Leprosy

  • Robert R. Jacobson
  • Leo J. Yoder
Chapter

Abstract

Leprosy (Hansen’s disease) is a chronic infectious disease caused by Mycobacterium leprae that primarily affects the skin, peripheral nerves, eyes, and mucous membranes. It has been known for well over 2000 years and afflicts several million people worldwide, mostly in underdeveloped nations. Hansen(1) discovered the etiologic agent over 100 years ago, but it still has not definitely been cultured in artificial media, and there is much about the disease process we do not understand.

Keywords

Household Contact Leprosy Patient Lepromatous Leprosy Lymphocyte Transformation Test Acute Bacterial Infection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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References

  1. 1.
    Hansen, G. H. A., Undersogelser angaende Spedalskhedens Ar-sager, Nor. Mag. Laegevidensk 4:76–79 (1874).Google Scholar
  2. 2.
    Browne, S. G., The history of leprosy, in: Leprosy (R. C. Hastings, ed.), pp. 1–14, Churchill Livingstone, Edinbrough, 1985.Google Scholar
  3. 3.
    Badger, L. F., Leprosy in the United States, Public Health Rep. 70:525–535 (1955).PubMedCrossRefGoogle Scholar
  4. 4.
    Faget, G. P., Pogge, R. C., Johansen, F. A., et al., The promin treatment of leprosy: A progress report, Public Health Rep. 58: 1729–1741 (1943).CrossRefGoogle Scholar
  5. 5.
    Shepard, C. C., The experimental disease that follows the injection of human leprosy bacilli into footpads of mice, J. Exp. Med. 112:445–454 (1960).PubMedCrossRefGoogle Scholar
  6. 6.
    Kirchheimer, W. F., and Storrs, E. E., Attempts to establish the armadillo (Dasypus novencintus Linn.) as a model for the study of leprosy. I. Report of lepromatoid leprosy in an experimentally infected armadillo, Int. J. Lepr. 39:693–702 (1971).Google Scholar
  7. 7.
    WHO Study Group, Chemotherapy of leprosy for control pro-grammes, WHO Tech. Rep. Ser. No. 675, Geneva, WHO, 1982.Google Scholar
  8. 8.
    World Health Organization, Progress towards eliminating leprosy as a public health problem, Wkly. Epidem. Rec. 69:145–151,153157 (1994).Google Scholar
  9. 9.
    Sengupta, U., Studies on lepromin and soluble antigens of M. leprae, Ind. J. Lepr. 63:457–465 (1991).Google Scholar
  10. 10.
    Meyers, W. M., Kvernes, S., and Binford, C. H., Comparison of human and armadillo lepromins in leprosy, Int. J. Lepe. 43:218–225 (1975).Google Scholar
  11. 11.
    Godal, T., and Negassi, K., Subclinical infection in leprosy, Br. Med. J. 3:557–559 (1973).PubMedCrossRefGoogle Scholar
  12. 12.
    Menzel, S., Bjune, G., Kronvall, G., et al., Lymphocyte transformation test in healthy leprosy contacts: Influence of household exposure (Abstract), int. J. Lepr. 47:374 (1979).Google Scholar
  13. 13.
    Job, C. K., Chacko, C. J. G., Taylor, P. M., et al., Evaluation of cell mediated immunity in the histopathologic spectrum of leprosy using lymphocyte transformation test, Int. J. Lepr. 44:256–266 (1976).Google Scholar
  14. 14.
    Ilangumaran, S., Robinson, P., Shankernarayan, N. P., et al., T lymphocyte reactivity of leprosy patients and healthy contacts from a leprosy-endemic population to delipified cell components of Mycobacterium leprae, Lepr. Rev. 65:34–44 (1994).Google Scholar
  15. 15.
    Abe, M., Fumishige, M., Yuji, Y., et al., Fluorescent leprosy-antibody absorption (FLA-ABS) test for detecting subclinical infection with Mycobacterium leprae, Int. J. Lepr. 48:109–119 (1980).Google Scholar
  16. 16.
    Harboe, M., and Closs, O., A revival of interest in antibody studies in leprosy (Abstract)? Int. J. Lepr. 47:372 (1979).Google Scholar
  17. 17.
    Smith, P. G., The serodiagnosis of leprosy, Lepr. Rev. 63:97–100 (1992).Google Scholar
  18. 18.
    de Wit, M. Y., Douglas, P. T., McFadden, J., et al., Polymerase chain reaction for detection of Mycobacterium leprae in nasal swab specimens, J. Clin. Microbiol. 31:502–506 (1993).PubMedGoogle Scholar
  19. 19.
    van Beers, S. M., Izumi, S., Madjid, B., et al., An epidemiological study of leprosy by serology and polymerase chain reaction, Int. J. Lepr. 62:1–9 (1994).Google Scholar
  20. 20.
    Franzblau, S. G., Biswas, A. N., Jenner, P., et al., Double-blind evaluation of BACTEC and Buddeymer-type radiorespirometric assays for in vitro screening of antileprosy drugs, Lepr. Rev. 63:125–133 (1992).Google Scholar
  21. 21.
    Chan, G. P., Garcia-Ignacia, B. Y., Chavez, V. E., et al., Clinical trial of sparfloxacin for lepromatous leprosy, Antimicrob. Agents Chemother. 38:61–65 (1994).CrossRefGoogle Scholar
  22. 22.
    de Witt, M. Y. L., Faber, W. R., Krieg, S. R., et al., Application of polymerase chain reaction for the detection of Mycobacterium leprae in skin tissues, J. Clin. Microbiol. 29:906–910 (1991).Google Scholar
  23. 23.
    Arnoldi, J., Schluter, C., Duchrow, M., et al., Species-specific assessment of Mycobacterium leprae in skin biopsies by in situ hybridization and polymerase chain reaction, Lab. Invest. 66: 618–623 (1992).Google Scholar
  24. 24.
    Gillis, T. P., and Williams, D. L., Polymerase chain reaction and leprosy, Int. J. Lepe. 59:311–316 (1991).Google Scholar
  25. 25.
    Shepard, C. C., and McRae, D. H., Mycobacterium leprae in mice: Minimal infectious dose, relationship between staining quality and infectivity, and effect of cortisone, J. Bacteriol. 89:365–372 (1965).PubMedGoogle Scholar
  26. 26.
    Krieg, R. E., and Meyers, W. M., Demonstration of Mycobacterium leprae in tissues from bacteriologically negative treated lepromatous leprosy patients (Abstract), Int. J. Lepr. 47:367 (1979).Google Scholar
  27. 27.
    Harris, E. B., Landry, M. T., Sanchez, R., et al., Viability of Mycobacterium leprae in soil, water, and degenerating armadillo tissue and its significance, Microbios Lett. 44:73–76 (1990).Google Scholar
  28. 28.
    Desikan, K. B., Viability of Mycobacterium leprae outside the human body, Lepr. Rev. 48:231–235 (1977).Google Scholar
  29. 29.
    Pattyn, S. R., Use of the mouse footpad in studying thermoresistance of Mycobacterium leprae, Int. J. Lepr. 33:611–615 (1965).PubMedGoogle Scholar
  30. 30.
    Shepard, C. C., Walker, L. L., and Vanlandingham, R., Heat stability of Mycobacterium leprae immunogenicity, Infect. Immun. 22:87–93 (1978).Google Scholar
  31. 31.
    Shepard, C. C., Stability of Mycobacterium leprae and temperature optimum for growth, Int. J. Lepr. 33:541–547 (1965).PubMedGoogle Scholar
  32. 32.
    Prabhakaran, K., and Kirchheimer, W. F., Use of 3,4-dihydroxyphenylalanine oxidation in the identification of Mycobacterium leprae, J. Bacteriol. 92:1267–1268 (1966).PubMedGoogle Scholar
  33. 33.
    Report of the Workshop on Microbiology of the XI International Leprosy Congress, Int. J. Lepr. 47:291–294 (1979).Google Scholar
  34. 34.
    Shepard, C. C., Experimental chemotherapy in leprosy, then and now, Int. J. Lepr. 41:307–319 (1973).Google Scholar
  35. 35.
    Colston, M. J., The molecular biology of Mycobacterium leprae, Lepr. Rev. 64:289–294 (1993).Google Scholar
  36. 36.
    Rees, R. J. W., and Young, D. B., The microbiology of leprosy, in: Leprosy, 2nd ed. (R. C. Hastings, ed.), pp. 49–83, Edinburgh, Churchill Livingston, 1994.Google Scholar
  37. 37.
    Colston, M. J., Leprosy 1962–1992. The microbiology of M. leprae; Progress in the last 30 years, Trans. R. Soc. Trop. Med. Hyg. 87:504–507 (1993).CrossRefGoogle Scholar
  38. 38.
    Rees, R. J. W., and Meade, T. W., Comparison of modes of spread and incidence of tuberculosis and leprosy, Lancet 1:47–49 (1974).PubMedCrossRefGoogle Scholar
  39. 39.
    Baumgart, K. W., Britton, W. H., Mullins, R. J., et al., Subclinical infection with Mycobacterium leprae-A problem for leprosy control strategies, Trans. R. Soc. Trop. Med. Hyg. 87:412–415 (1993).PubMedCrossRefGoogle Scholar
  40. 40.
    Wade, H. W., and Ledowsky, V., The leprosy epidemic at Nauru: A review with data on status since 1937, Int. J. Lepe. 20:1–29 (1952).Google Scholar
  41. 41.
    Leiker, D. L., Epidemiological and immunological surveys in Netherlands New Guinea, Lepr. Rev. 31:241–259 (1960).Google Scholar
  42. 42.
    Long, Gillis W., Unpublished data of the National Hansen’s Disease Registry, Carville, Louisiana.Google Scholar
  43. 43.
    Noussitou, F. M., Sansarricq, H., and Walter, J., Leprosy in Children, WHO, Geneva, 1976.Google Scholar
  44. 44.
    Girdhar, A., Mishra, B., Lavania, R. K., et al., Leprosy in infants. Report of two cases, Int. J. Lepr. 57:472–475 (1989).Google Scholar
  45. 45.
    Guinto, R. S., Epidemiology of leprosy: Current views, concepts and problems, in: A Window on Leprosy (B. R. Chatterjee, ed.), pp. 36–53, Statesman Commercial Press, Calcutta, 1978.Google Scholar
  46. 46.
    Newell, K. W., An epidemiologist’s view of leprosy, Bull. WHO 34:827–857 (1966).PubMedGoogle Scholar
  47. 47.
    Sehgal, V. M., Rege, V. L., and Singh, K. P., The age of onset of leprosy, Int. J. Lepr. 45:52–55 (1977).Google Scholar
  48. 48.
    Ponnighaus, J. M., Fine, P. E. M., Sterne, J. A. C., et al., Incidence rates of leprosy in Karonga District, Northern Malawi; Patterns by age, sex, BCG status and classification, Int. J. Lepr. 62:10–23 (1994).Google Scholar
  49. 49.
    Gray, H. H., and Dreisbach, J. A., Leprosy among foreign missionaries in northern Nigeria, Int. J. Lepr. 29:279–290 (1961).PubMedGoogle Scholar
  50. 50.
    Mathai, R., Rao, P. S. S., and Job, C. K., Risks of treating leprosy in a general hospital (Abstract), Int. J. Lepr. 47:322 (1979).Google Scholar
  51. 51.
    Kluth, F. C., Leprosy in Texas: Risk of contracting the disease in the household, Tex. State J. Med. 52:758–789 (1956).Google Scholar
  52. 52.
    Filice, G. A., and Fraser, D. W., Management of household contacts of leprosy patients, Ann. Intern. Med. 88:538–542 (1978).PubMedGoogle Scholar
  53. 53.
    Chaudhury, S., Hazra, S. K., Saha, B., et al., An eight-year field trial on antileprosy vaccines among high-risk household contacts in the Calcutta metropolis, Int. J. Lepr. 62:389–394 (1994).Google Scholar
  54. 54.
    Badger, L. F., Epidemiology, in: Leprosy in Theory and Practice, 2nd ed. (R. G. Cochrane and T. F. Davey, eds.), pp. 69–97, John Wright, Bristol, 1964.Google Scholar
  55. 55.
    Lucas, S., Human immunodeficiency virus and leprosy, Lepr. Rev. 64:97–103 (1993).PubMedGoogle Scholar
  56. 56.
    Brubaker, M. L., Binford, C. H., and Trautman, J. R., Occurrence of leprosy in US veterans after service in endemic areas abroad, Public Health Rep. 84:1051–1058 (1969).PubMedCrossRefGoogle Scholar
  57. 57.
    Ponninghaus, J. M., Fine, P. E. M., Sterne, J. A. C., et al., Extended schooling and good housing conditions are associated with reduced risk of leprosy in rural Malawi, Int. J. Lepr. 62:345–353 (1994).Google Scholar
  58. 58.
    Hastings, R. C., Transfer factor as a probe of the immune deficit in lepromatous leprosy, Int. J. Lepr. 45:281–291 (1977).Google Scholar
  59. 59.
    Dharmendra, and Chatterjee, B. R., Prognostic value of the lepromin test in contacts of leprosy cases, Lepr. India 27:149–158 (1955).Google Scholar
  60. 60.
    Chakravatti, M. R., and Vogel, F., A twin study on leprosy, Topics in Human Genetics. No. 1, Thieme, Stuttgart, 1973.Google Scholar
  61. 61.
    Kher, S. K., Rao, M. R., Raghunath, D., et al., HLA-linked genetic control of leprosy, Med. J. Armed Forces India 48:116118 (1992).Google Scholar
  62. 62.
    Rani, R., Zaheer, S. A., Mukherjee, R., Do human leukocyte antigens have a role to play in differential manifestations of multibacillary leprosy-A study on multibacillary leprosy patients from India, Tissue Antigens 40:124–127 (1992).PubMedCrossRefGoogle Scholar
  63. 63.
    Job, C. K., Chehl, S. K., and Hastings, R. C., Transmission of leprosy in nude mice through thorn pricks, Int. J. Lepr. 62:395–398 (1994).Google Scholar
  64. 64.
    Bechelli, L. M., Garbojosa, P. G., Gyi, M. M., et al., Site of early skin lesions in children with leprosy, Bull. WHO 48:107–111 (1973).PubMedGoogle Scholar
  65. 65.
    Enna, C. D., Jacobson, R. R., Trautman, J. R., et al., Leprosy in the United States, 1967–1976, Public Health Rep. 93:468–473 (1978).PubMedGoogle Scholar
  66. 66.
    Pedley, J. C., The hypothesis of skin to skin transmission, Lepr. Rev. 48:295–297 (1977).PubMedGoogle Scholar
  67. 67.
    Davey, T. F., and Rees, R. J. W., The nasal discharge in leprosy: Clinical and bacteriologic aspects, Lepr. Rev. 45:121–134 (1974).PubMedGoogle Scholar
  68. 68.
    Rees, R. J. W., and McDougall, A. C., Airborne infection with Mycobacterium leprae in mice, J. Med. Microbiol. 10:63–68 (1977).PubMedCrossRefGoogle Scholar
  69. 69.
    Narayanan, E., Sreevatsa, Kirchheimer, W. F., et al., Transfer of leprosy bacilli from patients to mouse footpads by Aedes aegypti, Lepe India 49:181–186 (1977).Google Scholar
  70. 70.
    Walsh, G. P., Storrs, E. E., Burchfield, H. P., et al., Leprosy-like disease occurring naturally in armadillos, J. Reticuloendothel. Soc. 18:347–351 (1975).PubMedGoogle Scholar
  71. 71.
    Job, C. K., Harris, E. B., Allen, J. L., et al., A random survey of leprosy in wild nine-banded armadillos in Louisiana, Int. J. Lepr. 54:453–457 (1986).Google Scholar
  72. 72.
    Centers for Disease Control, Leprosy-like disease in wild-caught armadillos, Morbid. Mortal. Week. Rep. 25:18–23 (1976).Google Scholar
  73. 73.
    Lumpkin, L. R., III, Cox, G. F., and Wolf, J. E., Jr., Leprosy in five armadillo handlers, J. Am. Acad. Dermatol. 9:899–903 (1983).PubMedCrossRefGoogle Scholar
  74. 74.
    Thomas, D. A., Mines, J.S., Thomas, D. C., et al., Armadillo exposure among Mexican-born patients with lepromatous leprosy, J. Infect. Dis. 156:990–992 (1987).PubMedCrossRefGoogle Scholar
  75. 75.
    Donham, K. J., and Leininger, J. R., Spontaneous leprosy-like disease in a chimpanzee, J. Infect. Dis. 136:132–136 (1977).PubMedCrossRefGoogle Scholar
  76. 76.
    Gormus, B. J., Wolf, R. H., Baskin, G. B., et al., A second sooty mangabey monkey with naturally acquired leprosy: First reported possible monkey-to-monkey transmission, Int. J. Lepr. 56:61–65 (1988).Google Scholar
  77. 77.
    Ingrens, L. M., and Kazda, J., The epidemiological significance of the occurrence of M. leprae-like microorganisms in the environment, Int. J. Lepr. 52:719 (1984).Google Scholar
  78. 78.
    Noordeen, S. K., The epidemiology of leprosy, in: Leprosy, 2nd ed. (R. C. Hastings, ed.), pp. 29–45, Churchhill Livingstone, Edinburgh, 1994.Google Scholar
  79. 79.
    Drutz, D. J., Chen, T. S. N., and Lu, W. H., The continuous bacteremia of lepromatous leprosy, N. Engl. J. Med. 287:159–164 (1972).PubMedCrossRefGoogle Scholar
  80. 80.
    Kaufmann, S. H. E., Cell mediated immunity, in: Leprosy, 2nd ed. (R. C. Hastings, ed.), pp. 157–168, Churchhill Livingstone, Edinburgh, 1994.Google Scholar
  81. 81.
    Waldorf, D. S., Sheagren, J. N., Trautman, J. R., et al., Impaired delayed hypersensitivity in patients with lepromatous leprosy, Lancet 2:773–776 (1966).PubMedCrossRefGoogle Scholar
  82. 82.
    Lim, S. E., Kiszkiss, E. F., Jacobson, R. R., et al., Thymus dependent lymphocytes of peripheral blood in leprosy patients, Infect. Immun. 9:394–399 (1974).Google Scholar
  83. 83.
    Oleinich, A., Altered immunity and cancer risks: A review of the problem and analysis of the cancer mortality experience of leprosy patients, J. Natl. Cancer Inst. 43:775–781 (1969).Google Scholar
  84. 84.
    Ridley, D. S., and Jopling, W. H., Classification of leprosy according to immunity; a five group system, Int. J. Lepr. 34:255–273 (1966).Google Scholar
  85. 85.
    Nousitu, F. M., Sansarricq, H., and Walter, J., Leprosy in Children, WHO, Geneva, 1976.Google Scholar
  86. 86.
    World Health Organization Expert Committee on Leprosy, Sixth Report, WHO Tech. Rep. Ser. No. 768, WHO, Geneva, 1988.Google Scholar
  87. 87.
    Sampaio, E. P., Kaplan, G., Miranda, A., et al., The influence of thalidomide on the clinical and immunologic manifestations of erythema nodosum leprosum, J. Infect. Dis. 168:408–414 (1993).PubMedCrossRefGoogle Scholar
  88. 88.
    WHO Study Group, Chemotherapy of leprosy, WHO Tech. Resp. Ser. No. 847, WHO, Geneva, 1994.Google Scholar
  89. 89.
    World Health Organization, A Guide to Leprosy Control, 2nd ed. WHO, Geneva, 1988.Google Scholar
  90. 90.
    WHO Expert Committee on Leprosy, Fifth Report, WHO Tech. Rep. Ser. No. 607, WHO, Geneva, 1977.Google Scholar
  91. 91.
    Pattyn, S. R., Search for effective short-course regimens for the treatment of leprosy, Int. J. Lepr. 61:76–81 (1993).Google Scholar
  92. 92.
    Noordeen, S. K., Long-term effects of chemoprophylaxis among contacts of lepromatous cases, Lepr. India 49:504–509 (1977).Google Scholar
  93. 93.
    Russell, D. A., Worth, R. M., Scott, G. C., et al., Experience with acedapsone (DADDS) in a therapeutic trial in New Guinea and the chemoprophylactic trial in Micronesia, Int. J. Lepr. 44:170–176 (1976).Google Scholar
  94. 94.
    Cartel, J. L., Chantaeu, S., Moulia-Pelat, J. P., et al., Chemoprophylaxis of leprosy with a single dose of 25 mg per kg rifampin in the Southern Marquesas; Results after four years, Int. J. Lepr 60:416–420 (1992).Google Scholar
  95. 95.
    Convit, J., Smith, P. G., Zuniga, M., et al., BCG vaccination protects against leprosy in Venezuela: A case-control study, Int. J. Lepr. 61:185–191 (1993).Google Scholar
  96. 96.
    Ponnighaus, J. M., Fine, P. E. M., Sterne, J. A. C., et al., Efficacy of BCG vaccine against leprosy and tuberculosis in Malawi, Lancet 1:636–639 (1992).CrossRefGoogle Scholar
  97. 97.
    Orege, P. A., Fine, P. E. M., Lucas, S. B., et al., Case-control study of BCG vaccination as a risk factor for leprosy and tuberculosis in Western Kenya, Int. J. Lepr. 61:542–549 (1993).Google Scholar
  98. 98.
    Reddi, P. P., Amin, A. G., Khandekar, P. S., et al., Molecular definition of unique species status of Mycobacterium w; a candidate leprosy vaccine strain, Int. J. Lepr. 62:229–236 (1994).Google Scholar
  99. 99.
    Chiplunkar, S. V., Kudalkar, J. L., Gangal, S. G., et al., Immunoreactivity of mycobacterial strain ICRC and Mycobacterium leprae antigens with polyclonal and monoclonal antibodies, Int. J. Lepr. 61:421–427 (1993).Google Scholar
  100. 100.
    Bloom, B. R., New strategies for leprosy and tuberculosis and for development of bacillus Calmette-Guérin into a multivaccine vehicle, Ann. NY Acad. Sci. 569:155–173 (1989).PubMedCrossRefGoogle Scholar

Suggested Reading

  1. Bahong, J., and Noordeen, S. K., Leprosy, in: Tropical Disease Research: A Global Partnership (J. Maurice and A. M. Pearce, eds.), pp. 113–124, WHO, Geneva, 1987.Google Scholar
  2. Harboe, M. (ed.), Immunology of leprosy: Proceedings of an interna-tional symposium, Lepr. Rev. 57(Suppl. 2):1–308 (1986).Google Scholar
  3. Hastings, R. C. (ed.), Leprosy, Churchill Livingstone, Edinburgh, 1994.Google Scholar
  4. World Health Organization Study Group, Chemotherapy of leprosy,WHO Tech. Rep. Ser. No. 847, Geneva, WHO, 1994.Google Scholar
  5. World Health Organization, A Guide to Leprosy Control, WHO, Geneva, 1988.Google Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Robert R. Jacobson
    • 1
  • Leo J. Yoder
    • 1
  1. 1.Gillis W. Long Hansen’s Disease CenterCarvilleUSA

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