Mycobacterium leprae

Hansens Disease aka leprosy

Ancient History
We all have heard about plague and the fear engendered with just that word. Long before the fear of the Black Plague there was a different plague; a bacterium that caused people to be separated from the masses and isolated into colonies, made to walk around covered in specific robes to identify them and ring bells to warn

others of their disease and shame. Found in ancient Egyptian

writings dated as far back as at least 1550 BC and still to this day there are new cases reported every year from all around the world.

The Discovery: GA Hansen

In 1873 G.A. Hansen, a Norwegian physician, identified Mycobacterium leprae as the bacterium responsible for what was then known as leprosy, which is now referred to as Hansens disease. Dr. Hansens study was actually performed three years prior to Robert Koch's conclusive demonstration of the bacterial cause of anthrax and is truly the first study performed linking bacteria as the causative agent behind a human disease.

The Culprit

A photomicrograph of Mycobacterium leprae taken from a leprosy skin lesion -Credit CDC

Current History
Common worldwide approximately 300,000 cases reported yearly (USA reported 213 in 2009) No vaccine to prevent it There is treatment and a cure First treatment was found in 1940 ( Dapsone ) in 1960s a strain resistant to the medication was found.

New treatment is a cocktail of dapsone, clofazamine,

fluoroquinolones, macrolids, and minocycline with aspirin and prednisone for inflammation

Symptoms
Can take years to notice Usually starts with decreased sensation ( touch, heat, or pain ) in the extremities Later symptoms include small ulcerations then large ulceration that dont heal and without treatment you have loss of extremities

It is likely that fear and shame keep people from seeking treatment early

The Bacterium
Considered one of the most pathogenic mycobacterial infectious diseases second only to tuberculosis.

To this day there is no vaccine for leprosy because we are still

unable to grow live cultures of the bacterium due to the pathogen being slow growing and its inability to live outside of a host. Only known bacterium to invade the nervous tissue by invading the Schwann Cells and macrophages in the dermis layer leading to peripheral neuropathy

The Spread

The mode of transmission is still unclear but the general consensus is the it spreads through the respiratory system via nasal droplets

Before A Cure Was Found

Pictures courtesy of Images from the History of Medicine circa 1899

The Bright Side

Approximately 90-95% of the population has natural immunity to the disease

There is a cure if treated early the disease is

arrested

The WHO gives free

treatment to those

effected