Leprosy (Hansen's Disease)
Leprosy, also called Hansen's disease, is a chronic infectious disease that primarily affects the skin, the peripheral nerves, the mucosa of the upper respiratory tract, and the eyes. Leprosy can lead to progressive permanent damage of these structures, and the resulting devastating disfigurement and disability has led to the historical social stigma and isolation (leper colonies) of those affected by the disease.
Historically speaking, leprosy has existed since at least 4000 BC, and the disease was present and described in the ancient civilizations of China, India, and Egypt. The first known written reference to the disease on Egyptian papyrus dates from about 1550 BC. It is believed that leprosy was brought to Europe by the Romans and the Crusaders and that later the Europeans brought it to the Americas. For centuries, leprosy remained a poorly understood disease characterized by human suffering and social isolation. In 1873, G.A. Hansen discovered the bacterial cause of this infectious disease. The first medication breakthrough occurred in the 1940s with the development of the drug dapsone, and later it was discovered that the bacteria which caused leprosy was more effectively killed by using multiple medications.
Leprosy is a curable disease with the use of multidrug therapy (MDT). In 1991, the World Health Assembly passed a resolution to eliminate leprosy as a public-health problem by the year 2000. The elimination of leprosy was defined as a prevalence rate of less than one case per 10,000 population. With assistance from the World Health Organization (WHO), MDT has been distributed free to all patients with leprosy since 1995. Though leprosy is still endemic in a few developing countries (primarily in the tropics), there has been a dramatic worldwide decrease in the prevalence of the disease due to this successful public-health initiative. Over the past 20 years, more than 14 million leprosy patients have been cured, and the prevalence rate of the disease has decreased by 90%. In the United States, 150 new cases were reported in 2008 (the most recent data available), with most cases occurring in Texas, California, New York, Louisiana, Hawaii, and Massachusetts.
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