Section 17. Infectious Diseases >
Part 5. Bacterial Infections >
Chapter 271. LeprosyWayne M. Meyers, Françoise Portaels, and Douglas S. Walsh
Topics Discussed: infectious diseases; leprosy; mycobacterium leprae.
Sections: Historical Overview, Transmission, Epidemiology, Mycobacteriology and Pathophysiology, Pathogenesis and Pathology, Prognosis, Vaccination, Immunoprophylaxis, and Immunotherapy, References.
Excerpt:"Leprosy is a chronic infectious
disease caused by Mycobacterium leprae, an acid-fast
bacillus (AFB). It was first recognized by Hansen in 1873 in Bergen,
Norway, while examining smears from lepromas of Norwegian patients. Notably,
the organism was the first reported bacterium causing chronic disease
in humans that principally affects the cooler parts of the body,
especially the skin, upper respiratory tract, testes, eyes, and
superficial segments of peripheral nerves.1,2 The
stigma suffered by patients with leprosy has historically been severe.
For a review of the history of leprosy refer to the electronic text.
Because of the stigma of leprosy, the physician must carefully consider
the social implications of a diagnosis of leprosy, especially in
children. In 1999, the World Health Organization (WHO) reported that approximately
800,000 patients were being treated for active leprosy, with 738,000
newly diagnosed cases. By 2006, the numbers had dropped to 225,000 and
259,000, respectively.3 However, many authorities
consider that the total global prevalence of patients with active
leprosy is much higher (1.52 million) and that new case
rates are not necessarily rapidly declining.4,5 The stigma
of the disease and inefficiency in health care delivery systems
contribute to this disparity in statistics.6 ..."
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