City sees two-fold rise in leprosy cases in 2022-23; 77% in advanced stage
Mumbai has seen a two-fold increase in new leprosy cases in 2022-23 compared to the previous year, with 626 cases reported. The majority of cases are multibacillary leprosy, and there has also been a rise in Grade II cases. The city's health department attributes the increase to special drives conducted after the pandemic. Prompt detection and treatment are crucial to preventing deformities caused by the disease. Health experts emphasize the need for early detection and referral to interrupt transmission and achieve the government's goal of zero leprosy transmission by 2027. Migration and high disability rates are contributing factors in Mumbai's rise in cases.
Mumbai: The city has witnessed a two-fold rise in notifications of new leprosy cases in 2022-23, with 626 new cases compared to 336 cases registered in 2021-22, according to the civic body’s data. Out of the 626 new cases, 482 (77%) are suffering from multibacillary leprosy (MB) – an advanced stage of contagious leprosy.
According to the Brihanmumbai Municipal Corporation (BMC) health department, the city used to see 400 to 500 cases annually before the pandemic. After the pandemic, the department had started special drives that led to more notifications, they said.
“In 2021-22, the MB cases were 254, while in 2020-21, there were 123 MB cases. Before that, the city saw 286 and 312 MB cases in 2018-19 and 2019-20 respectively. The MB percentage has been rising for the last few years. This year, between April-June it has been 78.47%,” a BMC health official said. He added that detection of MB and putting them on medication helps them from preventing them from the deformity.
“All of them have been put on treatment, and their close contacts have been screened for leprosy. If MB is not treated on time, the disease advances towards non-reversible deformity,” said the official.
The data shows that on average 10% of the new leprosy cases have been Grade II – advanced stage of leprosy with deformity. “In 2022-23 there were 58 (9.27%) Grade II cases. Between April to June, we saw 15 Grade II cases (10.42%). In 2021-22 there were 42 (12.54%) and in 20-21 the city saw 18 (10.84%) cases. Before the pandemic too, the percentage remained more or less the same,” said a BMC health official.
While MB patients need 12 months of treatment, paucibacillary (PB) – the non-infectious stage of leprosy patients – needs a six-month course of medication. Leprosy, also known as Hansen’s disease, is a chronic infectious disease which mainly affects the skin, the peripheral nerves, the mucosa of the upper respiratory tract, and the eyes.
While leprosy is curable with multidrug therapy, if untreated, the disease can lead to progressive and permanent damage to the skin, nerves, limbs and eyes, according to the WHO. It also states that the Covid-19 pandemic led to a reduction in new case detection by 37% in 2020 compared with 2019.
Dr VV Pai, director, Bombay Leprosy Project, said there has to be a paradigm shift in how leprosy is detected to achieve the Indian government’s strategic plan and roadmap to achieve zero transmission of leprosy by 2027. “You have to identify the disease early and identify the progressive form of the disease (MB) much earlier. Healthcare personnel including paramedical staff need to be trained to suspect and refer MB at an early stage. This will help in interrupting the transmission of the disease,” he added.
Dr Pai said Mumbai has seen a rise in new leprosy cases due to the city opening up post Covid-19 pandemic. “Migration has taken place, and most MB cases are from the migrant population. It may not have been picked up in their hometown. Grade II disability too is high,” he said.