Leprosy (Hansens Disease)

Amanda Lee BIOL 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 Leprosy http://www.leprosyhistory.org/graphics/gallery/hansen.jpg

Bacteria Resides in Cooler Parts of the Body

Skin

Peripheral Nerves
http://www.nlm.nih.gov

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.

Symptoms & Diagnosis: (2) Skin Smear Tests

Ziehl Neelsen Carbol Fuchsin Stain (ZNCF)

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

Transmission

Nasal/oral Droplets Dermal Inoculations

Immunocompromised individuals are more susceptible to disease

Mechanism of Nerve Damage

1.Entry Through Blood Vessels 2. Inflammatory Response
3. Demyelination
Scollard, DM et al. 2006. The continuing challenges of leprosy. Clinical microbiology reviews 19, no. 2: 338-81.

Outcomes of Nerve Damage

Sensory Loss

Paralysis Deformities
Leprosy: eMedicine Infectious Diseases http://emedicine.medscape.com/article/220455-overview

Sensory Loss Can Lead to Secondary Infections and Severe Deformities

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

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.

1960s: Rifampicin and Clofazimine Discovered

Rifampicin (Rifampin): Inhibit RNA synthesis

Clofazimine: Anti-inflammatory

1981: WHO Proposes MultiDrug 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

STIGMA

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

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.

References
1. 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 Hansens Disease (Leprosy) Program. Hansens 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.