Leprosy (Hansen’s Disease)

Amanda LeeBIOL 402

Leprosy is caused by Mycobacterium leprae

Scollard, DM et al. 2006. “The continuing challenges of leprosy.” Clinical microbiology reviews 19, no. 2: 338-81.

Discovered by Gerhard Armauer Hansen in 1873

Global Project on the History of Leprosyhttp://www.leprosyhistory.org/graphics/gallery/hansen.jpg

Bacteria Resides in Cooler Parts of the Body

http://www.nlm.nih.gov

Skin Peripheral Nerves

Symptoms & Diagnosis: (1) Skin Lesions

Worobec, Sophie M. 2009. “Treatment of leprosy/Hansen's disease in the early 21st century.” Dermatologic therapy 22,

no. 6: 518-37.

Global Project on the History of Leprosyhttp://www.leprosyhistory.org/graphics/gallery/mleprae.jpg

Symptoms & Diagnosis: (2) Skin Smear Tests

Ziehl Neelsen Carbol Fuchsin Stain (ZNCF)

Transmission

Nasal/oral Droplets

Dermal Inoculations

Immunocompromised individuals are more

susceptible to disease

Mechanism of Nerve Damage

Scollard, DM et al. 2006. “The continuing challenges of leprosy.” Clinical microbiology reviews 19, no. 2: 338-81.

1.Entry Through Blood Vessels

2. Inflammatory Response

3. Demyelination

Sensory Loss

Paralysis

Deformities

Outcomes of Nerve Damage

Leprosy: eMedicine Infectious Diseaseshttp://emedicine.medscape.com/article/220455-overview

International Federation of Anti-Leprosy Associations (ILEP)http://www.ilep.org.uk/en/

Sensory Loss Can Lead to Secondary Infections and Severe Deformities

1941: Discovery of Dapsone

Targets dihydropteroate synthase (DHPS)

Inhibits nucleic acid synthesis

1964: Dapsone Resistance from Missense Mutations in DHPS

Matsuoka, Masanori M. 2010. “Drug Resistance in Leprosy.” Japanese journal of infectious diseases 63, no. 1: 1-7.

1960’s: Rifampicin and Clofazimine Discovered

Rifampicin (Rifampin): Inhibit RNA synthesis

Clofazimine: Anti-inflammatory

1981: WHO Proposes Multi-Drug Therapy (MDT) Combination of DAPSONE,

RIFAMPICIN, and CLOFAZIMINE

+ +

The Nippon Foundation http://www.nippon-foundation.or.jp/eng/

1995: WHO Distributes MDT Drugs for Free to Worldwide Patients

1999: Global Alliance to Eliminate Leprosy As a Public Health Problem

Obstacles to Eliminating Leprosy in Endemic Countries

World Health Organization. 2001. “Leprosy: Learning from Success.” WHO Publications on Leprosy.

STIGMA

Overcoming Stigma

Mass Media

Integrated Primary Health Services

Education & Training

Worobec, Sophie M. 2009. “Treatment of leprosy/Hansen's disease in the early 21st century.” Dermatologic therapy 22, no. 6: 518-37.

References1. Leprosy Today. “Leprosy: The Disease.” World Health Organization.

http://www.who.int/lep/leprosy/en/index.html (accessed February 25 2010).

2. Matsuoka, Masanori M. 2010. “Drug Resistance in Leprosy.” Japanese journal of infectious diseases 63, no. 1: 1-7. http://www.nih.go.jp.libproxy.lib.unc.edu (accessed February 25, 2010).

3. National Hansen’s Disease (Leprosy) Program. “Hansen’s Disease (Leprosy) Facts.” U.S. Department of Health and Human Services. http://www.hrsa.gov/hansens/ Accessed February 25 2010.

4. Scollard, DM, LB Adams, TP Gillis, JL Krahenbuhl , RW Truman, and DL Williams. 2006. “The continuing challenges of leprosy.” Clinical microbiology reviews 19, no. 2: 338-81. http://www.ncbi.nlm.nih.gov.libproxy.lib.unc.edu (accessed February 25, 2010).

5. Worobec, Sophie M. 2009. “Treatment of leprosy/Hansen's disease in the early 21st century.” Dermatologic therapy 22, no. 6: 518-37. http://www3.interscience.wiley.com.libproxy.lib.unc.edu (accessed February 25, 2010.