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 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 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.

Integrated Primary Health Services 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.