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Chapter 14

Chapter 14 - Hansen's Disease or Leprosy

4 Pages

Health Studies
Course Code
Caroline Barakat

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Hansen’s 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 Pompeii's troops from Asia Minor • Disease of the soul o Earlier thought to be a hereditary illness, or caused by a curse or by punishment from God • Middle Ages o Considered a disease of the soul and happened to people irascible and suspicious, but mostly had a desire for lustful sex o Accepted as the punishment for sins of the flesh • Lepers were stigmatized o 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-12 century - loss of civic status, removal from public office th • 13 century - 19,000 ‘leprosaria’ in use • Mass of Separation o Decline around 1350 AD • Spread to North America • 1823 – leprosy in Hawaii o Used quarantine and segregation o 1865 – leper colony establish on Molokai o 1873 – Father Damien joined colony as priest, stayed for 16 years; bandaged sores, built homes, a hospital, a reservoir and plumbing system and buried hundreds of victims; did not avoid contact of lepers; may have contacted leprosy before going to island but story increased of the infectious nature of leprosy • 1917 – leprosarium established in Carville Louisiana; treated like prisoners Dr. Armauer Hansen of Norway-1873. • Discovers the leprosy germ under a microscope • Mycobacterium leprae (M. leprae ) • Leprosy is now also called Hansen's Disease Etiology • M. leprae • Slow multiplying bacillus o average doubling time of 12 – 14 d • Incubation period of 3 – 5 yrs • 1-10 bacilli can cause infection • No known vector or reservoir hosts and no satisfactory way of determining past infections • 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 (IL) • Tuberculoid (TT) • Borderline tuberculoid (BT) • Borderline lepromatous (BL) • Lepromatous (LL) 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
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