Leprosy: Background information when reading Daughter of Moloka'i

Leprosy

This article relates to Daughter of Moloka'i

In Daughter of Moloka'i by Alan Brennert, the main character is forcibly taken from her mother and put up for adoption because her mother was diagnosed with leprosy. Also called Hansen's Disease, leprosy affects a person's skin and peripheral nerves causing a loss of sensation and tissue degeneration. Those impacted may experience the gradual loss of their extremities or even the amputation of a limb as hands and feet become deformed and eroded over time, generally because minor injuries go unnoticed and untreated. This is particularly true of populations who are poor and who may lack basic healthcare to treat such wounds.

The disease is caused by a bacillus called Mycrobacterium leprae (M. leprae). It's been a somewhat mysterious ailment, and even today scientists are uncertain about the exact mechanism of its transmission. It's never been successfully grown in a culture, and in fact the bacillus dies a few hours after being removed from its host. It takes three to five years for someone who's been exposed to develop symptoms (and it could be up to 20 years), and even then, symptoms progress very slowly. Leprosy affects surprisingly few animals, being isolated to primates and armadillos (and people infected the armadillos, not the other way around). It takes prolonged, intimate contact with an infected person to contract the disease, and those with healthy immune systems are able to successfully fight off M. leprae.

According to Britannica, the oldest known leprous cadaver was discovered in India and dates to approximately 2000 BCE, although genetic studies of M. leprae indicate it's been around for something like 100,000 years and may have originated in eastern Africa or southwestern Asia. One theory is that it spread to Europe as the armies of Alexander the Great and Pompey marched through, eventually becoming so commonplace throughout the continent that people thought it was highly infectious; by 1200 CE there were an estimated 19,000 leprosy hospitals throughout Europe.

Individuals thought to be lepers often lived isolated lives. They could only be on the road if they wore a sign identifying themselves as diseased and had to continuously ring a bell as a warning to healthy people to steer clear. Leprosy was referred to as the "living death," because those who contracted it were treated as if they had already died. Some thought it was hereditary, so not only was the infected individual ostracized, but frequently their family was as well. It was common for people to be forced to live in leper colonies so as to not expose others.

In 1873, Dr. G.H. Armauer Hansen of Bergen, Norway, identified the leprosy organism under a microscope and demonstrated that it was, indeed, an infectious disease – and something that could be treated. Over the ensuing decades, drugs were developed that completely cure it. Instances of leprosy have decreased by 90% since the 1990s, largely thanks to an initiative by the World Health Organization to stamp out the disease. In spite of great progress, though, approximately 200,000 new cases are reported worldwide each year, with 150-250 occurring in the United States.

Filed under Medicine, Science and Tech

This "beyond the book article" relates to Daughter of Moloka'i. It originally ran in April 2019 and has been updated for the January 2020 paperback edition. Go to magazine.

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