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Health Studies
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Caroline Barakat

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Test #2 Leprosy (Hansens Disease), Tuberculosis, and
Leprosy-disease of soul
-written in Egyptian Papyrus document (1550 BC) and Indian
writings (600BC), Ancient Greece after Alex the Great returned
from India (320 BC) and Rome (62 BC) with return of Pompeii
Troops from Asia Minor
-thought to be: hereditary, punishment of god, or by curse
-leprosariums(lazaretto, leper colony, lazar house) first one in
england 936 AD
-mid 12th century lost status and removal from public office
-13th- 19000 leprosariums used
-mass of separation: no fountain drinking, small halls, wear gloves,
no touching children
-decline around 1350 AD -spread to NA
-Dr. Armauer Hansen of Norway 1873:delivered leprosy germ under
microscope called mycobacteriusm leprae (M. leprae), now called
Hansens Disease
-Etiology: slow multiplying bacillus, avg. doubling time 12-14 days,
incubation period 3-5 yrs., thought to be transmitted through
sneezing droplets during close/frequent contact, not highly
infectious, may link genetic susceptibility, mainly affects
skin,nerves, mucous membranes
-Risk: affect anyone, common in warm, wet areas of (sub)tropics,
ages 10-14 and 35-44
-Clinical Manisfestation (5): interdeterminate leprosy (IL)-earliest,
mildest, few lesions, loss of sensation rare. Tuberculoid (TT)- large
lesions, loss of sens. Nerves affected thick, progression can occur to
BL. Borderline tuberculoid (BT)- lesions smaller and more.
Borderline lepromatous (BL)-lesions numerous: popules, plagues,
nodules, saucer looking lesions, may remain in this stage.
Lepromatous (LL)-never goes back, early sympt:nasal stufiness,
discharge, bleeding, following occur: skin thickens, facial hair loss,
photophobia, fingers toes deform=Lion Face
-treatment: chaulmoogra nut, promin (1941), dapsone (1950s), WHO
recommends multidrug therapy (MDT)- dapsone, rifampicin,
-Nine banded armadillo-dont develop human form but more fatal +
severe, low body temp (28-33) may promote, mid 1980s-scared it
could affect humans to0
-prevention: handwashing, disinfection of fomites, nasal secretions,
household stuff, young household=drugs, vaccine
-Possible Reasons for Disappearance of Lep. 1)selective mortality of
lep. Patients during pandemic 2)cross immunity w mycobacteria
3)loss of pathogenicity 4)genetic selection of pop. 5) improved
quarantine 6)improved socioeconomic cond. 7)better sanitation and
housing 8)climate
-DArcy Island- first case Chinese railroad labourers 1890s, prison
for Chinese lepers, supply ships every 3 mths (food, opium, coffins),
closed in 1957 after last person died
-Tracadie, NB- may intro by sailors, slowly fam to fam to neighbor,
first case 1815, left unattended living in hut, 1844 legistlation
passed to prevent spread, lazaretto in Sheldrake island
-212 000 in 2008
-brazil, Nepal, timor lake still prevalent
Tuberculosis- White Plague
-History: tb present since antiquity still present, Egyptian
mummies(2400 BC) died of TB, 460BC-hippocrates believed due to
evil air but not contagious, Aristotle (384-322 BC) TB may be due to
bad and heavy breath
-documented in China, Egypt, India
-abnormal spinal deformities due to tuber in skeleton
-origins: first limited to animals in prehistoric times, changes in
host and environment may caused it to be transmitted to humans,
claims of super powers during middle ages, royal ppl healing powers
Kings Evil or Royal Touching
-Modern History: fracastorius made ref. to being caused by germs in
lungs leading to TB called Modern Theory of Contagion,
consumption aka tuber leading cause of death in London, sylvius
clinical work and discovers lung nodules tubercles, marten tb may
be transmitted from human to human, 19th tb spread to rest of
Europe by 1900 reached NA
-1839 tuberculosis used, leprosy still a epidemic scare
-mid 19th tb romanticized
-tb curable dr brehmer (1854)
-sanitoriums took care of ppl. Last one in 1970. 1896 started.
-Etiology: agent-tubercle bacillus germ mycobacterium tuberculosis,
acid fast bacillus. 3 main types of human: type 1, india, least
virulent. Type A china, Africa, japan, Europe, NA. type B exclusive
NA and Europe
-forms of TB: several animal forms, bovine type may lead to
pulmonary TB (most common) or military TB, common in infants,
fatal within weeks or days
-spread through air eg)cough sneeze 300 000 per sneeze
-only ppl with active lung tb infectious. You can get tb again
-left untreated affect 10-15 per year
-in other parts TB-kidney or spine (potts diease) not easily
-Epidemiology- 1/3 pop infected bacillus. Each year 30m infected, 10
mill develop active tb, 2 mill deaths per year
-Diagnosis: TST (tuberculin skin test) determines infection. Positive
tb doesnt mean tb disease. Chest xray for lungs, + sputum for
-Tb affects: middle ear, tonsil, opposite lung, pericardium, cns,
bones, intestine, genitals, muscle, liver, ireter
Treatment: cured by combos fo drugs for 6-12 mths, ppl exposed to
active tb receive preventive therapy for 6m-1 year to reduce risk of
again, BCG (bacilli calmet guerrin)
Drug resistant tb- mdr tb dangerous form, recommended.
Resistance caused by : inconsistment or partial treatment, wrong,
unreliable drug supply
Dr. Selman A Waksman- discovers new antibiotics
BCG vaccine: protection against further spread, 1925 bcg clinic est.
in montreal to grow vaccine
Syphyllis/Great Pox
15th everywhere
-king Charles viii of france invades Italy 30000 toop ppl
-pandemic in many
Invaded naples and new worlds
-blame on French
-open wounds conveyor to death
-theories: Columbian theory-intro to Europe from new world
Linked to when Columbus went to new world or after he returned.
Intro to Europe from Americas. Similar to cause being syphyllis
from skeletal remains. New disease ppl had no immunity
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