After 2-year slump in screening, Mumbai sees rise in leprosy cases

Mumbai: There is a marked rise in notifications of new leprosy cases in the city this year, a jump that appears to be caused by the normalizing of screening and health systems hit by the pandemic. Worryingly, the proportion of advanced multibacillary leprosy has increased in the new detections.

Civic data shows that between April and August, the city has recorded 236 cases already, which is almost 70% of the total cases (335) detected in the entire 2021-2022. If a monthly average is considered, the city has recorded 47 cases every month in 2022-23, which is significant considering the monthly detections usually hovered below 40 in pre-pandemic years.

Mumbai has seen plateauing in leprosy cases for almost a decade now. The detections have remained between 400-500 over the years. But the backlog of missed detections of the past two years could push this year's notifications beyond 600, officials fear. Dr Mangala Gomare, BMC's executive health officer said the rise was expected to an extent as notifications had significantly dropped in 2020-2021. In the first pandemic year, the city recorded just 166 new leprosy cases, down by 65% from cases found in 2019-2020 (466). In 2021-22, detections had slightly improved. Among the new detections, almost 50-60% are migrants and out of Mumbai residents, she added.
An even worrying finding is that of all the new cases registered in the last five months, 80% were found to be multibacillary, where an individual has six or more lesions. Leprosy is caused by a slow-growing type of bacteria called Mycobacterium leprae. The bacterial infection is known to affect the skin and peripheral nerves and in advanced stages causes deformity and disfigurement.

If someone developed lesions or any disfigurement, it's possible the disease would have advanced in two to two-and-half years, said Dr Vivek Pai, director of Bombay Leprosy Project (BLP), an organisation working to eradicate leprosy since 1976. Previously, the proportion of multibacillary cases used to be around 60% which has evidently seen an increase. Dr Pai said that the systems must be prepared to treat more cases of multibacillary leprosy and people with deformities. "Both are reflections that cases are being found late. Many patients coming to our outpatient department for the first time already have a deformity, which means they have been living with the disease for a while," he said.

Outpatient departments across civic medical colleges and Acworth Leprosy Hospital in Wadala have started seeing the normal load of cases. Dr Amita Pednekar said that leprosy is completely curable now-multibacillary treatment takes a year while paucibacillary takes six months. So, people should proactively get tested and seek treatment.