It’s not as prevalent as it used to be, but cases are still reported in Malaysia. In fact, according to the Health Ministry, the number of cases detected increased from 142 in 2021 to 164 in 2022. Statistics for 2023 have not been finalised.
To mark this year’s World Leprosy Day today, FMT Lifestyle spoke with family physician Dr Mohd Shaiful Ehsan about the disease.
“It’s important for us to know about leprosy because it can be diagnosed early,” he said. “If we treat it early, it’s curable and complications can be prevented.”
Leprosy is also known as Hansen’s disease, after Norwegian physician Gerhard Armauer Hansen, who in 1874 discovered the slow-growing bacterium causing it, mycobacterium leprae.
Superficial areas of the body, such as the skin, peripheral nerves and eyes, are particularly prone to leprosy infection. Because of this, Shaiful said, victims could end up handicapped or lose functions in their hands or joints. There is also a risk of blindness.
Why are the superficial areas more vulnerable than the deeper tissues? Shaiful said this was because the bacterium would be most stable between 27ºC and 30ºC, the range of temperature associated with the skin.
He said there was no solid answer to the question of how the disease was spread, but he mentioned a widespread belief pinpointing nasal droplets and respiratory airways.
In fact, the bacterium cannot survive long outside the human body. Shaiful said this was why leprosy was not as infectious as, say, tuberculosis.
What are the symptoms to watch out for? The most obvious signs are hypopigmented reddish areas or macular patches on the body, usually the hands or feet.
Since the bacteria destroy the cells when they enter the skin, the localised area’s nerves will be affected and the victim will experience numbness or a reduction in sensation.
If left untreated, ulceration and a worsened infection can happen, sometimes necessitating amputation of one or more limbs or leading to blindness if the eyes are infected.
There used to be a myth that a leprosy victim must be isolated far away from those who were not infected. “But the infectivity is actually very low,” Shaiful said. “The incubation period can take up to 20 months or even years and the replication is very slow.
“Even if you’re in close contact with the patient, as long as he receives treatment and takes the prescribed antibiotics, he’s not going to infect others easily.”
Nevertheless, he added, the elderly, malnourished people, diabetic patients and others with low immunity levels were more prone to infection.
Treatment is carried out through a multiple-drug therapy introduced by the World Health Organisation.
Shaiful said family doctors like himself would refer suspected cases to a public hospital for further examination. Confirmed cases are given antibiotics for free.
He warned that the earlier stages of leprosy could easily be confused with skin diseases such as fungal infections, eczema or psoriasis.
What sets leprosy apart from these is that the patient will complain of numbness in the skin patches instead of itchiness.
“Prevention is always better than cure,” Shaiful said. “We should make sure our body is healthy in terms of immunity levels.
“If you are diabetic, control your sugar intake. Control your nutrition and practise a good quality of life when you become elderly. Ensure you have good muscle strength, maintain a healthy diet, and stay physically active.
“When your bodily functions are good, that is one of the mechanisms to prevent you from getting infected.”
Head to the Ministry of Health’s website for more information.