Leprosy control in 7 districts of south Sulawesi, Indonesia, 1986-91.

This paper describes the leprosy control programme in 7 districts of the South Sulawesi Province in Indonesia. This province is reported to have the highest prevalence of leprosy in the country. The programme started in 1986 with re-registration of all patients on the cumulative registers. Strict criteria for admission of patients to MDT were initially applied. In 1990 it appeared that these criteria had been too strict, thus necessitating a second re-registration of patients still on DDS monotherapy. More flexible criteria for admission to MDT led to an increase in MDT coverage from 45% to 78% within 6 months. By April 1991, 5 years after the start of the programme, the registered prevalence had decreased from 4.4 per 1000 in 1986 to 1.6 per 1000; the coverage with MDT had increased from 6% in 1986 to 78%, and the case detection rate remained stable around 4 per 10,000 after an initial increase at the start of the programme.     

Leprosy in young children. 2 cases at 3 years of age

Two children (age 3 years) presented with leprosy in endemic area: one was type T (tuberculoid paucibacillary); the other was type BL (borderline lepromatous) considering a very fast evolution, and was treated as a multibacillary leprosy. The family of the second child reported that the onset of the disease was consecutive to an insect bite at 5 1/2 months of age. Such observations remind us that leprosy must be suspected or thought about very early since the incubation period is likely to be shorter than previously proclaimed.     

Leprosy in Germany 100 years and the early development of anti-leprosy drugs

Leprosy was nearly eliminated in central Europe by the beginning of 18th century. In the 2nd half of the 19th century, leprosy was imported by Lithuanian rural workers immigrating from the Russian empire into East Prussia. At that time, the ways of infection, the bacteria, and essential diagnostic methods were already known, but there was no effective treatment. A leprosarium was founded in 1899 in Memel. Legislation in 1900 and 1904 regulated the fight against the disease. The patients had to be isolated and not allowed to work with others, in contrast to the situation with cutaneous tuberculosis. Patients with lupus vulgaris, which was not infectious, even had suitable jobs in hospitals. In 1907, Antileprol (Bayer) became available, the first industrial preparation developed from chaulmoogra oils, which had been long used in Indian medicine. The situation of patients, however, remained nearly unchanged, up to the middle of the 20th century, when the first effective mycobacteriostatic agents were introduced.     

Zoonotic sporotrichosis of lymphocutaneous type in a man acquired from a domesticated feline source: report of a first case in southern Karnataka, India

Background  Sporotrichosis is commonly encountered due to traumatic implantation of thorns or decayed vegetation with the dimorphic fungi, Sporothrix schenckii . Zoonotic spread of Sporotrichosis is rare and we describe here the first case of feline transmission of lymphocutaneous sporotrichiosis encountered in India.
Methods  An excision biopsy of nodulo-ulcerative lesion from the patients right elbow and forearm were collected for histopathology and portion of the specimen processed for mycological work up. Animal pathogenicity test performed in Swiss albino mice with intraperitoneal & foot pad inoculation. In addition an investigation of the ulcerative skin lesion from the domesticated cat was carried out.
Results  Histopathology examination of tissue sample from the patient and feline lesion revealed granulomatous reaction and a few slender elongated yeast cells consistent with Sporotrichosis. The diagnosis was confirmed by culturing Sporothrix schenkii and demonstration of thermal dimorphism. Pathogenicity testing in mice lead to orchitis in 12–15 days and the organism was re-isolated in pure culture. The patient was treated with oral saturated potassium iodide solution with complete resolution of the lesions.
Conclusion  Close contact with infected domesticated feline can be a potential source of transmission for Sporotrichosis as evidenced in this report.