Leprosy, also known as Hansen’s disease, is a chronic infectious condition caused by the bacterium Mycobacterium leprae or Mycobacterium lepromatosis. While rarely a direct cause of death, untreated leprosy can lead to severe, life-threatening complications. The disease progresses slowly, with effects accumulating over many years.
Understanding Leprosy’s Impact on the Body
Mycobacterium leprae primarily targets the peripheral nerves, skin, eyes, and the lining of the upper respiratory tract. This bacterium multiplies slowly, with symptoms potentially appearing within one year or taking as long as 20 years or more after infection.
Damage to the peripheral nerves can lead to a significant loss of sensation, particularly in the hands and feet. This numbness means individuals may not feel pain from injuries, burns, or other trauma, increasing their susceptibility to unnoticed wounds and subsequent infections. Motor nerve damage can also occur, resulting in muscle weakness, paralysis, and deformities like “clawed hand” or “dropped foot.”
The disease can cause skin sores, lumps, or bumps that do not heal, and it may also affect the eyes, leading to vision problems or even blindness if untreated. Involvement of the upper respiratory tract can cause chronic nasal congestion or nosebleeds. Untreated leprosy can lead to progressive tissue damage and physical disabilities.
Indirect Causes of Death from Leprosy
Death from leprosy is an indirect consequence of severe complications arising from prolonged, untreated disease. One major cause is severe secondary bacterial infections, which can develop in areas of the body where sensation has been lost or where skin integrity is compromised. Chronic ulcers on the feet, for example, can become deeply infected, potentially leading to widespread infection in the bloodstream, known as sepsis.
Organ failure can also contribute to mortality in advanced cases. Kidney failure is a recognized complication. If the disease affects the larynx or other parts of the upper respiratory tract, it can lead to respiratory compromise and, in severe cases, respiratory failure.
Prolonged illness from advanced leprosy can also result in severe malnutrition due to the body’s increased metabolic demands and potential difficulties with eating. The cumulative impact of nerve damage, tissue destruction, and chronic inflammation can weaken the body, making individuals vulnerable to these life-threatening systemic complications.
Modern Treatment and Recovery
Leprosy is a curable disease with Multi-Drug Therapy (MDT), a treatment regimen available since the early 1980s. MDT involves a combination of three medicines: dapsone, rifampicin, and clofazimine. This combination therapy is highly effective in killing Mycobacterium leprae, stopping disease progression, and preventing further complications.
The duration of MDT varies depending on the type of leprosy; paucibacillary cases (fewer skin lesions) are treated for 6 months, while multibacillary cases (more widespread lesions or nerve involvement) require 12 months of treatment. Early diagnosis and consistent adherence to MDT are important to prevent severe disabilities and complications. The World Health Organization (WHO) has historically provided MDT free of charge, significantly contributing to global efforts to reduce the disease burden.