Cookie policy: This site uses cookies (small files stored on your computer) to simplify and improve your experience of this website. Cookies are small text files stored on the device you are using to access this website. For more information please take a look at our terms and conditions. Some parts of the site may not work properly if you choose not to accept cookies.

Join

Subscribe or Register

Existing user? Login

A new look at an ancient disease

  • Print
  • Share
  • Comment
  • Save
  • Print Friendly Version of this pagePrint Get a PDF version of this webpagePDF

The past week (23-29 January 2010) has been World Leprosy Week, drawing attention to one of the oldest scourges of mankind, which has been recognised for more than 4,000 years in various ancient civilisations.

Western attitudes towards the disease come directly from the Bible, in which leprosy is described as a “punishment for sin”. Even though its prevalence steadily declined in Western Europe after a peak in the 14th century, it became epidemic in other parts of the world.

In 1873, Armauer Hansen identified the causative agent as the bacterium Mycobacterium leprae. Contrary to historical opinion, the disease is not easily transmitted. The exact mechanism of transmission is not known. Prolonged close contact and nasal droplet transmission have been proposed, but both remain unproven.

Until the introduction of dapsone in the 1940s there was no effective treatment for leprosy and infected individuals were routinely isolated and segregated from all contact with society. Skin lesions are the primary external signs, and the bacterium causes damage to the nerves of the hands and feet, leading to a loss of sensation with subsequent injury, and fingers and toes may be lost to infection.

It also affects the nerves around the eyes, causing loss of the blinking reflex. The eyes become dry and infected, and the patient may develop many complications, including iritis, cataracts and corneal ulceration.

Today leprosy is in rapid decline as a direct result of the introduction by the World Health Organization, in 1982, of a multidrug therapy (rifampicin, dapsone and clofazimin) to treat multibacillary leprosy. A two-year course usually produces a complete bacteriological cure.

During treatment, the body may react to the dead bacteria, causing pain and swelling in the skin and nerves. This is treated with analgesics and prednisolone and, under controlled conditions, thalidomide.

In spite of the WHO campaign, leprosy still affects more than 10 million people, mainly in Africa, Brazil and the Indian subcontinent. In the past 20 years, 15 million people have been cured, yet over 200,000 new cases are diagnosed each year.

One major concern is the apparent progression of eye damage even after the bacterium has been eradicated, leading eventually to blindness, and this is a focus of current research.

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

  • Print
  • Share
  • Comment
  • Save
  • Print Friendly Version of this pagePrint Get a PDF version of this webpagePDF

From: Beyond pharmacy blog

Take a look here for thoughts and musings beyond the pharmacy realm

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.