CURRENT LITERATURE

International Journal of Leprosy and Other Mycobacterial Diseases, Dec 2004

This department carries selected abstracts of articles published in current medical journals dealing with leprosy and other mycobacterial diseases.

General and Historical

Anonymous. A Romanist View of the FishEating Leprosy Theory. Archives A Century Ago. Arch. Dermatol. 140 (2004) 789.

Even in an age of masterful clinicians, Sir Jonathan Hutchinson was exceptional. In addition to his clinical work, Sir Jonathan was a prolific writer serving as editor for a time of the British Medical Journal. . . and, most incredibly, from 1889-1900 singlehandedly writing every article in his 1 -man journal, the Archives of Clinical Surgery. Sir Jonathan was a medical polymath, an expert in ophthalmology, neurology, pathology, surgery, and dermatology. It is in syphilology where his eponymous fame is most enduring . . . having seen over 1 million cases (1) of syphilis. . .

Unfortunately appended to his illustrious career will always be the enduring embarrassment of his idée fixe-that leprosy is caused by eating rotten fish. Notwithstanding the questionable geography or the lessthan-obvious logical dietary leap, for the rest of his life Hutchinson espoused his doctrine despite universal rejection by contemporary leprologists. Even the discovery of the leprosy bacillus by his good friend Gerhard Hansen in 1874 couldn't dissuade Hutchinson. Hutchinson was mildly nonplused when no one could discover [the bacillus] in any fish. . . Hutchinson confessed that one reason he never sought to experimentally test his theory was "the assured conviction that the general facts were overwhelmingly conclusive and that they needed only to be clearly set forth." Indeed the only reason Hutchinson's theory gained any circulation at all, if never actual acceptance, was because of his otherwise impeccable reputation. - [Condensed from the essay. DMSJ Archives of Dermatology

Al Sarnie, A. R., and Al Qubati, Y. Leprosy control in the Republic of Yemen: cooperation between government and nongovernment organizations, 1989-2003. Lepr. Rev. 75(2) (2004) 164-170.

Although the prevalence rate of leprosy in the Republic of Yemen has dropped below the WHO elimination level of less than one case per 10,000 of the population, it is still regarded as a serious public health problem calling for continued vigilance, notably in the detection and treatment of hidden and undiagnosed cases. In the past, religious misinterpretation has generated adverse behaviour patterns towards people affected by leprosy, characterized by aggression, negligence and isolation. Until about 1982, following a visit of a leprologist (Dr. S. K. Noordeen) from the World Health Organization, there was no leprosy control program and attempts to establish one remained ineffective until in 1989, when an agreement was signed between the Ministry of Public Health and Population and the German Leprosy Relief Association. This led to the development of a leprosy control program in four governorates, later extended to the rest of the country. This paper describes the progress made in the control of leprosy in the Yemen, 1989-2003, by the Ministry of Health and Population and the GLRA, in association with two local societies.-Authors' Abstract

Donoghue, H. D., Spigelman, M., Greenblatt, C. L., Lev-Maor, G., Bar-Gal, G. K., Matheson, C., Vernon, K., Nerlich, A. G., and Zink, A. R. Tuberculosis: from prehistory to Robert Koch, as revealed by ancient DNA. Lancet Infect. Dis. 4(9) (2004) 584-592.

During the past 10 years palaeomicrobiology, a new scientific discipline, has developed. The study of ancient pathogens by direct detection of their DNA has answered several historical questions and shown changes to pathogens over time. However, ancient DNA (aDNA) continues to be controversial and great care is needed to provide valid data. Here we review the most successful application of the technology, which is the study of tuberculosis. This has provided direct support for the current theory of Mycobacterium tuberculosis evolution, and suggests areas of investigation for the interaction of M. tuberculosis with its host.-Authors'Abstract

Hughes, M. S., James, G., Taylor, M. J., McCarroll, J., Neill, S. D., Chen, S. C., Mitchell, D. H., Love, D. N., and Malik, R. PCR studies of feline leprosy cases. J. Feline Med. Surg. 6(4) (2004) 235-243.

16S rRNA gene sequence analysis provided evidence for two different mycobacterial species, Mycobacterium lepraemurium and a potentially novel species, as causative agents of "feline leprosy." Comparison of 16S rRNA gene sequence data obtained for M. lepraemurium and the potentially novel species indicated 12 nucleotide differences over a 446 bp region encompassing the V2 and V3 hypervariable regions. From available 16S rRNA gene sequence data, M. lepraemurium shared greatest nucleotide identity with M. avlum subsp. paratuberculosis and M. avium. The novel species had a long helix 18 in the V3 region and shared greatest nucleotide identity with M. leprae, M. haemophilum and M. malmoenxe. The novel species had an additional 'A' nucleotide at position 105 of the aligned 16S rRNA gene sequence, the only other mycobacterial database sequence having this same extra nucleotide being M. leprae. This nucleotide variation was exploited to develop specific PCR assays for the two species. These were found to be effective and specific when tested against a panel of mycobacteria including species found in feline leprosy lesions and closely related mycobacteria and also when applied directly to formalin-fixed, paraffin-embedded tissues from feline leprosy cases. -Authors' Abstract