1. Leprosy Kristopher Brevard 1

2. What is leprosy? Ancient disease Causes skin sores, nerve damage and muscle weakness Worsens with time 2

3. What causes leprosy? Mycobacterium leprae Not very contagious Spread through prolonged close contact. Long incubation period 3

4. Prevalence of leprosy About 41,780 new cases in The United States in 2005 Typically in the south, California, Hawaii, and U.S islands About 201,635 New Cases in Southeast Asia in 2005 4

5. Mycobacterium leprae Causes leprosy Found in warm tropical countries Pleomorphic Acid-fast Can take up to 13 days for one replication cycle 5

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7. How does it get in? Binds to macrophages, and Schwann cells Phagocytosis Creates electron transparent zone Protects against phagolysosome 7

8. Evasion ! Replicates exclusively inside macrophages and Schwann cells Most phagocytes and APCs don't encounter pathogen Up regulated Mcl-1 Down regulates Bak and Bad 8

9. Evasion part 2 NK cells and neutrophils are important in activating more immune response TH2 response not effective Bacteria is allowed to continue to replicate 9

10. What are the symptoms? Skin lesions (lighter than normal skin) Decreased sensation to touch, heat or pain Muscle weakness Numbness 10

11. Forms of leprosy 11 Tuberculoid Less severe Skin lesions Asymmetrically distributed Lepromatous Pale macules Failure of Th1 cell activation. More severe Large lumps and nodules

12. Diagnosis Lepromin skin test Skin lesion biopsy Skin scraping examination 12

13. Treatments and Prevention 13 Multi drug therapy Rifampicin, Dapasone, Clofazimine Prevention is achieved by avoiding physical contact with untreated people

14. References 14 Sehgal, Virendra N., Kabir Sardana, and Sunil Dogra. "The Imperatives Of Leprosy Treatment In The Pre- And Post-Global Leprosy Elimination Era: Appraisal Of Changing The Scenario To Current Status." Journal Of Dermatological Treatment 19.2 (2008): 82-91. Academic Search Complete. Web. 28 Mar. 2012.Barker, L. 2006. Mycobacterium leprae interactions with the host cell: recent advances (Review article). Indian J Med Res, 123: 748-59. “Leprosy Fact Sheet”. World Health Organization. October 2005. linklink “Hansen’s Disease: Leprosy”. Centers for Disease Control and Prevention: Division of Bacterial and Mycotic Diseases. Dept. of Human Health and Services. October 2005. linklink Lavanya, M., Deena, V., Sujai, S., Balasubramanian, A., et al. 2001. Biochemical aspects of mycobacterium leprae binding proteins: A review of their role in pathogenesis. Int. J Leprosy and Other Mycobacterial Dis. LinkLink Greer, Alex Mycobacterium Leprae. Davidson College, 2007. Web. 10 Mar. 2012.