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Leprosy (Hansen’s 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.

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Leprosy (Hansen’s Disease)

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Leprosy (Hansen’s 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

Peripheral Nerves

Skin

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

  • 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.


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

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

  • Leprosy Today. “Leprosy: The Disease.” World Health Organization. http://www.who.int/lep/leprosy/en/index.html (accessed February 25 2010).

  • 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).

  • 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.

  • 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).

  • 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.


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