Elderly patient first case in 20 years – but expert says no need to panic
IN the first confirmed leprosy diagnosis in Nelson Mandela Bay in more than 20 years, an elderly Uitenhage woman has been diagnosed with the ancient disease at Livingstone Hospital.
While the bacteria that causes leprosy – which dates back almost 2 500 years – occurs naturally in the Eastern Cape, with the former Transkei being the centre of major epidemics in the 1800s and 1900s, the disease has all but died out in South Africa and the province.
Leprosy Mission South Africa Eastern Cape field worker Bulelani Qhosholo said yesterday the woman was the second patient this year to be diagnosed with leprosy.
The other case was in the former Transkei earlier this year.
Qhosholo said 58 patients with the disease had been diagnosed in the past 10 years in the province.
Livingstone Hospital chief executive Thulane Madonsela confirmed that the patient, re – ferred from Uitenhage Provincial Hospital, had leprosy.
“Leprosy is a communicable and notifiable disease,”Madonsela said.
“Although the patient reported she had been suffering symptoms since 1989, none of the family members was affected or reported signs of infection from the condition.”
Madonsela said the patient would be started on chronic treatment, coupled with re h a – bilitation, education on infection prevention and control for her family and those in contact with her.
The provincial Department of Health and the district authority had been notified and a copy sent to the communicable disease control (CDC) coordinator to take action.
The woman has been placed under the care of infectious disease specialist at Livingstone, Dr John Black, and Dr Basil Magigaba, head of the department of dermatology.
Leprosy Mission official Peter Laubscher said there was no need to panic. “Leprosy is caused by a germ, similar to the germ which causes tuberculosis.
“The germ is spread by coughing and sneezing. “Of the people exposed to the leprosy germ, only a tiny group will develop the disease,” Laubscher said.
“Once patients start receiving treatment, they are no longer able to transmit leprosy to other people.
“It is important for close family mcontacts of patients to be screened for signs, which include pale patches on the skin accompanied by poor sensation in the patch, and swelling of the skin of the ears and forehead.
“Persons may also be unable to feel pain in their hands and feet and so may have hand and foot injuries.
“They may also struggle to blink and may have signs of eye injuries,” he said. Laubscher said about 100
people were receiving treatmentfor leprosy nationally. In some cases it was very difficult to diagnose.
“Leprosy is a complex disease and affects different people in different ways.”
He said in a suspected leprosy case, the person should tell the doctor he or she may have it because, for example, a relative had it in the past.
Black said there was a wide spectrum of symptoms. “These can vary from a very
mild disease affecting the skin only, to extensive skin and nerve damage that can cause deformities and ulcers that do not heal.
“It is generally transmitted through the spread of droplets after prolonged contact with affected individuals.
“The transmission rate is very low since most people, particularly in South Africa, receive the BCG vaccination which provides a certain level of immunity.”
Black said leprosy was a curable disease.
“The long-term prognosis depends on the degree of neurological damage.”
He said surgical intervention was individualised and generally aimed at restoring function of affected body parts.