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University of Toronto Scarborough
Health Studies
Caroline Barakat

Hansens disease Leprosy: HISTORY-------------------------------------------- -Egyptian Papyrus document (1550 BC) -Indian writings, approximately 600 BC -In records of ancient Greece, after the army of Alexander the Great returned from India (320 BC) -In Rome (62 BC) with the return of Pompeiis troops from Asia Minor -Disease of the soul -Earlier thought to be a hereditary illness, or caused by a curse or by punishment from God - Lepers were stigmatized -E.g. special clothing, arrival notification, separate hospitals, and often had to live in colonies called leprosariums lazaretto leper colony lazar house -First leper house in England 936 AD - 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 ) -Leprosy is now also called Hansens Disease Etiology------------------------------------------------- -M. Leprae -Slow multiplying bacillus - average doubling time of 12 14 d -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------------------------------------------------------- -Leprosy can affect people of all races all around the world -Most common in warm, wet areas in the tropics and subtropics -Most common between the ages of 10 and 14 and in those aged 35-44 years old -Rarely seen in infants -Genetic susceptibility Clinical Manifestations------------------------------------------------- -Indeterminate Leprosy (IL): Earliest and mildest form, Usually few lesions, Loss of sensation is rare -Tuberculoid Leprosy (TT): Development of large lesions, Loss of sensation, Affected nerves become thick, Progression can occur resulting in borderline-type leprosy - Borderline tuberculoid leprosy (BT): Lesions are smaller and more numerous -Borderline Lepromatous Leprosy (BL): Lesions are 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 in this stage -Lepromatous Leprosy (LL): Never reverts to a less severe form, Early symptoms - nasal stuffiness, discharge and bleeding, and swelling of the legs and ankles, Following problems may occur: Skin thickens, Eyebrows and eyelashes are lost, Nose deformation or collapses, Ear lobes thicken, Photophobia (light sensitivity), blindness, Enlarged liver and lymph nodes, Hoarseness of voice, Fingers and toes become deformed Diagnosis and Treatment------------------------------------------------------ Diagnosis on clinical symptoms, Laboratory studies, Treatment: chaulmoogra nut, Promin (1941), Dapsone (1950s), WHO recommends multidrug therapy (MDT) Nine-banded armadillo----------------------------------------------------- Important animal for research -Armadillos do not develop human type leprosy; disease usually more severe and fatal - Low body temperature (28-33 C) may promote the disease - Mid-1980s - concern of being infected from armadillos to humans Multidrug Therapy------------------------------------------ Dapsone, Rifampicin and Clofazimine.
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