Leprosy easily cured, difficult to transmit

Content image - Phnom Penh Post
A man rides past the National Centre for Tuberculosis and Leprosy Control in Boeung Keng Kang II commune of the capital’s Boeung Keng Kang district last year. Heng Chivoan

Hansen's disease, formerly known as leprosy, can cause paralysis of the nerves if not treated by a physician. This could include crippling of the hands and feet or the loss of nerves in the face, leading to stretched skin and a permanently contorted appearance.

If a person contracts the disease, these disabilities can be avoided entirely with immediate treatment. It is also important to remember that the bacteria that cause disease are very hard to transmit, a health official said.

Huot Chanyuda, director of the National Centre for Tuberculosis and Leprosy Control (CENAT), told The Post: “Hansen’s disease is 100 percent curable. In previous generations, people used to refer to leprosy and tuberculosis as hereditary diseases, but they are actually not. If the patient receives treatment and follows the WHO guidelines, the disease will be cured.”

He warned that if left untreated it could cause paralysis, although it would take years to do so.

“If we treat it in time, it will not leave a victim disabled. Our centre pays close attention to catching infections early enough that treatment can be offered,” he said.

According to Chanyuda, treatment may take up to a year, although this varies from patient to patient. Doctors will treat patients according to their symptoms. If an ulcer develops, for example, doctors will treat it with specific medicine, and the wound will be healed. While undergoing treatment, the disease cannot be transmitted to others, providing the doctor’s instructions are followed.

He said that according to CENAT’s research, 32 cases of Hansen’s disease have been discovered nationwide so far this year. This is an improvement over the 37 that had been found at this point last year.

Whether the rate decreases or increases depends on the efforts of national officials as well as the local authorities in all the provinces, he said.

Troeng village in Mean commune of Kampong Cham province’s Prey Chhor district used to be a place where majority of patients were treated during the Sangkum Reastr Niyum period of 1955 to 1970 as many lepers were forced to live there.

Bun Kimsron, a 62-year-old man is the resident of Troeng village. He lived in Kampong Siem district of the province until 1995, when he was diagnosed with Hansen’s and was transferred to the village for treatment. Doctors treated him for six months before he recovered, but he did not return to his home village. While undergoing treatment, he fell in love with a widow in the village and decided to stay. His wife does not have the disease.

Kimsron explained that Hansen’s caused numbness, a rash, and pain in the extremities. Wherever there were white spots on his skin, he lost sensation, and could not feel heat or cold. Because he was not diagnosed for a long period of time, the disease destroyed the cartilage in his nose and crippled his legs.

If there is even the slightest hint of infection, he urged people to seek treatment. Once you are medicated, you cannot pass the disease on to other people, he said.

People who are not treated before symptoms take affect may not be able to return to hard work, he said, because they won’t have enough energy. Old scars can easily become ulcers if they rub against the surrounding flesh, he added.

“My wife was not infected by me, because when I married her, I was taking my medication and receiving treatment. The doctors explained that the medicine kills the bacteria which cause the disease. I cannot infect anyone, but I still face discrimination from some members of the public when I leave the village,” he said.

Heng Hing, chief of Troeng village, told The Post that although the village had been used as a leper colony during the Sangkum Reastr Niyum era, the village was evacuated under the Pol Pot regime. If any lepers had not worked for them, they would have been executed. After 1979, most of the former residents returned to the village.

He said that at present, there were no infected residents in the village, as doctors had cured them of Hansen’s. There were still 39 men and women over the age of 50, who bore disabilities and scars from the disease.

He said that the lasting damage from the illness – coupled with their age – meant that they were unable to work and needed the care of their children, who were safe from infection. Some of their children had gone to work in South Korea, while some worked in garment factories or on construction sites.

“The next generation of Hansen patients knows that the disease can be cured and will seek treatment long before the symptoms get bad. Those who suffered in the past cannot earn livings because of their disabilities. In addition to that, their appearance means that they are sometimes discriminated against outside of Troeung village,” he added.

Chin Yen, a doctor at Kampong Cham Provincial Referral Hospital in Troeng village, said that at present there is only patient receiving treatment from his team. The children of Hansen’s sufferers often consulted with doctors and checked their health, he added, because they were anxious due to the condition of their parents and grandparents.

He said that there had been no new cases in the village since the last resident was cured inn 2017, although a 37-year-old patient from outside the district was being treated.

Yen explained that the symptoms of Hansen’s disease are white spots or red bumps on the skin. Sufferers will lose feeling and will not feel pain even if they are pinched or scratched, because of the damage to their nervous system. If the disease is left untreated, it can infect the nasal bones and leave rashes on the face, ears, elbows and nose.

“The disease initially begins to affect the nerves in the elbow joint, causing the wrists and elbows to become paralysed, which makes it difficult for the patient to move. Before the bacteria causes any symptoms, it has already been active on the human body for two to three years, so it can spread before we know we are infected. However, the disease is fully treatable once detected,” the doctor added.