WHAT IS NOMA?

Noma (derived from the Greek "nomein" meaning "to devour") is a devastating gangrenous disease which attacks children, quickly destroying their mouth, nose, and face, and which can prove fatal after just a few weeks. Noma, also known as cancrum oris, seems to start on the gum and extends outwards to the cheeks and lips. Without prompt treatment, mortality rates from this disease are as high as 70-90%, with most deaths attributed to complications such as pneumonia, diarrhea and septicemia.

A common predecessor to noma is Acute Necrotizing Gingivitis (ANG), one of the relatively severe forms of inflammation of the gum margin between the teeth. ANG and noma occur most frequently in poor children whose immunity is compromised as a result of severe malnutrition and endemic infections, particularly malaria and infections by the measles virus, the human cytomegalovirus, Epstein-Barr virus, and herpes simplex virus, among others.

The early features of noma include soreness of the mouth, a swollen tender cheek, a foul-smelling purulent oral discharge, fetid odor in the mouth of the affected child, swelling of the regional lymph nodes, anorexia, and a grayish-black discoloration of the skin in the affected area. The long-term effects of Noma depend largely on the anatomic sites of the lesion, the extent and severity of tissue destruction and the stage of development of the dentition and facial skeleton prior to onset of the disease.

Survivors of the disease suffer the dual problems of facial disfigurement and associated functional impairment, such as difficulty in eating, drinking, and speaking. Surgical Reconstruction of the deformity is time-consuming as well as expensive, rarely available or affordable in the areas where it is most needed, and can only repair part of the damage. Therefore prevention of the disease is the best option. Noma survivors are disfigured for life, and are commonly shunned by their communities, relegated to a life with little social or emotional comfort or support. They carry the burden of being the face of poverty for a lifetime.

NOMA FACTS

Mainly attacks children 2-14 years old.

Africa accounts for the majority of the cases.

The World Health Organization estimates that 100,000 children contract noma every year.

Without treatment, the mortality rate is 70-90%.

Most victims starve to death because their jaw muscles are literally eaten away and they cannot chew; others die as the infection spreads.