Let’s talk about a disease I learned about from nuns when I was eight years old. Well, a disease other than AIDS. The nineties were a ride, kids.
Today’s Moment of Science… Leprosy.
Hansen’s Disease, more commonly referred to as leprosy, is caused by a bacterial infection. There are multiple presentations of the illness caused by two strains of bacteria, Mycobacterium leprae and Mycobacterium lepromatosis.
The way my third grade teacher, Sister Doris, explained to us was, “it made your face just fall off so they had to send away the lepers. Some priests went on missionary work to pray and care for the lepers and- through the power of Christ- didn’t get sick for twenty years.”
Well. To clear up a few misconceptions.
Typically the first sign is discolored patches of skin on the extremities that can be dry and thickened. These areas lose a bit of sensitivity to pain and temperature. As more severe nerve damage sets in the disease presents with progressive numbness and enlarged peripheral nerves. The nose can flatten as cartilage is absorbed into the body. This same effect in the extremities can cause shortened hands and feet. Over time, muscle weakness, gangrene, paralysis, and blindness could all set in.
The earliest suspected case was found in a 4,000 year old skeleton, and Hippocrates wrote about an illness that was almost certainly leprosy 2,500 years ago. We’re not gonna get rid of it any time soon. Plenty of people are still diagnosed with leprosy every year, even in the US.
Which might have come as a surprise, but don’t worry, there’s not an outbreak to speak of. It’s one of many old timey diseases we haven’t eradicated.
One reason? An absurdly long incubation period. By all accounts, not only are the chances of catching it from exposure extremely low, the incubation period typically lasts five years. Even without divine intervention you can be waiting to hatch a case of leprosy for decades. There are even asymptomatic cases.
Another reason is that this is a zoonotic illness. Humans originally spread this biological treat to the armadillos, and bless their hearts, they’re like “no you keep it.” So our populations are just gonna pass this fuckery back and forth until the heat death of the universe.
Leprosy never made anyone too dead in a hurry. Even so, I’m not entirely surprised that ancient desert dwelling humans weren’t up for a game of “gotch’yer nose” with this mysterious illness.
So, leper colonies.
Leprosy was the original zombie disease, referred to casually as ‘living death.’ It wasn’t unheard of for funerals to be held for those still alive and well with the disease, as they became a ghost to their community. Nobody wanted to catch whatever this curse was that left them disfigured, and so they were pushed out of society informally at first. In the Middle Ages, thousands of facilities sprung up to segregate and treat them away from other medical patients. It’s not clear if these were all hospitals or more “communal living with doctor visits,” and it’s further not clear what the distinction is between that and a colony.
Long before shipping people off to an island in the middle of the Pacific, facilities in Harbledown, England were opened in 1084 that are largely considered to constitute the first leper colony.
It’s hard to find consistent reports on the typical conditions at the colonies as they varied greatly. In some cases, people were being shipped away from a life that already involved a great deal of ostracization, and paradoxically were less isolated after being sent away. On the other hand, shipping humans to their permanent isolation is considered by most societies- this being one of them- to be a human rights violation.
In 2001, Japan’s leper colonies were investigated for abusing patients and restricting them to “absolute quarantine,” despite successful treatment.
Today leprosy is treated successfully with a firehosing of antibiotics. Or if you don’t trust big pharma, there’s still prayer.
This has been your Moment of Science, forever wondering how many things I still have to unlearn from the nuns.
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It should be noted that Thalidomide has been used extremely effectively in the treatment of the nodules produced by the Disease.