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.