You are on page 1of 5

Leprosy Leprosy or Hansen's disease (HD), is a chronic disease caused by the bacteria Mycobacterium leprae and Mycobacterium lepromatosis.

[1][2] Named after physician Gerhard Armauer Hansen, leprosy is primarily a granulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract; skin lesions are the primary external sign.[3] Left untreated, leprosy can be progressive, causing permanent damage to the skin, nerves, limbs and eyes. Contrary to folklore, leprosy does not cause body parts to fall off, although they can become numb or diseased as a result of infection; infection results in tissue loss, so fingers and toes become shortened and deformed as the cartilage is absorbed into the body.[4][5][6] Although the mode of transmission of Hansen's disease remains uncertain, most investigators think that M. leprae is usually spread from person to person in respiratory droplets.[7] Studies have shown that leprosy can be transmitted to humans by armadillos.[8][9][10] Leprosy is now known to be neither sexually transmitted nor highly infectious after treatment. Approximately 95% of people are naturally immune[11] and sufferers are no longer infectious after as little as 2 weeks of treatment. The minimum incubation period reported is as short as a few weeks, based on the very occasional occurrence of leprosy among young infants. The maximum incubation period reported is as long as 30 years, or over, as observed among war veterans known to have been exposed for short periods in endemic areas but otherwise living in non-endemic areas. It is generally agreed that the average incubation period is between three and five years. Leprosy has affected humanity for over 4,000 years,[12] and was well-recognized in the civilizations of ancient China, Egypt, and India.[13] In 1995, the World Health Organization (WHO) estimated that between 2 and 3 million people were permanently disabled because of leprosy at that time.[14] In the past 20 years, 15 million people worldwide have been cured of leprosy.[15] Although the forced quarantine or segregation of patients is unnecessary in places where adequate treatments are available, many leper colonies still remain around the world in countries such as India (where there are still more than 1,000 leper colonies),[15] China,[16] Romania,[17] Egypt, Nepal, Somalia, Liberia, Vietnam,[18] and Japan.[19] Leprosy was once believed to be highly contagious and was treated with mercury all of which applied to syphilis, which was first described in 1530. It is now thought that many early cases of leprosy could have been syphilis.[20] The age-old social stigma, in other words, leprosy stigma[21] associated with the advanced form of leprosy lingers in many areas, and remains a major obstacle to self-reporting and early treatment. Effective treatment for leprosy appeared in the late 1930s with the introduction of dapsone and its derivatives. Leprosy bacilli resistant to dapsone soon evolved and, due to overuse of dapsone, became widespread. It was not until the introduction of multidrug therapy (MDT) in the early 1980s that the disease could be diagnosed and treated successfully within the community.[22] MDT for multibacillary leprosy consists of rifampicin, dapsone, and clofazimine taken over 12 months. Dosages adjusted appropriately for children and adults are available in all Primary Health Centres in the form of blister packages.[22] Single dose MDT for single lesion leprosy consists of rifampicin, ofloxacin, and minocycline. The move toward single-dose treatment strategies has reduced the prevalence of disease in some regions, since prevalence is dependent on duration of treatment. World Leprosy Day was created to draw awareness to leprosy and its sufferers.

Expanded Program on Immunization (Philippines) The standard routine immunization schedule for infants in the Philippines is adopted to provide maximum immunity against the seven vaccine preventable diseases in the country before the child's first birthday. The fully immunized child must have completed BCG 1, DPT 1, DPT 2, DPT 3, OPV 1, OPV 2, OPV 3, HB 1, HB 2, HB 3 and measles vaccines before the child is 12 months of age.[2] Minimum Minimum Number Interval Age Dose of Doses Between at 1st Dose Doses

Vaccine

Route

Site

Reason

Bacillus CalmetteGurin

Birth or anytime after birth

0.05 mL

--

DiphtheriaPertussisTetanus Vaccine

6 weeks

0.5 mL

4 weeks

Oral Polio Vaccine

6 weeks

2-3 drops

4 weeks

Hepatitis B Vaccine

At birth

6 weeks interval from 1st dose to 0.5 2nd dose, mL 8 weeks interval from 2nd dose to third dose.

Measles Vaccine

9 months

0.5 mL

--

BCG given at earliest possible age Right protects the deltoid possibility of TB Intradermal region meningitis and of the other TB infections arm in which infants are prone[3] Upper An early start with outer DPT reduces the Intramuscular portion chance of severe of the pertussis.[4] thigh The extent of protection against polio is increased the earlier the OPV Oral Mouth is given. Keeps the Philippines poliofree.[5] An early start of Hepatitis B vaccine reduces the chance of being infected and becoming a carrier.[6] Prevents liver Upper cirrhosis and liver outer cancer which are Intramuscular portion more likely to of the develop if infected thigh with Hepatitis B early in life.[7][8] About 9,000 die of complications of Hepatits B. 10% of Filipinos have Hepatitis B infection[9] Subcutaneous Upper At least 85% of outer measles can be portion prevented by

(not MMR)

of the arms

immunization at this age.[10]

When given to women of childbearing age, vaccines that contain tetanus toxoid (TT or Td) not only protect women against tetanus, but also prevent neonatal tetanus in their newborn infants.[17] Vaccine TT1 Minimum Percent Age/Interval Protected As early as possible -during pregnancy

Duration of Protection -infants born to the mother will be protected from neonatal tetanus gives 3 years protection for the mother infants born to the mother will be protected from neonatal tetanus gives 5 years protection for the mother infants born to the mother will be protected from neonatal tetanus gives 10 years protection for the mother gives lifetime protection for the mother all infants born to that mother will be protected

TT2

At least 4 weeks later

80%

TT3

At least 6 months later

95%

TT4

At least 1 year later

99%

TT5

At least 1 year later

99%

In June 2000, the 57 countries that have not yet achieved elimination of neonatal tetanus were ranked and the Philippines was listed together with 22 other countries in Class A, a classification for countries close to maternal and neonatal tetanus elimination.[18]
Tuberculosis Tuberculosis, MTB or TB (short for tubercle bacillus) is a common and in many cases lethal infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis.[1] Tuberculosis usually attacks the lungs but can also affect other parts of the body. It is spread through the air when people who have an active MTB infection cough, sneeze, or otherwise transmit their saliva through the air.[2] Most infections in humans result in an asymptomatic, latent infection, and about one in ten latent infections eventually progresses to active disease, which, if left untreated, kills more than 50% of its victims. The classic symptoms are a chronic cough with blood-tinged sputum, fever, night sweats, and weight loss (the last giving rise to the formerly prevalent colloquial term "consumption"). Infection of other organs causes a wide range of symptoms. Diagnosis relies on radiology (commonly chest X-rays), a tuberculin skin test, blood tests, as well as microscopic examination and microbiological culture of bodily fluids. Treatment is difficult and requires long courses of multiple antibiotics. Social contacts are also screened and treated if necessary. Antibiotic resistance is a growing problem in (extensively) multi-drug-resistant tuberculosis. Prevention relies on screening programs and vaccination, usually with Bacillus Calmette-Gurin vaccine. One third of the world's population is thought to be infected with M. tuberculosis,[3][4] and new infections occur at a rate of about one per second.[3] The proportion of people who become sick

with tuberculosis each year is stable or falling worldwide but, because of population growth, the absolute number of new cases is still increasing.[3] In 2007 there were an estimated 13.7 million chronic active cases, 9.3 million new cases, and 1.8 million deaths, mostly in developing countries.[5] In addition, more people in the developed world contract tuberculosis because their immune systems are more likely to be compromised due to higher exposure to immunosuppressive drugs, substance abuse, or AIDS. The distribution of tuberculosis is not uniform across the globe; about 80% of the population in many Asian and African countries test positive in tuberculin tests, while only 510% of the US population test positive.[1] Signs and symptoms When the disease becomes active, 75% of the cases involve infection in the lungs (pulmonary TB). Symptoms include chest pain, coughing up blood, and a productive, prolonged cough for more than three weeks. Systemic symptoms include fever, chills, night sweats, appetite loss, weight loss, pallor, and fatigue.[6] In the other 25% of active cases, the infection moves from the lungs, causing other kinds of TB, collectively denoted extrapulmonary tuberculosis.[7] This occurs more commonly in immunosuppressed persons and young children. Extrapulmonary infection sites include the pleura in tuberculous pleurisy, the central nervous system in meningitis, the lymphatic system in scrofula of the neck, the genitourinary system in urogenital tuberculosis, and bones and joints in Pott's disease of the spine. An especially serious form is disseminated TB, more commonly known as miliary tuberculosis. Extrapulmonary TB may co-exist with pulmonary TB.[8] Transmission When people suffering from active pulmonary TB cough, sneeze, speak, sing, or spit, they expel infectious aerosol droplets 0.5 to 5 m in diameter. A single sneeze can release up to 40,000 droplets.[41] Each one of these droplets may transmit the disease, since the infectious dose of tuberculosis is very low and inhaling fewer than ten bacteria may cause an infection.[42][43]

Treatment Main article: Tuberculosis treatment Treatment for TB uses antibiotics to kill the bacteria. Effective TB treatment is difficult, due to the unusual structure and chemical composition of the mycobacterial cell wall, which makes many antibiotics ineffective and hinders the entry of drugs.[85][86][87][88] The two antibiotics most commonly used are isoniazid and rifampicin. However, instead of the short course of antibiotics typically used to cure other bacterial infections, TB requires much longer periods of treatment (around 6 to 24 months) to entirely eliminate mycobacteria from the body.[8] Latent TB treatment usually uses a single antibiotic, while active TB disease is best treated with combinations of several antibiotics, to reduce the risk of the bacteria developing antibiotic resistance.[89] People with latent infections are treated to prevent them from progressing to active TB disease later in life.

Paucibacillary tuberculoid ("TT"), borderline tuberculoid ("BT") A30.1, A30.2 Tuberculoid It is characterized by one or more hypopigmented skin macules and anaesthetic patches, where skin sensations are lost because of damaged peripheral nerves that have been attacked by the human host's immune cells. Positive bacillus (Th1) Multibacillary midborderline or borderline ("BB") A30.3 Borderline Borderline leprosy is of intermediate severity and is the most common form. Skin lesions resemble tuberculoid leprosy but are more numerous and irregular; large patches may affect a

whole limb, and peripheral nerve involvement with weakness and loss of sensation is common. This type is unstable and may become more like lepromatous leprosy or may undergo a reversal reaction, becoming more like the tuberculoid form. Multibacillary borderline lepromatous ("BL"), and lepromatous ("LL") A30.4, A30.5 Lepromatous It is associated with symmetric skin lesions, nodules, plaques, thickened dermis, and frequent involvement of the nasal mucosa resulting in nasal congestion and epistaxis (nose bleeds), but, typically, detectable nerve damage is late. Negative plasmid inside bacillus[citation needed] (Th2)

You might also like