Gerhard Armauer Hansen (1841–1912)
Few diseases over the millennia have generated as much terror, superstition, and false beliefs as leprosy, one of the oldest recorded diseases. Scholars believe that the leprosy of the Bible was actually other unrelated benign skin conditions. The leprosy we know was prevalent in Europe between 1000 and 1400, and then it declined. The many works of art from the period support the assumption that it was widespread. Leper houses, estimated to number 19,000 in Europe, were built to house the afflicted, and those not confined were required to wear special garb and to carry a wooden clapper warning the unsuspecting of their approach.
That leprosy was not a Divine punishment, or hereditary, or originating in bad air was established in 1873 by the Norwegian physician Gerhard Armauer Hansen, who discovered the first bacterium found to cause disease in humans: Mycobacterium leprae. Leprosy (Hansen’s disease) causes disfiguring skin lesions and nerve damage resulting in muscle weakness and a loss of sensation in the skin. Although the afflicted have long been stigmatized, rejected, and excluded from society, this condition is not highly contagious—some 95 percent of people have natural immunity to it—and the symptoms generally appear slowly (three to seven years) after initial infection.
The “modern” era of drug treatment of leprosy has its origins in 1937, when dapsone, a sulfa-related drug, was tested for its antibacterial potential. It proved highly effective but was perceived as too toxic. Dapsone’s effectiveness against experimental tuberculosis in animals provided a lead for its use in leprosy, because the two diseases are caused by closely related bacteria.
For more than six decades, dapsone (DDS) has remained the most important drug for leprosy treatment. To reduce the development of bacterial resistance, since the early 1980s dapsone has been given as a key component of multidrug therapy (MDT), in combination with rifampin and clofazimine, for at least a two-year treatment period. During the past two decades, this treatment has cured 15 million people worldwide.
SEE ALSO Sulfanilamide (1936), Streptomycin (1944), Rifampin (1967).
Contact with infected armadillos, long used for the testing of anti-leprosy drugs, has been found to be responsible for one-third of the 150–250 leprosy (Hansen’s disease) cases that arise in the United States each year.