When a frightening new virus suddenly emerged in December 2019, awareness spread quickly, and measures to slow its spread were adopted almost immediately. By December 2020 — just around one year after the scientific community first learned of the existence of the novel coronavirus dubbed Covid-19 — the Pfizer vaccine was already approved for emergency use and rolled out at record speed.
Every year, many thousands of new cases are diagnosed. In 2020, for instance, a grand total of 127,558 people was diagnosed with Hansen's Disease. While most cases are found in developing countries, a few hundred new leprosy cases are diagnosed each year even in the United States.
How Long Has Leprosy Been Around?
Nobody knows, precisely, because leprosy has existed since ancient times, and likely since before any kind of record was kept about such things. The fist emerging literature, that of ancient civilizations, spoke of the disease. Back then, nobody knew precisely what caused leprosy, now also called Hansen's Disease.
Scared of the symptoms, ancient societies cast people with leprosy out of the community — and spread the idea people developed Hansen's Disease as a punishment for some sort of sin.
Leprosy is, in fact, the first disease to have been stigmatized in this way. The practice has continued ever since. In some parts of the world, it very much remains in place. Leprosy is an unfinished story not just because the rights of people who live with it remain in jeopardy, but also simply because humanity hasn't managed to eradicate it yet.
Separating Myth and Reality: What Is Leprosy Really?
Leprosy, also called Hansen's Disease, is a chronic infectious disease. It is caused by a bacterium, Mycobacterium leprae, that has an extremely long incubation period. Some people who are infected with the causative bacteria develop symptoms within a year, but it takes, on average, five years for symptoms to appear. In some cases, the signs of leprosy do not become apparent until 20 years after the infection.
Leprosy is now thought to be transmitted mainly through droplets from an infected person's mouth or nose, during close contact. It is not airborne and not transmitted by touching the skin of someone who has it. In fact, leprosy is only mildly contagious.
There are at least six different subtypes of leprosy, each of which has unique symptoms. Broadly speaking, however, the most visible symptoms of leprosy are:
- Discolored skin lesions on various parts of the body, lighter than the person's normal skin color.
- Skin growths called nodules.
- Dry, stiff, and unusually thick skin.
- Ulcers on the feet.
- Lumps and swelling around the face.
- Losing eyelashes and eyebrows.
- A disfigured nose.
In addition, leprosy causes symptoms only the patient experiences:
- Numbness of the skin or burning sensations in the skin.
- Paralysis in certain muscle groups, especially in the extremities.
- Enlarged and painful nerves.
- Vision loss and even blindness.
- A chronically stuffy nose, and frequent nosebleeds.
Can Leprosy Be Treated?
Since leprosy is a bacterial infection, but a chronic and hard-to-treat one, antibiotics are prescribed for its treatment. Some drugs that were previously used to treat leprosy are already ineffective on their own, as the bacteria have developed resistance. Currently, the standard protocol is dapsone with rifampicin, as well as clofazimine for some subtypes.
Why Is There No Safe and Effective Vaccine for Leprosy Yet?
The BCG vaccine, which protects against tuberculosis, has been found to have a protective effect against leprosy as well. However, given the shocking number of new leprosy cases across the world every single year, it is painfully obvious that the effect is not strong enough.
The simple fact is that leprosy is a neglected disease — no vaccine has been developed yet due to lack of funding, a deficiency that hails from the fact that there simply hasn't been enough interest in eradicating this terrible ancient disease that continues to cause immense suffering today.
LepVax: Hope Against a Horrible Ancient Disease? Finally?
The leprosy vaccine, the first of its kind, went through stage one clinical trials in 2019. Over the course of that early trial, it was shown to:
- Reduce the transmission of Hansen's Disease.
- Protect patients against serious complications of leprosy, including nerve damage.
LepVax achieved FDA approval during this time.
The next stage is a larger-scale clinical trial in Brazil, in an area where leprosy remains endemic. Ironically, further progress was disrupted by the Covid-19 pandemic. It will now go ahead whenever approval is obtained.