[Leprosy is definitely not a disease of the past].
In this review we present a synthesis of the current knowledge of leprosy based on the epidemiological studies and the latest data obtained in basic research and the strategies undertaken to fight out this pathology. The significant progress in the genomic study of the leprosy bacillus, and in understanding the basic mechanisms governing the individual susceptibility to the disease, together with the stagnation in the incidence of the new cases observed for ten years, represent focus of interest. If the efficiency of the recommended treatments is actually confirmed by a low relapse rate, however the drying up of new cases, which could be expected by reducing the infectiousness of the treated cases, is nonetheless slow in coming. Recent studies support the effectiveness of prophylaxis based on a single dose of rifampicin and/or a BCG vaccination of patient contacts. This could allow an increased reduction of the incidence of the disease. However, no official position validates such strategies. Because of an ambiguity in the expression of the objectives for managing the disease, i.e. « elimination of a disease considered as a public health problem », which should not to be confused with « eradication of the disease », which, in fact, has no relevance today, demobilization in fighting against leprosy is to be feared.
Service de dermatologie, Centre hospitalier Louis Pasteur, 39 avenue de la Liberté, 68024 Colmar, France.
Antoine
A
Mahé
D006801:Humans; D007918:Leprosy / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D009166:Mycobacterium leprae / Q000235:genetics