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Final

Exam Study Guide - Leprosy, Tuberculosis, Syphilis


Department
Health Studies
Course Code
HLTB21H3
Professor
Caroline Barakat
Study Guide
Final

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Leprosy (Hansens disease)
History
1550BC Egyptian Papyrus document
Approx. 600BC Indian writings
320BC Records in Ancient Greece, after army of Alexander the Great returned from
India
62BC - Rome returned with Pompeiis troops from Asia Minor
Disease of soul
Thought to be hereditary illness, caused by a curse or punishment of God
Lepers were stigmatized special clothing, arrival notification, separate hospitals,
leprosariums/lazaretto/leper colony/lazar house
936AD England - First leper house
Mid-12th century loss of civic status removal from public office;
13th century - 19,000 ‘leprosaria in use
Mass of Separation
Decline around 1350 AD
Spread to North America
Dr. Armauer Hansen of Norway 1873
Discovers the leprosy germ under a microscope
Mycobacterium leprae (M. leprae )
Etiology
Slow multiplying bacillus
- average doubling time of 12 14 days
Incubation period of 3 5 yrs
Thought to be transmitted via droplets, from the nose during close and frequent
contact
Not highly infectious may be related to genetic susceptibility
Mainly affects the skin, nerves, and mucous membranes
Risk
All races;
common in warm, wet areas in the tropics and subtropics;
Most susceptible between the ages of 10 and 14 years old, 35-44 years old
Rarely seen in infants; Genetic susceptibility
Diagnosis and Treatment
Based on clinical symptoms; laboratory studies
Chaulmoogra nut
promin (1941)
Dapsone (1950s)
WHO recommends multidrug therapy (MDT) dapsone, rifampicin, clofazimine
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Nine-banded armadillo
Do not develop human type leprosy, usually more severe and fatal;
low body temperature (28-33C) may promote disease;
mid-1980s concern of infection from armadillos
Prevention hand washing; disinfection of fomites, handkerchiefs; nasal secretions;
household contacts (young - treat with drugs); vaccine
Possible causal factors for the disappearance of disease
Selective mortality of leprosy patients during plague pandemic
Cross-immunity with other Mycobacteria
Loss of pathogenecity
Genetic selection of the population
Improved quarantine
Improved socio-economic conditions
Better housing and sanitation
Climate
Indeterminate
Leprosy (IL)Tuberculosis
Leprosy (TT)Borderline
Tuberculoid
Leprosy (BT)
Borderline
Lepromatous
Leprosy (BL)
Lepromatous Leprosy
(LL)
-earliest, mildest
form
-usually few
lesions
-loss of sensation
is rare
-development of
large lesions
-loss of sensation
-affected nerves
become thick
-progression can
occur to BT
-lesions are
smaller and
more numerous
-lesions are more
numerous, but
they may also
consist of papules,
plaques, and
nodules
-punched-out-
appearing lesions
that look like
inverted saucers
are common
-the disease may
remain at this
stage
-never reverts to a less severe
form
-early symptoms: nasal
stuffiness, discharge and
bleeding, and swelling of the
legs and ankles
-other problems: skin
thickens; eyebrows and
eyelashes lost; nose
deformation or collapses; ear
lobes thicken; photophobia
(light sensitivity); blindness;
enlarged liver and lymph
nodes; hoarseness in voice;
fingers and toes become
deformed
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