Leprosy

Leprosy

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Leprosy


Leprosy, now more commonly referred to as Hansen’s disease, is one of the world’s oldest and most feared maladies. Over the course of thousands of years, it has managed to afflict millions of people in every region of the world. In addition to physical suffering, leprosy patients also faced tremendous psychological distress, due to the fact that, until as recently as last century, the disease was seen as a punishment from God and thought to be highly contagious. As a result, leprosy sufferers faced many indignities and, in some instances, were removed from their communities and relocated to so-called “Leper Colonies.” However, in recent times, the conditions for people with leprosy have vastly improved in terms of both the treatment of the disease and removal of the stigma attached to it.

The origins of leprosy cannot be definitively traced to any particular place or time. The earliest evidence of the disease is provided by the Hindu Vedas, which mention a disease that most believe to have been leprosy, suggesting its existence in India since at least 1400 BCE (Skillicorn). There is more concrete evidence from members of the medical community that the disease existed in China by the fifth-century BCE and in Egypt as early as the second-century BCE. The disease is believed to have spread to Europe in the first-century BCE by Roman soldiers returning from war in Egypt. Its existence in Europe was first documented by Aractus and Galen in approximately 150 CE (Skillicorn). It is believed to have been spread from Europe to the Americas and South Pacific islands by European colonists. The disease became universally known as Hansen’s disease in 1873 after a Norwegian scientist, Dr. Armauer Hansen, discovered the bacterium that causes the disease, which eventually served to end the myth that the disease was a curse of God (Skillicorn).

The disease is caused by a slowly multiplying bacillus, called Mycobacterium leprae, which primarily affects the nerves, skin, and mucous membranes (Hansen’s Disease). Scientists are still unable to cultivate the organism in any bacteriological media, although it has been successfully grown on the foot pads of mice.

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The disease is divided into five categories based on medical laboratory findings - tuberculoid, borderline tuberculoid, borderline, borderline lepromatous, and lepromatous (Wathen). The tuberculoid form of the disease, also known as paucibacillary leprosy, is characterized by a strong immune system response to the infection. Patients with paucibacillary leprosy have only a few skin macula and these are located primarily around the peripheral nerves. The problematic symptom of this form of the disease is the thickening of the affected nerves, resulting in the loss of motor and sensory function (Wathen). The lepromatous form of the disease, or multibacillary leprosy, features a minimal immune response to the infection. It is characterized by an abundance of skin lesions located in the cooler areas of the body. The borderline forms of the disease are the ones that demonstrate characteristics of both forms of the disease and, therefore, cannot be categorized as one or the other (Wathen).

Although it was believed for many years that leprosy was highly contagious, studies have shown that the disease is rarely transmitted to humans through casual contact with infected persons. Children are slightly more susceptible to the disease than are adults (Wathen). It is difficult to come up with precise data regarding transmission because the disease may take up to twenty years to manifest itself. Although it remains to be proven, scientists believe that the disease is usually spread through respiratory droplets, which contain a high concentration of the bacilli (Hansen’s Disease). In the 1970’s, it was discovered that the nine-banded armadillo is a carrier of the disease, dispelling the previously held notion that only humans were carriers (Wathen). It is believed that armadillos are responsible for many of the leprosy cases in the Southwestern United States.

The first treatment for leprosy, Chaulmoogra Oil, was developed in 1853 by the Indian physician, J.F. Mouat (Skillicorn). While this did offer some benefits to leprosy sufferers, it was not an effective cure for the disease. A more advanced treatment came in 1908, when Gerhardt Domack, a German chemist, produced the drug Dapsone. Although the drug was originally considered too toxic to be administered to humans, a derivative was eventually tested, with great success, on leprosy patients in Carville, Louisiana (Skillicorn). Dapsone was able to prevent the bacillus from multiplying, although it would be years later, when the bactericidal drug Rifampicin was introduced, that the disease could be completely eradicated. Presently, multi-drug therapy, a combination of medications generally taken for six to twelve months, is the standard treatment for leprosy.

The effectiveness of multi-drug therapy is evident in the fact that, from the time it became the World Health Organization’s standard treatment for leprosy in 1982, the number of people suffering from the disease has fallen from 10 million to around 2 million today, with the majority of the cases occurring in Southeast Asia and the South Pacific islands (Wathen). The psychological situation for the victims of leprosy has also improved. Patients are no longer quarantined, and instead, are able to remain at home while they are being treated. Perhaps even more significantly, the stigma attached to the disease has virtually disappeared and the word “leper,” formerly synonymous with sinner, has been practically erased from our language (Skillicorn).


Works Cited

“Hansen’s Disease (Leprosy).” (Online) Available http://www.cdc.gov/ncidod/dbmd/diseaseinfo/hansens_t.htm, December 2001.

Mathen, Patricia I. “Hansen’s Disease.” (Online) Available http://www.sma.org/smj/96jul1.htm, July 1, 1996.

Skillicorn, Keith. “The History of Leprosy.” (Online) Available http://www.webspawner.com/users/LEPHISTORY/, 2001.
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