The type of leprosy a person will develop is dependent on their natural resistance to the disease not the type of germ. There is only one leprosy germ but people react to it in different ways. If a person has no resistance, the germs multiply freely in the skin, the lining of the nose and even deep organs like the liver. This is lepromatous leprosy. Other types are tuberculoid, borderline and indeterminate, each with their own typical symptoms. Many people have a natural resistance to leprosy and will never develop clinical signs though exposed to untreated, active patients for long periods.

The early signs and symptoms of leprosy can vary considerably depending on a patient’s resistance to the disease. They can be easily missed or mistaken for some other disease by the untrained person. People with lepromatous leprosy usually develop a skin rash or nodules while tuberculoid leprosy might first show itself as an area of numbness or pins and needles. Dark-skinned people sometimes have patches that are paler in colour than their normal skin and light-skinned patients show pinkish and reddish patches. There is no one “first sign” of leprosy. Careful consultation by a competent doctor with the examination of skin smears under a microscope is necessary for correct diagnosis.

Like the common cold. Scientifically speaking, it is almost impossible to prove how the leprosy germ gets from one person to another, but people with lepromatous leprosy expel large numbers of germs from their nose and mouth. Like the common cold it is probable that the germs get into the body by inhalation or ingestion as happens in other diseases such as tuberculosis and influenza. Researchers are still working on how exactly the germ moves from one person to the next.