Leprosy: an ancient disease shows tenacity in 21st century
By Olivier Thibault ,AFPPARIS -- It has been called the world's oldest recorded disease, an evil that humans have known for more than 3,500 years, as papyri from ancient Egypt testify.
January 26, 2013, 12:02 am TWN
Yet drugs to cure leprosy are cheap, plentiful and effective.
So why is this biblical curse still around?
Doctors speaking ahead of World Leprosy Day on Sunday point to wonderful news about the bid to stamp out this nightmare — but they also acknowledge sizable hurdles.
“There has been enormous progress in treating and controlling the leprosy epidemic,” says British microbiologist Stewart Cole. “Six million people have been cured by multi-drug therapy.”
Multi-drug therapy, or MDT, is a cocktail of three antibiotics designed to kill the parasitic rod-shaped germ, Mycobacterium leprosae, that after a long incubation spreads from nerve cells to muscles and other tissues.
Several drugs are always used, as only one drug enables the germ to develop resistance to it.
Without treatment, the microbe causes crippling damage to the hands, skin, the nose and eyes. The condition goes hand-in-hand with ostracism, even though scientists say M. leprosae, transmitted by droplets from the nose and mouth, is generally not very infectious.
According to World Health Organization (WHO) figures, there were roughly 5.2 million people with leprosy in 1985.
The burden has fallen sharply, driven especially by free MDT treatment made available by the WHO to poor countries. With it, a leper can be cured in six to 12 months.
But even as the WHO is demanding a “final push” against leprosy, the decline in new infections seems to have plateaued.
In 2004, there were around 400,000 new cases, which fell to 228,000 new cases in 2010, then to 219,000 in 2011.
“The WHO is starting to wonder why this is the case,” says Cole, who chairs the scientific and medical commission of the Raoul Follereau Foundation, a French NGO inspired by a 20th-century campaigner.
“For years, they told us that if we carried on using MDT, prevalence would gradually hit zero, but this hasn't happened, and we are concerned.”
Leprosy has been eliminated from 119 countries out of 122 countries where the disease was considered a public health problem in 1985.
But tenacious pockets remain in parts of Brazil, Indonesia, Philippines, Democratic Republic of Congo, India, Madagascar, Mozambique, Nepal and Tanzania, according to the U.N.'s health body.