Leprosy (Hansen’s Disease)

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Leprosy is caused by Mycobacterium leprae

Scollard, DM et al. 2006. “The continuing challenges of leprosy.” Clinical microbiology reviews 19, no. 2: 338-81.

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Discovered by Gerhard Armauer Hansen in 1873

Global Project on the History of Leprosyhttp://www.leprosyhistory.org/graphics/gallery/hansen.jpg

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Bacteria Resides in Cooler Parts of the Body

http://www.nlm.nih.gov

SkinPeripheral

NervesBrought to you by

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.

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

Symptoms & Diagnosis: (2) Skin Smear Tests

Ziehl Neelsen Carbol Fuchsin Stain (ZNCF)

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Transmission

Nasal/oral Droplets

Dermal Inoculations

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Immunocompromised individuals are more

susceptible to disease

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Mechanism of Nerve Damage

Scollard, DM et al. 2006. “The continuing challenges of leprosy.” Clinical microbiology reviews 19, no. 2: 338-81.

1. Entry Through Blood Vessels

2. Inflammatory Response

3. DemyelinationBrought to you by

Sensory Loss

Paralysis

Deformities

Outcomes of Nerve Damage

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Sensory Loss Can Lead to Secondary Infections and Severe Deformities

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1941: Discovery of Dapsone

Targets dihydropteroate synthase (DHPS)

Inhibits nucleic acid synthesis

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1964: Dapsone Resistance from Missense Mutations in DHPS

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1960’s: Rifampicin and Clofazimine Discovered

Rifampicin (Rifampin): Inhibit RNA synthesis

Clofazimine: Anti-inflammatoryBrought to you by

1981: WHO Proposes Multi-Drug Therapy (MDT) Combination of DAPSONE,

RIFAMPICIN, and CLOFAZIMINE

+ +

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1995: WHO Distributes MDT Drugs for Free to Worldwide Patients

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1999: Global Alliance to Eliminate Leprosy As a Public Health Problem

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Obstacles to Eliminating Leprosy in Endemic Countries

STIGMA

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Overcoming Stigma

Mass Media

Integrated Primary Health Services

Education & TrainingBrought to you by

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References1. 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 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.

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. Brought to you by

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