LEPROSY

LEPROSY, or Hansen's disease, is a chronic infectious disease caused by the microorganism Mycobacterium leprae, which mainly affects the skin, the peripheral nerves, and the upper respiratory tract. A complex affliction, Hansen's disease manifests itself through skin discoloration and loss of sensation in minor cases to disfigurement and physical debilitation in the most severe and advanced cases. Equally devastating have been the social stigma, rejection, and exclusion that sufferers of Hansen's disease have endured throughout history. Although popularly regarded as incurable, contagious, and mutilating, the disease is curable, it is not highly contagious, and mutilation occurs only in the most severe cases and is not an inevitable feature of the disease's course. Because of the stigma associated with the terms "leprosy" and "leper," the disease has since the 1950s been alternatively called Hansen's disease, named after Gerhard Armauer Hansen, the Norwegian physician who identified Mycobacterium leprae in 1873.

The fear of leprosy's importation by immigrants played an important role in anti-immigrant policies and racist rhetoric directed against Chinese immigrants in the 1870s and 1880s. Notable American efforts to combat leprosy abroad were led by Victor Heiser, director of health in the American colonial administration in the Philippines, and by Joseph de Veuster (Father Damien), a Belgian priest on the Hawaiian island of Molokai. Also leprosy was endemic in regional pockets of Louisiana and the upper Midwest among French Acadian and Norwegian immigrants, respectively.

Immigrants diagnosed with leprosy were often deported to their native countries. Those who could not be deported and native-born patients with leprosy were forcibly isolated in the few leprosy hospitals that existed. The Louisiana Leper Home in Carville, Louisiana, opened in 1893 and in 1921 the federal government assumed control and designated it the national leprosarium, to which all states subsequently sent patients. It became the leading American center for medical research on leprosy, culminating in the discovery in 1941 that sulfones (sulfa-based drugs) could effectively treat the disease. The leprosarium operated continuously until June 1999, when it was closed and the care of patients with leprosy moved to outpatient centers throughout the United States. Therapeutic regimens that relied exclusively on sulfones have been supplanted by multidrug therapy programs, which the World Health Organization expected will lead to the total eradication of leprosy by 2005.

BIBLIOGRAPHY

Gussow, Zachary. Leprosy, Racism, and Public Health: Social Policy in Chronic Disease Control. Boulder, Colo.: Westview Press, 1989.

Joseph, D. George. "Americans Confront the 'Loathsome' Disease: Leprosy and Tropical Medicine in Progressive Era Massachusetts." Ph.D. diss., Yale University, 2002.

Kalisch, Philip A. "Lepers, Anachronisms, and the Progressives: A Study of Stigma, 1889–1920." Louisiana Studies: An Inter-disciplinary Journal of the South 12 (1973): 489–531.

Moran, Michelle T. "Leprosy and American Imperialism: Patient Communities and the Politics of Public Health in Hawai'i and Louisiana." Ph.D. diss., University of Illinois, Urbana-Champaign, 2002.

D. GeorgeJoseph

See alsoHealth Care .