condition in which nerves become bundled, resembling an onion shape, and causes entrapment and fibrosis of the nerves. This type of chronic pain often continues, even after a multi-drug therapy treatment has been started to treat the infection.
[nextpage title=“Next” ]5. Deep Pressure Sensation
In normal circumstances, we experience a deep pressure sensation, also called proprioception, which simply means the ability to sense our body’s movements and position. When leprosy or some other condition inhibits that sensation, it can affect the way we interact with our surroundings. It may mean moving with rougher motions and jerks and the individual may seem clumsy or accident-prone to others. As the symptom advances, it can become more difficult to write or draw, because complex motor skills will be affected. In children, the condition may also be marked by an increased habit to fidget or rock back and forth. They may chew on their fingers or foreign objects, such as pencils and crayons. People with an affected deep pressure sensation may also bump into walls and other people frequently.
[nextpage title=“Next” ]6. Nerve Injury
Once the Mycobacterium leprae begins to affect the nerves, the bacteria is absorbed by the Schwann cells located in the nerves. This causes nerve injury that presents in a number of ways. Primarily, axonal atrophy begins to affect cells, which involves the degeneration of the myelin sheath. This is the process that begins to cause the deformities common to leprosy and can also cause the individual to experience a burning sensation in the skin. Once this process starts, the individual will require long-term rehabilitative therapy to help them manage the results of nerve damage. While the damage may not be reversed, rehabilitation can train the individual to cope with the physical manifestations of the damage.
[nextpage title=“Next” ]7. Weight Loss
Unexplained weight loss is another indication that you may have contracted the bacteria that causes leprosy. If you’re not trying to lose weight, but you do keep losing weight, this can be an indication of a problem. Typically, losing more than 5% of your body’s mass within a six month period indicates a deeper medical problem. While this alone doesn’t indicate that you may have contracted the M. leprae bacteria, the onset of the other symptoms listed here may support this possibility. In either case, unexplained weight loss should be reported to your doctor as soon as possible to identify the cause.
[nextpage title=“Next” ]8. Blisters
A blister often begins with a red patch of skin, similar to a rash, but may worsen and form the recognizable bump. It may be filled with clear pus or blood. Often, blisters are caused by friction against the skin, burns that may include sunburn, or as allergic reactions. Where these external factors aren’t the cause and blisters aren’t confined to one part of the body, it may indicate a more serious medical problem. In any case, if you feel certain the blisters weren’t caused by skin irritation and they seem to swell or leak pus, a doctor should be consulted immediately.
[nextpage title=“Next” ]9. Ulcers
As the blisters worsen, they will begin to develop into open or overt skin ulcers. Continued pressure against the necrotic skin forces the liquefied skin or pus to the surface along with blood. The ulcers can sometimes go unnoticed, even where it has affected the subcutaneous layer of skin tissue, if it’s in an area where the skin is tougher. In some cases, the ulcer can appear at a distance from the blister, taking the easiest route to manifestation. As the ulcer is exposed, it can spread the necrosis to cover a larger portion of the skin’s surface. This is another reason it’s important to have unexplained blisters examined before they have a chance to burst.
[nextpage title=“Next” ]10. Skin Lesions
Skin lesions or rashes can consist of a number of different characteristics. They can be flat, raised, lightly colored, or darker. Additionally, they can cover a relatively small area of skin or a broader surface area. Most commonly, skin lesions caused by leprosy affect the face, ears, wrists, elbows, knees, or buttocks. In many cases, it may affect more than one area at a time. as is true with many of these early signs of leprosy, the manifestation of skin lesions in itself doesn’t make leprosy a certainty, but, in conjunction with other symptoms, the likelihood is increased. Any skin lesions should be treated by a doctor as soon as possible.
