It is one of the oldest diseases in the world. And yet, after having believed in its eradication in the 2000s, specialists agree that we will still have to live with leprosy for a little while: 200,000 new cases are still detected each year in the world, particularly in India and Brazil.
For several years, the American states of Florida and Louisiana have also been affected by a resurgence of this disease. Should we fear his return to France? On the occasion of World Leprosy Days, which take place from this Friday to Sunday, 20 minutes asked Dr. Michel-Yves Grauwin (see box), a former surgeon specializing in leprosy with the Raoul Follereau Foundation, a historic player in the fight against this disease, for his opinion.
Does leprosy still convey a particular image?
Of course. The imagination is still very present and patients are very stigmatized. They are often victims of social exclusion due to the misconceptions and ignorance that still surround this disease. However, it is not very contagious, and if it is detected very early, at the stage of simple spots on the skin, it is perfectly treatable with three identified antibiotics. On the other hand, if we do not intervene quickly, the dermatological disease becomes neurological and can lead to paralysis of the eyes, hands and feet.
Why can’t we eradicate it with these antibiotics?
It is a disease that affects the poorest, who have difficult access to care, as is the case for half of the population in Madagascar, for example. In addition, Hansen’s bacillus – which causes leprosy – is a bacteria that we breathe in the air. The incubation is very long and therefore difficult to monitor.
Today, there are less than one case per 10,000 inhabitants in African countries, but the fewer patients there are, the better they must be taken care of. The World Health Organization had imagined being able to eradicate this disease with the arrival of new antibiotics, offered by a laboratory, in the 1980s. But there is a plateau effect.
We are also seeing a resurgence in a Western country, the United States. Is this worrying?
What was worrying was that the approximately 150 annual cases recorded there were not linked to an importation of the disease from a tropical country. Today, the hypothesis of a zoonosis, that is to say transmission by animals, has been confirmed. We know that the bacillus is hosted by animals: it has been found on squirrels and armadillos. And in fact, a study showed that the cases detected in Florida and Louisiana were linked to the armadillo. The people suffering from leprosy had all eaten this animal. Obviously, this is a habit in this region of the United States.
Without an armadillo on its territory, is France protected from a return of leprosy?
In our country, leprosy has disappeared, and there is no reason for it to return. The only and very rare cases detected in France come from travel or migration. I have personally been confronted with it on very few occasions. A few years ago, I had to operate on a Burkinabé who had arrived with leprosy in Lille. In Bastia, I also advised the foreign legion installed in Calvi for a Brazilian legionnaire. In addition, if antibiotic treatment is prescribed early, there is no risk of disability.
Leprosy specialist by chance
At 74, Doctor Michel-Yves Grauwin has devoted most of his career to the treatment and prevention of leprosy. A bit by chance. “When I was a young neuro-orthopedic surgeon, I went to visit a friend of a friend in Mali,” he says. He took care of lepers in a dispensary. It was through surgery that I began to take care of patients. »
Originally from Lille, the doctor spent ten years in Africa working in institutes for lepers in Mali and Senegal, before returning to practice in his region of origin, notably at the Lille hospital center. Retired for two and a half years, he is today a consultant for the Raoul Follereau Foundation, with which he still works in the field of prevention in French-speaking Africa.
He also returned from a mission in Senegal, before moving on to Guinea in February. It works in particular, in conjunction with the Ministry of Health of these countries, on the prevention of disabilities and physical rehabilitation (operation, physiotherapy, prosthesis, adapted shoes, etc.).