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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

Leprosy (Hansen’s Disease)

Amanda Lee

BIOL 402


Leprosy is caused by mycobacterium leprae
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
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
Bacteria Resides in Cooler Parts of the Body

Peripheral Nerves

Skin

http://www.nlm.nih.gov


Symptoms diagnosis 1 skin lesions
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
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
Transmission

  • Nasal/oral Droplets

  • Dermal Inoculations



Mechanism of nerve damage
Mechanism of Nerve Damage disease

  • 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.


Leprosy hansen s disease

Outcomes of Nerve Damage disease

  • 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
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
1941: Discovery of Dapsone Deformities

  • Targets dihydropteroate synthase (DHPS)

  • Inhibits nucleic acid synthesis


1964 dapsone resistance from missense mutations in dhps
1964: Dapsone Resistance from Missense Mutations in DHPS Deformities

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


1960 s rifampicin and clofazimine discovered
1960’s: Rifampicin and Clofazimine Discovered Deformities

  • Rifampicin (Rifampin): Inhibit RNA synthesis

  • Clofazimine:

    Anti-inflammatory


1981 who proposes multi drug therapy mdt
1981: WHO Proposes Multi-Drug Therapy (MDT) Deformities

  • Combination of DAPSONE, RIFAMPICIN, and CLOFAZIMINE

+

+


Leprosy hansen s disease

The Nippon Foundation Deformities

http://www.nippon-foundation.or.jp/eng/




Obstacles to eliminating leprosy in endemic countries
Obstacles to Eliminating Leprosy in Endemic Countries Health Problem

STIGMA

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

WHO Publications on Leprosy.


Overcoming stigma
Overcoming Stigma Health Problem

  • Mass Media

  • Integrated Primary Health Services

  • Education & Training


Leprosy hansen s disease

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

Dermatologic therapy 22, no. 6: 518-37.


References
References disease in the early 21st century.”

  • 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.