Transcript Leprosy (Hansen`s Disease)

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
1.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 MultiDrug 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
1. 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.