Biological Sciences
Leprosy
Leprosy, also known as Hansen's disease, is a chronic infectious disease caused by the bacterium Mycobacterium leprae. It primarily affects the skin, peripheral nerves, and mucous membranes, leading to skin lesions and nerve damage. Leprosy is transmitted through respiratory droplets and close contact with an infected individual, and early diagnosis and treatment are crucial in preventing disability and further transmission.
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12 Key excerpts on "Leprosy"
eBook - ePub- Christopher E. M. Griffiths, Jonathan Barker, Tanya O. Bleiker, Robert Chalmers, Daniel Creamer, Christopher Griffiths, Jonathan Barker, Tanya Bleiker, Robert Chalmers, Daniel Creamer, Christopher E. M. Griffiths, Tanya O. Bleiker, Christopher Griffiths, Jonathan Barker, Tanya Bleiker, Robert Chalmers, Daniel Creamer(Authors)
- 2016(Publication Date)
- Wiley-Blackwell(Publisher)
CHAPTER 28 Leprosy Diana N. J. Lockwood London School of Hygiene & Tropical Medicine, London, UKDefinition and nomenclature
A chronic granulomatous disease caused by Mycobacterium leprae, principally affecting peripheral nerves and skin.Synonyms and inclusions
- Hansen's disease
- Hanseniasis
- Names in local languages in endemic areas
Introduction and general description
Endemic in India and the Far East since ancient times, Leprosy was imported into Europe in the 4th century BC, perhaps by the troops of Alexander the Great. The European epidemic peaked in the 13th century, then slowly died out [1]. French settlers took Leprosy to Canada and African slaves took it to America. Even after the discovery of the agent, Mycobacterium leprae, by Armauer Hansen in Norway in 1873 (the first bacillus to be associated with a human disease), the infectious nature of Leprosy was not readily accepted [2]. The slow spread of the disease and its familial association suggested that it was inherited. This belief, and the fear of the deformities that Leprosy may cause, have contributed to the stigma and ostracization that still characterize attitudes towards Leprosy. Stigma remains a major obstacle to Leprosy control, despite advances in bacteriology, chemotherapy and epidemiology. New patients today can be reassured that their bacterial infection is readily treatable with antibiotics although associated nerve damage is more difficult to treat.Epidemiology
Incidence and prevalence
About 4 million people have, or are disabled by, Leprosy. The apparent fall in registered patients from 12 million in 1988 to 0.25 million on treatment in 2014 hides an intriguing picture. Prevalence has fallen due to a combination of effective antibiotic therapy and a change in case definition. Incidence, however, remains stable at around 250 000 new cases annually, with high rates of childhood cases [3].
- Alfonso J. Rodriguez-Morales(Author)
- 2018(Publication Date)
- IntechOpen(Publisher)
Section 1 Neglected Tropical Diseases Chapter 1 Leprosy: The Ancient and Stubborn Disease Prasetyadi Mawardi Additional information is available at the end of the chapter http://dx.doi.org/10.5772/intechopen.79984 Abstract Leprosy can be caused by an infection of Mycobacterium leprae commonly acquired through contact with an infected person. Clinical presentation depends on the patient ’ s immune status at the time of infection and during the course of disease. Leprosy is associated with disability and marginalization. The Global Leprosy Strategy 2016 – 2020 released in April 2016 underscored its goal of “ accelerating towards a Leprosy free-world. ” Today ’ s Leprosy differs from the Leprosy of the past, but yet there are still many things that are not immediately known, so it is still a broad socioeconomic challenge for scientists to solve. Leprosy has low pathogenicity, only a small proportion of infected people develop signs of the disease. If Leprosy is not diagnosed and treated in the early stages, further progress of the disease is determined by the strength of the patient ’ s immune response. Various clinical signs can be known during the early phase of Leprosy, defined as indeter-minate phase, so that it is difficult to diagnose the disease. Multidrug therapy (MDT) was recommended as the standard treatment. The morbidity report of Leprosy will be impor-tant in epidemiology because it is based on real events and not based on estimate. Keywords: Leprosy, multidrug therapy, Mycobacterium leprae 1. Introduction Leprosy or Hansen disease is caused by an infection of Mycobacterium leprae , an acid-fast, rod-shaped bacillus, usually acquired through contact with an infected person. However, not every person exposed to an infected contact will develop Leprosy [1]. M. leprae multiplies slowly, and the incubation period of the disease, on average, is 5 years. In some cases, symptoms may occur within 1 year but can also take as long as 20 years to occur.
No longer available |Learn more- (Author)
- 2014(Publication Date)
- Orange Apple(Publisher)
________________________ WORLD TECHNOLOGIES ________________________ Chapter 1 Leprosy Leprosy (Hansen's disease) A 24-year-old man infected with Leprosy. ICD-10 A30. ________________________ WORLD TECHNOLOGIES ________________________ ICD-9 030 OMIM 246300 DiseasesDB 8478 MedlinePlus 001347 eMedicine med/1281 derm/223 neuro/187 MeSH C01.252.410.040.552.386 Leprosy or Hansen's disease ( HD ), is a chronic disease caused by the bacteria Mycobacterium leprae and Mycobacterium lepromatosis . Named after physician Gerhard Armauer Hansen, Leprosy is primarily a granulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract; skin lesions are the primary external sign. Left untreated, Leprosy can be progressive, causing permanent damage to the skin, nerves, limbs and eyes. Contrary to folklore, Leprosy does not cause body parts to fall off, although they can become numb and/or diseased as a result of infection; infection results in tissue loss, so fingers and toes become shortened and deformed as the cartilage is absorbed into the body. Although the mode of transmission of Hansen's disease remains uncertain, most investigators think that M. leprae is usually spread from person to person in respiratory droplets. The minimum incubation period reported is as short as a few weeks and this is based on the very occasional occurrence of Leprosy among young infants. The maximum incubation period reported is as long as 30 years, or over, as observed among war veterans known to have been exposed for short periods in endemic areas but otherwise living in non-endemic areas. It is generally agreed that the average incubation period is between three and five years. Leprosy is now known to be neither sexually transmitted nor highly infectious after treatment. Approximately 95% of people are naturally immune and sufferers are no longer infectious after as little as 2 weeks of treatment.
eBook - PDF- Joseph P. Byrne(Author)
- 2008(Publication Date)
- Greenwood(Publisher)
Historically, Leprosy has tended to cluster in certain geographic areas. In North Amer- ica the disease was once prevalent in Louisiana and New Brunswick, Canada. Although Leprosy is generally endemic rather than epidemic, major population dislocations under conditions of war or natural disaster expose more people to the disease. For example, Leprosy 353 NAMING THE UNSPEAKABLE Near the end of the twentieth century, victims, caregivers, and the medical community at large decided that use of the term “leper,” with its centuries-old stigmatizing power, should be abandoned in favor of “Hansen’s Disease,” a name recognizing the central role of Norwegian biologist Gerhard Hansen in Leprosy research. Around the globe and across time, however, Hansen’s Disease has had many dif- ferent labels. The term in Old Norse, ancestor of Hansen’s Norwegian, is directly related to the verb “to suffer.” In Mali it is “the big disease,” while Brazilians refer to it as “the spot disease.” In the southern United States some folks refer to it as “this package,” but among Cajuns in Louisiana it is “the disease you do not name.” Arabic has long had two labels: one is djudham, which derives from the verb to cut off or mutilate, and the other is al-baras, a reference to the hypo- pigmented white blotches on the victim’s skin. dozens of American servicemen con- tracted Leprosy in the Philippines during the Spanish-American War. Theories explaining the sharp decline in Leprosy in Europe in the fourteenth century include improved standard of living, advances in hygiene, crossover immunity from tuber- culosis, depopulation from bubonic plague, and the effectiveness of isolation measures. In retrospect, isolation was probably never very effective in prevent- ing spread of the disease. The last endemic focus of Leprosy in Western Europe was in Norway, where the disease lingered into the early twentieth century.
eBook - PDF- Rene Germanier(Author)
- 2012(Publication Date)
- Academic Press(Publisher)
14 Leprosy TORE GODAL Laboratory for Immunology Department of Pathology and the Norwegian Cancer Society Norsk Hydro's Institute for Cancer Research The Norwegian Radium Hospital Montebello, Oslo, Norway I. Introduction 419 II. Causative Agent 420 III. Clinical Manifestation 421 A. Polar Tuberculoid 421 B. Borderline Tuberculoid 422 C. Borderline 422 D. Borderline Lepromatous 422 E. Lepromatous 422 IV. Pathogenesis of Lepromatous Leprosy 423 V. Epidemiology 425 VI. Treatment of Leprosy 425 VII. Vaccines against Leprosy 427 A. General Consideration 427 B. The Use of BCG as a Vaccine against Leprosy 428 C. Research Program for the Development of a Specific AntiLeprosy I. Introduction Leprosy is a chronic infectious disease caused by the acid-fast bacillus My-cobacterium leprae. Leprosy is an ancient disease, first believed to be referred to as early as 600 B.C. in Indian literature. From its origins either in Africa or on the Indian subcontinent, Leprosy spread to Europe, becoming endemic during the Middle Ages. From Europe it was brought to the New World by early explorers. The Leprosy bacillus was first described by Hansen in 1874. Leprosy today Vaccine D. Planned Clinical Trials References 428 429 429 419 Bacterial Vaccines Copyright © 1984 by Academic Press. Inc. All rights of reproduction in any form reserved. ISBN 0-12-280880-0 420 Tore Godal affects between 10 to 15 million people worldwide, with the majority of patients found in tropical and subtropical areas of developing countries. Climatic factors per se, however, are unlikely to be the sole determining factor of the disease. Several thousand Leprosy cases were registered in Norway in 1860, and cases as far north as the Lofoten islands (above the arctic circle) have been reported. In endemic areas, the annual incidence may reach 4 to 6 cases per thousand; rates of 10 cases per thousand have been noted in Africa and some regions of Asia.
eBook - PDF- U.K. Misra(Author)
- 2003(Publication Date)
- CRC Press(Publisher)
C hapter 6 Leprosy K V Desikan Leprosy is endemic in many of the tropical countries due to poor health stan dards. Whereas it is endemic in India and in some countries of Africa and Southeast Asia, Leprosy is the most common cause of peripheral neuritis. In these countries, therefore, Leprosy should be considered first while investigating a case of peripheral neuropathy. Leprosy has been known since ancient times, and there was no cure until very recently. This fact, together with the hideous disfigurement of neglected cases, pro duced a great fear of this disease and a hatred of its victims. Consequently, the concept in the minds of most people about Leprosy was that of a socially repulsive enigma rather than a physical ailment. In the past five decades, there have been significant developments in epidemiology, bacteriology, immunology and therapeu tics. Considerable research has been carried out on the immunology and pathogen esis of Leprosy. Subsequent to the discovery of Dapsone as an anti-Leprosy drug in 1950, several new and more effective drugs have been developed and are in use. Surgical repair and reconstruction of deformities have gone a long way in the reha bilitation of disabled patients. Effective methods of control of Leprosy have helped in achieving a remarkable fall in the global prevalence. Equally important as all these notable medical and scientific achievements is the fact that the age old fear and stigma of Leprosy have considerably diminished as a consequence of increased aware ness about Leprosy. Etiology The causative organism of Leprosy, Mycobacterium leprae, was discovered by Armeur Hansen in 1874. Interestingly it was the first human pathogenic bacterium to be identified and is the only such organism that has not yet been cultured. Myco bacterium leprae is a nonmotile, nonsporing Gram positive bacilli, 5-8 p long and 0.5 p wide and takes an acid-fast stain by the Ziehl-Neelsen technique.
eBook - PDFViewing Disability in Medieval Spanish Texts
Disgraced or Graced
- Connie Scarborough(Author)
- 2018(Publication Date)
- Amsterdam University Press(Publisher)
4 Leprosy – Los Gafos This chapter deals with a disabling disease of paramount importance in the Middle Ages – Leprosy. I have chosen to include Leprosy in a book dealing with physical disabilities for a number of reasons. First, Leprosy is indeed disabling, both in the medical sense and from a social standpoint since a diagnosis of Leprosy could result in social isolation and stigmatization. Secondly, the disease may manifest symptoms, especially skin lesions, that result from the constricted flow of blood to the body’s extremities, that make the leper as visible, if not more so, than other disabled persons in a community. Also, the symptoms of Leprosy can develop slowly over time, thus subjecting the af flicted to long years of the experience of disability. Medical Knowledge The cause of Leprosy was not discovered until 1873, when Gerhard Armauer Hansen identif ied the organism responsible for the disease, the mycobacte-rium leprae . The organism multiplies and af fects peripheral nerves, the skin, and finally the bones; the rate of progression of the disease depends on the individual’s immune system. Leprosy is not, in fact, very contagious and is usu-ally spread by contact with nasal fluid from an infected individual, but even in cases where such contact occurs, many people have natural resistance to the bacteria. If contracted, the disease can range from the mild tuberculoid type known as paucibacillary Leprosy to the more serious multibacillary form that results in gross physical disf igurement. The milder form can manifest itself as pale areas of desensitized skin but it can worsen and later result in crip-pling from atrophy, secondary infections, and, finally, loss of the extremities. 1 Luke Demaitre addresses the very valid question about whether the disease identif ied by Hansen, and often called Hansen’s disease, was identical to Pre-Modern Leprosy.
eBook - PDF- R. J. Schnitzer, Frank Hawking, R. J. Schnitzer, Frank Hawking(Authors)
- 2013(Publication Date)
- Academic Press(Publisher)
— 10— Experimental Chemotherapy of Leprosy PHILIP C. EISMAN* Page I. Human Leprosy (Hansen's Disease) 501 A. Origin of the Disease 501 B. Distribution 502 C. Immunological Relationship to Tuberculosis 502 D. Transmission of Leprosy 503 E. Pathology 504 II. Mycobacterium leprae (Hansen's Bacillus) 505 A. General Considerations 505 B. Morphology 505 C. Attempts at Cultivation 506 III. Murine Leprosy 511 A. Causative Organism: Mycobacterium lepraemurium (Stefansky's Bacillus; Rat or Murine Leprosy Bacillus) 511 B. Cultivation 511 IV. Screening Procedures with Mycobacterium lepraemurium 516 A. General Considerations 516 B. Experiments in Rats 517 C. Experiments in Mice 518 V. Chemotherapeutic Activity of AntiLeprosy Agents 520 A. Chaulmoogra Oil and Its Derivatives 520 B. Sulfur-Containing Compounds 521 C. Isoniazid (INH) and Its Derivatives 533 D. /»-Aminosalicylic Acid (PAS) 535 E. Streptomycin and Dihydrostreptomycin 535 F. Other Antibiotics 538 G. Miscellaneous Compounds 540 H. Relationship between Antituberculous and AntiLeprosy Activity 541 References 542 I. Human Leprosy (Hansen's Disease) A. Origin of the Disease Leprosy is probably the oldest infectious disease known to afflict mankind. It is considered by certain historians to have originated in the rain forests of * This chapter is dedicated to the memory of Dr. Rudolf L. Mayer, who enriched the lives of many who knew him as a scientist and as an individual. 501 502 PHILIP C. EISMAN Africa or in India or China. Regardless of where it first appeared, it is known with certainty that it existed in Egypt from the earliest recorded times (2000 B.c.) in the delta and the Nile Valley. From Egypt, Leprosy invaded Asia Minor and Europe. It was carried from the Middle East to Rome by Pompey during the Syrian Campaign of 62 B.C. and thence to the provinces of Gallia, Hispania, and Brittania. Simultaneously, the Arab invaders from North Africa further disseminated the disease throughout Spain and southern France.
eBook - PDFCriminalising Contagion
Legal and Ethical Challenges of Disease Transmission and the Criminal Law
- Catherine Stanton, Hannah Quirk(Authors)
- 2016(Publication Date)
- Cambridge University Press(Publisher)
8 Rod Edmond, Leprosy & Empire: A Medical and Cultural History (New York: Cambridge University Press, 2006), p. 12. 9 Alison Bashford, Imperial Hygiene: A Critical History of Colonialism, Nationalism and Public Health (New York: Palgrave Macmillan, 2004), pp. 81 and 83. 10 Ibid., p. 113. 11 One of the dilemmas in this history is over what to call those ‘persons with Leprosy’ – because of stigma, hurt, and the derogatory nature of the term ‘leper’ it is not used unless quoting directly from historical sources. Contemporary scholars often use Leprosy and Hansen’s disease interchangeably in their writings. Kerri A. Inglis 58 it is important to privilege their experiences, as medical anthropolo- gist Arthur Kleinman has stated, ‘we, each of us, injure the humanity of our fellow sufferers each time we fail to privilege their voices, their experiences’. 12 As the medicalisation and criminalisation of the disease throughout the 104 years of isolation policy in Hawaiʿi developed, both served to objectify those with Leprosy and perpetuate the stigma attached to the disease. Those with Leprosy were criminalised through the arrest and treatment that came with their banishment from Hawaiian society; moreover, medical experiments and notions of ‘progress’ further objecti- fied these victims of disease. There are many descriptions from former patients concerning their experiences with Leprosy. For many, both the policies and the terminology surrounding the disease left a deep imprint. Naming or labelling of course brings with it implications of identity. What follows is an account from a man who was sent to Kalaupapa in the early 1900s. His narrative, offered through an oral history project decades after he was diagnosed with the disease, describes his experience with contracting Hansen’s disease when he was a young boy. Being labelled as one who had contracted Leprosy brought with it an immediate shift in his identity: My father came to take me home from school.
eBook - PDFBioinsecurities
Disease Interventions, Empire, and the Government of Species
- Neel Ahuja(Author)
- 2016(Publication Date)
- Duke University Press Books(Publisher)
As such, patients often experience disease progression through numbing of nerves in the extremities, inflammation, and granulomas, which, in advanced cases, can permanently impact the capabilities and form of hands or feet. The bones of digits may be absorbed, which contributes to the myth that the disease causes extremi-ties to fall of f. Diagnosis of Hansen’s has long been divided into two main forms, the “tuberculoid” (which emphasizes the presence of a small number of granulomas), and the “lepromatous” (emphasizing multiple infections with a greater number of granulomas and systemic impacts on the nervous system). “AN ATMOSPHERE OF Leprosy” 39 However, these distinctions are of degree rather than kind, and most patients are diagnosed with a combined, “borderline” presentation. Even this brief synopsis of the physiology of Hansen’s disease posits the bacillus and the immune system in a drama of interspecies battle. However, it is possible to modify this description, foregrounding the interactivity of microbes moving within and across the skin-bound human body, as well as the spectrum of resulting immune balances that confound divisions between the diagnostic categories. M. leprae lives primarily housed in or near the ex-tremities depending on the immune response, allowing in adaptive cases (i.e., cases of disease where the bacillus successfully adapts to the body of a human host) for physical transmission of bacteria between proximate bodies and shelter for the bacillus from the stronger macrophagic response within tissues and fluids deeper beyond the skin. The limb impairment, facial transitions, skin blemishes, and nerve damage that have come to define visual images of Hansen’s disease, then, are signs of an adapted macrophagic response, the balance struck with bacteria that transit across human bodies with dif fering genetic vulnerabilities and immune antibodies.
eBook - ePub- William R. Faber, Roderick J. Hay, Bernard Naafs, William R. Faber, Roderick J. Hay, Bernard Naafs(Authors)
- 2012(Publication Date)
- Wiley-Blackwell(Publisher)
In 2006 the World Health Organization declared that Leprosy had been “eliminated” as a “public health problem.” This would have been a huge achievement if it was true. However, it is shown that changing operational and administrative targets played a decisive role in achieving the elimination targets. Definitions have been changed and treatment periods shortened. Leprosy services have been dismantled and integrated into the general health services without proper training and follow-up [1,4]. To date the true prevalence of the disease is in some areas more than twice the registered [5]. With the increase in and the extent of mobile populations in the world it is a disease to reckon with, a disease that may lead to severe disabilities when not diagnosed in time and not treated properly. Doctors' delay is a big problem in Europe and the United States [6,7]. Moreover, it is so in many of the Leprosy endemic countries too, where Leprosy is often hardly taught at Medical Schools [8].Increasingly, Leprosy shows as an immune reconstitution inflammatory syndrome (IRIS): seropositive HIV patients infected with M. leprae , when treated with ARVs, recover their cell-mediated immunity and then develop clinical Leprosy, indicating that there may be a pool of M. leprae of unknown size [9].Until 2005, Leprosy was the disease to be eliminated; now it is counted among the neglected diseases. EpidemiologyLeprosy is still endemic in Middle and South America, in Africa south of the Sahara, and in Asia from Iran to Indonesia, on some islands in the Pacific, and in the northern territory of Australia. (Figure 8.1 ) More than 85% of the Leprosy patients live in the following countries: India, Brazil, Indonesia, Nepal, Mozambique, Madagascar, United Republic of Tanzania, Democratic Republic of the Congo, and Central Africa.Figure 8.1 Leprosy prevalence rates, data reported in January 2011 (reproduced from Leprosy prevalence rates, data reported to WHO as of beginning January 2011, with permission WHO)Leprosy is an infectious disease caused by an intracellular acid-fast bacterium: M. leprae . In 1873, Armauer Hansen was the first to describe the bacterium as the cause of Leprosy, instigated by the work of Drognat Landré, a Dutch physician working in Suriname, who from his observations concluded that Leprosy must be a contagious disease [10]. However the postulates of Koch have still not been fulfilled. It has not yet been possible to infect someone willfully with M. leprae
eBook - PDFMacrophage Activation
Biology and Disease
- Khalid Hussain Bhat(Author)
- 2020(Publication Date)
- IntechOpen(Publisher)
69 Chapter 4 Macrophages in the Pathogenesis of Leprosy Rhana Berto da Silva Prata, Mayara Garcia de Mattos Barbosa, Bruno Jorge de Andrade Silva, Jéssica Araujo da Paixão de Oliveira, Tamiris Lameira Bittencourt and Roberta Olmo Pinheiro Abstract Leprosy is a chronic infectious disease caused by the intracellular pathogen Mycobacterium leprae . The disease may present different clinical forms depending on the immunological status of the host. M. leprae may infect macrophages and Schwann cells, and recent studies have demonstrated that macrophages are funda-mental cells for determining the outcome of the disease. Skin lesions from patients with the paucibacillary form of the disease present a predominance of macrophages with a pro-inflammatory phenotype (M1), whereas skin lesions of multibacillary patients present a predominance of anti-inflammatory macrophages (M2). More recently, it was shown that autophagy is responsible for the control of bacillary load in paucibacillary macrophages and that the blockade of autophagy is involved in the onset of acute inflammatory reactional episodes in multibacillary cells. So, strategies that aim to induce autophagy in infected macrophages are promising not only to improve the efficacy of multidrug therapy (MDT) but also to avoid the occurrence of reactional episodes that are responsible for the disabilities observed in Leprosy patients. Keywords: macrophages, Leprosy, innate immunity, scavenger receptors, autophagy 1. Introduction Macrophages are highly plastic and heterogeneous in several aspects, present-ing a spectrum of distinct phenotypes according to the microenvironment [1–3]. During mycobacterial infection, its membrane components have the ability to induce polarization and interaction with this type of cell [4]. The cell wall of M. leprae consists of lipids and contains large amounts of phthiocerol dimycocerosate and phenolic glycolipid-1 (PGL-1) [5, 6].
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