World Leprosy Day is observed on the last Sunday of January every year. It provides an opportunity for enhanced efforts and renewed commitment for elimination/eradication of the debilitating disease at the earliest. It focuses on the target of zero cases of leprosy-related disabilities in children. Early detection is prime focus to achieve this target, along with strengthening interventions to prevent leprosy transmission. Leprosy is also known as Hansen’s disease.

Leprosy affected 173358 people globally at the end of 2016. Brazil, Indonesia and India are high-burden countries. Leprosy is curable and treatment in the early stages can prevent disability.

What is leprosy?

Leprosy is a chronic infectious disease caused by a bacillus, Mycobacterium leprae (M. laprae). The symptoms of the disease occur generally after a long period after getting infection on average 5 years, as M. leprae multiplies very slowly. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and also the eyes.

The disease is classified as paucibacillary (PB) or multibacillary (MB), depending on the bacillary load. PB leprosy is a milder disease characterized by few (up to five) skin lesions (pale or reddish), whereas MB is associated with multiple (more than five) skin lesions, nodules, plaques, thickened dermis or skin infiltration.

How does the disease spread? 

Untreated leprosy-affected person is the only known source for transmission of the bacteria.

• Respiratory tract, especially nose, is the major route of exit of the organism from the body of infectious persons. 
• Disease causing organism enters the body commonly through respiratory system by droplets from the nose and mouth during close and frequent contacts with untreated cases.
• After entering the body, the organism migrates towards the nerves and skin.
• If it is not diagnosed and treated in early stages, it may cause further damage to nerves leading to development of permanent disability.

What are the signs and symptoms of leprosy?

Leprosy should be suspected if a person shows the following signs and symptoms:

• Dark-skinned people might have light patches on the skin, while pale-skinned people have darker or reddish patches 
• Loss or decrease of sensation in the skin patches
• Numbness or tingling in hand or feet
• Weakness of hands, feet or eyelids
• Painful nerves
• Swelling or lumps in the face or earlobes
• Painless wounds or burns on hands or feet.

What should be done in case of suspicion of leprosy?

In case of presence of signs and symptoms of leprosy, please contact ASHA or ANM of your area or visit the nearest dispensary. Treatment of leprosy is available free of cost at all government dispensaries in India.

What is MDT (multi drug therapy)?

MDT is a combination of different drugs as leprosy should never be treated with any single antileprosy drug. 

• One should complete the full course of MDT as prescribed by a trained health worker according to the type of leprosy. 
• MDT is available free of charge at most health facilities including in remote areas.

National Leprosy Eradication Programme (NLEP)

The National Leprosy Control Programme was launched by the Government of India in 1955. After introduction of Multi Drug Therapy in 1982, the programme was converted in to National Leprosy Eradication Programme (NLEP) in the year 1983 with the objective of achieving eradication of the disease from the country.

In 2005, though the elimination of leprosy at national level has been achieved; but still around 57% of the worlds' leprosy affected persons live in India. 554 districts (81.23%) out of total 682 districts have achieved elimination by March 2017.

Early case detection and treatment is the key to achieve elimination as detection of leprosy cases early in the community will lead to reduction of sources of infection in the community and also interrupt the transmission of the disease. ASHAs are helping in case detection and to assure complete treatment at community level; for that they are being paid an incentive.

Post Exposure Prophylaxis has been started for all contacts of leprosy cases from 2^nd October 2018 under NLEP.

Sparsh Leprosy Awareness Campaign, 2018 was conducted as an annual activity during the fortnight from 30th January to 13th February to create awareness about leprosy.

Sparsh Leprosy Elimination Campaign (SLEC): In order to pay homage to our Father of the Nation, Mahatma Gandhi, on his 150th Birth Anniversary, Central leprosy Division, Ministry of Health and Family Welfare, Government of India has committed to achieve the new cases with Grade II disability < 1 case/ million population by introducing a yearlong comprehensive campaign called ‘Sparsh Leprosy Elimination Campaign’ (SLEC) till 2nd Oct 2019, it is being rolled out in 36 states.

Keys messages

• Leprosy is curable with MDT (multi drug therapy).
• Multi drug therapy taken regularly ensures complete cure of leprosy, prevents deformities and stops transmission to other individuals.
• Early diagnosis, appropriate treatment and completion of full course will prevent disability due to leprosy.
• Leprosy is not hereditary; it does not transmit form parents to children.
• Leprosy does not spread through causal touch like shaking hands or playing together, or working in same office. Close and frequent contacts with untreated cases favour the spread.
• Leprosy is not the result of past sins or immoral behavior. It is caused by a bacterium called Mycobacterium leprae.
• People affected by leprosy have right to livelihood and right to live with dignity.

Know more about National Leprosy Eradication Programme

References-

searo.who.int

http://nlep.nic.in/