lecture 3

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2 Nov 2010

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history of Hansens disease/Leprosy
- referred to in an Egyptian Papyrus document (1550 BC)
- in Indian writings (600 BC)
- ancient Greece - after Alexander the Great returned from India (320 BC)
- Rome (62 BC) - return of Pompeii troops from Asia Minor
- feared and misinterpreted
- hereditary illness - curse or punishment by God
- Lepers (those infected) were stigmatized/shunned
- Europe
had to wear special clothing & bell to notify others - had to walk on the
other side of the street to opposing
- patience treated in separate hospitals - live in colonies (separated) called
leprosariums/lazaretto/leper colony/lazar house
- first leper house in England 936 AD
- mid 12th century - those infected loss civic status and removed from public office
- 13th century - 19 000 leper houses in use (a lot of cases)
- Mass of Separation -- priest would hold a ceremony to let them know their
forbade to enter areas, leave house, had to drink from own utensils, have no
contact with others
- 1350 AD -- leprosy decreased in huge amounts --
endemic more than epidemic
- Hansen of Norway 1873
- Mycobacterium leprae -- not hereditary or caused by a curse
- Mycobacterium leprae
- average doubling time of 12-14 days
- incubation period of 3-5 days
- thought to be transmitted skin to skin -- via droplets, from the nose during
close/frequent contact
- not highly infectious - may be related to genetic susceptibility
- mainly affects the skin, nerves, and mucous membranes
- Brazil, Madagascar and India still has a lot of cases
- began to decline in large numbers around the world
- people of all races around the world
- some people are genetically susceptible
- more common in warm, wet areas in the tropics/subtropics
- most common between ages 10-14 (children) and 35-44 -
- rarely seen in infants & pregnant women
clinical manifestations
interdeterminate (IL)
- earliest and mildest form
- very few lesions
- loss of sensation is very rare
- majority of cases develop into a later form
- some patients with strong immunity (recover) or continue without progressing
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