History of Leprosy

Overview:

Leprosy has tormented humans throughout recorded history. The earliest possible account of a disease that many scholars believe is leprosy appears in an Egyptian Papyrus document written around 1550 B.C. Around 600 B.C. Indian writings describe a disease that resembles leprosy. In Europe, leprosy first appeared in the records of ancient Greece after the army of Alexander the Great came back from India and then in Rome in 62 B.C. coinciding with the return of Pompeii's troops from Asia Minor.

Throughout its history, leprosy has been feared and misunderstood. For a long time leprosy was thought to be a hereditary disease, a curse, or a punishment from God. Before and even after the discovery of its biological cause, leprosy patients were stigmatized and shunned. For example, in Europe during the Middle Ages, leprosy sufferers had to wear special clothing, ring bells to warn others that they were close, and even walk on a particular side of the road, depending on the direction of the wind. Even in modern times, leprosy treatment has often occured in seperate hospitals and live-in colonies called leprosariums because of the stigma of the disease. Leprosy has been so prevalent in various areas as certain times throughout history that is has inspired art work and influenced other cultural practices.

Nigerian Mask: A representation of leprosy disfigurement

Photo credit: Charles Davis. Photo courtesy of the National Museum of Health and Medicine.

Modern History of Leprosy: a timeline of trials and treatments

1873:

Dr. Gerhard Henrik Armauer Hansen of Norway was the first person to identify the germ that causes leprosy under a microscope. Hansen's discovery of Mycobacterium leprae proved that leprosy was caused by a germ, and was thus not hereditary, from a curse, or from a sin.

early 20th century: Until the late 1940s, leprosy doctors all over the world treated patients by injecting them with oil from the chaulmoogra nut. This course of treatment was painful, and although some patients appeared to benefit, its long term efficacy was questionable.

 

Chaulmoogra Nut

http://www.herbs2000.com/herbs/herbs_chaulmoogra.htm

 

Chaulmoogra Oil Injection

http://www.leprosyhistory.org/graphics/gallery/chaul3.jpg

1921:

U.S. Public Health Service established the Gillis W. Long Hansen’s Disease Center in Carville, Louisiana, which became known as “Carville.” It became a center of research and testing to find a cure for leprosy and a live-in treatment center for leprosy patients.

1941: Promin, a sulfone drug, was introduced as a treatment for leprosy. It was first identified and used at Carville. Promin successfully treated leprosy but unfortunately treatment with Promin required many painful injections.
1950s: Dapsone pills, pioneered by Dr. R.G. Cochrane at Carville, became the treatment of choice for leprosy. Dapsone worked wonderfully at first, but unfortunately, M. leprae eventually began developing dapsone resistance.
1970s: The first successful multi-drug treatment (MDT) regimen for leprosy was developed through drug trials on the island of Malta.
1981: The World Health Organization began recommending MDT, a combination of three drugs: dapsone, rifampicin, and clofazimine. MDT with these drugs takes from six months to a year or even more, depending on stregnth of leprosy infection.
Now: MDT with a combination of dapsone, rifampicin, and clofazimine is still the best treatment for preventing nerve damage, deformity, disability and further transmission. Researchers are working on developing a vaccine and ways to detect leprosy sooner in order to start treatment earlier.

MDT Blister Packs

http://www.who.int/tdr/research/progress/lep_afr/treatment.htm