The document discusses leprosy and plague. It provides information on the causative agents, symptoms, transmission, diagnosis and treatment of both diseases. For leprosy, it describes Mycobacterium leprae and the different classifications of the disease. It also discusses the WHO recommended multidrug therapy. For plague, it outlines the bacterium Yersinia pestis and the different forms it can take including bubonic, septicemic and pneumonic plague. Diagnosis and treatment options for plague are also presented.

1. Leprosy
and
Plague

2. Our Team
Aditi Tanwar Deepanshi Debia Angel
Bsz/21/107 Bsz/21/109 Bsz/21/110 Bsz/21/108
Neha Bisht

3. About the Disease
Here you can describe the
topic of the section
01
Pathology
Here you can describe the
topic of the section
04
Epidemology
Here you can describe the
topic of the section
02
Treatment
Here you can describe the
topic of the section
05
Transmission
Here you can describe the
topic of the section
03
Prevention
Here you can describe the
topic of the section
06

4. Introduction
Leprosy is an age-old disease and
is described in the literature of
ancient civilizations. It is a chronic
infectious disease which is caused
by a type of bacteria called
Mycobacterium leprae. The disease
affects the skin, the peripheral
nerves, mucosa of the upper
respiratory tract, and the eyes.

5. About Mycobacterium
Mycobacteria are immobile, slow-growing rod-shaped, gram-
positive bacteria with high genomic G+C content (61-71%).
Notuberculous
mycobacterium
Mycobacterium
leprae
Mycobacterium
tuberculosis

6. Epidemiology
Mycobacterium leprae is thought to have
originated in East Africa and spread
across the globe through human
migratory trends, reaching the Western
world within the last 500 years. In 2012,
the World Health Organization recorded
a prevalence of approximately 180,000
cases. Through eradication efforts, the
total number of cases worldwide has
decreased, yet the number of new cases
each year has remained consistent.
Mortality is difficult to measure with
leprosy, as the infection is not the
immediate cause of death in many cases

7. ● The disease is transmitted
through droplets from the
nose and mouth.
● Prolonged, close contact
over months with someone
with untreated leprosy is
needed to catch the disease.
TRANSMISSION

8. symptoms

9. ● Paucibacillary Leprosy
(PB) This classification, which
includes indeterminate,
tuberculoid, and borderline
tuberculoid leprosy, is based on
a negative skin smear.
● Multibacillary Leprosy
(MB) Individuals in this category
have a large number of bacteria
present in their skin and nerves,
and their symptoms are more
widespread. Those with MB
leprosy tend to have six or more
affected skin areas.
Diagnosis

10. ● Infection is acquired by prolonged contact with patients with lepromatous leprosy who
discharge M. leprae in large numbers in nasal secretions and from skin lesions.
● Route of Transmission: Skin and inhalation.
● M. leprae multiplies very slowly (cell replication cycle; 2 weeks ; slowest growing human
bacterial pathogen).
● Incubation period of the disease is about five years. Symptoms can take as long as 20 years to
appear
● Mycobacterium leprae is uncultivable in microbial culture or in cell culture systems. Almost half
of the genes in M. leprae are pseudogenes that no longer code for proteins to be transcribed in
the cell hence it relies on host cell to survive acting as parasite in animals with lower body
temperature – armadillos, mice and extremities of human body.
FEATURES

11. PATHOGENESIS OF LEPROSY

13. ● Main Objective: detect all the cases as early as possible and register them.
● Until 1981, Dapsone (Diamino Diphenyl Sulphone—DDS) was used to treat leprosy which
resulted in the development of resistance and relapse, making leprosy control difficult.
Multidrug Therapy: In 1982, WHO recommended Multidrug Therapy (MDT) for all leprosy
patients.( DAPSONE, RIFAMPICINE,CLOFAZIMINE)
● The drugs used in Multibacillary MDT and dosages are:
● Rifampicin: 600 mg once monthly, supervised.
● Dapsone: 100 mg daily, self administered.
● Clofazimine: 300 mg once monthly, supervised and 50 mg daily, self administered.
● The drugs used in Paucibacillary MDT and dosages are:
● Rifampicin 600 mg once a month for 6 months supervised.
● Dapsone 100 mg daily for 6 months self administered.
TREATMENT

14. ● Duration of treatment for Multibacillary leprosy
is 12 months, can be extended to 18 months
and continued where possible up to smear
negativity. Sometimes LL/BL patients with high
bacilli may need 2–3 years or more of MDT for
achieving bacteriological negativity.
● Paucibacillary leprosy is treated for 6 months.
● Clinical surveillance of the patients after
completion of treatment is an important part of
MDT to ensure complete cure. For
paucibacillary cases follow up for at least once
a year for 2 years after completion of treatment
and for multibacillary cases at least once a year
for 5 years

15. MYTHS ABOUT
LEPROSY
● 1. LEPROSY NO LONGER EXISTS: leprosy affects a sizeable number of people
every year but they are reluctant to come forward and discuss the condition
because of the misunderstandings surrounding it which delays its diagnosis and
treatment
● 2. PEOPLE WHO HAVE LEPRPSY MUST BE ISOLATED AND KEPT IN
SECLUSION: of course not just get them proper treatment. Antibiotics can cure
leprosy And you can leave a normal life among family and friends.
● 3. LEPROSY IS HIGHLY CONTAIGIOUS: You cannot get leprosy by shaking
hands or casual social contact. Think of Mother Teresa who served for years
among those with leprosy and never contracted the disease 95% of adults don’t
due to the built in immune system.
● 4. LEPROSY CAUSES FINGERS AND TOES TO DROP OFF: Leprosy attacks the
nerves causing fingers and toes to become numb and prone to infection and
damaged not fall off.

16. Plague
1894: Hong Kong epidemic
• Alexandre Yersin
− Gram negative
− Bacillus
• 1896 − Developed
antiserum

17. ● Caused by Yersinia pestis
● Gram negative, non-motile, non-spore-forming bacillus
● Resistant to freezing temperature and drying, killed by heat and sunlight
● Zoonotic infection; Humans are accidental hosts
Epidemiology Of Plague

18. ● Plague is a zoonotic infection transmitted
to human by the bite of an infected rat
flea.
● Infection may also be transferred by
contamination of the wound resulted by
bite with the feces of infected rat fleas.
● Human to human transmission occurs only
in pneumonic plague which is spread by
droplet infection.
Transmission Of Plague

19. Pathogenesis of plague
● Yersinia pestis is a highly virulent bacterium which causes
plague with a high mortality rate. The ability of Yersinia spp. to
resist pathogenetic killing is the hallmark of pathogenesis of
plague.
● Y. pestis causes natural disease of rats and other rodents.
● The infected host dies. If no other rodent is available for the flea
to colonize the flea searching for a new host transmit the
infection to humans.
● In human plague occurs in 3 forms

20. ● It starts with a flea biting a human being and spreading the contamination
into the tissue.
● The Yersinia Pestis bacteria gets transmitted.
● They later enter the lymphatic system; they then spread through the
lymphatic tubes to the lymphatic node. This results in acute lymphadenitis,
i.e., intense swellings of the lymphatic nodes.
● These swollen lymph nodes also are haemorrhagic (causing bleeding) or
necrotic (characterised by the death of cells).
Bubonic Plague

22. Septicemic Plague
• This is the secondary form of infection in which the over-
swollen lymphatic nodes drain their fluids into the
bloodstreams. This makes way for the bacteria to spread
across the different parts of the body.
• The released endotoxins by the pathogen cause the blood
throughout the body to coagulate (curdle).
• The semisolid blood is not effective in oxygenation and
perfusion of the body anymore and causes necrosis of the
tissues throughout several parts of the body.
• Bleeding inside the skin, making it swell with extreme
redness and blackness.

23. Pneumonic Plague
● In this type of plague, the infection enters into the patient’s lungs.
● This level of the infection makes the disease contagious.
● When the patient coughs, the droplets get airborne, and one can
get infected by inhaling or ingesting the droplets. If untreated, the
infection at this stage will definitely result in fatality.

25. Diagnosis of plague
ELISA test
Detects F1antibody or
F1 antigen
PCR (detects
pla gene, caf1
gene)
Caf1, pla genes or
chromosomal fragments
are detected.
Rapid
diagnostic test
(f1 antigen)
Detects F1 antigen present
in the outer surface of the
pathogen.
Gram staining Media culture
Cultivated in
MacConkey agar, sheep
blood agar.
Pleomorphic rod shaped
Fluorscent
antibody test
Detects F1 antibody or
F1 antigen
Giemsa or wayson
staining.
Appears bipolar.

26. Signs and symptoms of plague
Bubonic plague
•Sudden onset of
fever and chills.
•Headache
•Fatigue
•Muscle ache
Pneumonic plague
•Cough with bloody
mucus
•Difficulty in
breathing
•Nausea
•High fever
•Weakness
•Chest pain
•headache
Septicemic plague
•Fever and chills
•Extreme weakness
•Abdominal pain,
vomiting
•Bleeding from
mouth, nose, rectum
•Blackening and
death of tissues

28. Treatment
Plague can be treated with the help of antibiotics such as-:
1. Gentamicin
2. Doxycycline
3. Ciprofloxacin
4. Levoflocin
5. chloramphenicol

29. Plague is one of the deadliest diseases
in human history, second only to
smallpox. Then we found a cure.

30. How to Prevent Plague
Prevention
1. Reduce rodent habitat in your
surrounding
2. Keep your pets free of fleas
3. Wear gloves while handling
potentially infected animals
4. Use insect repellent
5. Do not allow the animals to sleep
on your bed.

31. —Someone
Famous
“This is a quote, words full of
wisdom that someone
important said and can make
the reader get inspired.”
Thank You!