Of Mice and Leprosy

The fleshy pads beneath the feet of the common house mouse and its albino kin in the laboratory are so tiny that it takes a highly imaginative researcher to suggest how they might be useful in the control of human leprosy. Dr. Charles C. Shepard had that kind of imagination. He knew that countless other investigators had failed to persuade Hansen's bacillus, the microbe that causes leprosy, to grow in lab animals--a vital step in virtually all infectious-disease research. At the National Communicable Disease Center in Atlanta, Shepard reasoned that perhaps the bacilli needed a cool environment like that in the foot pads of mice. Shepard injected bacilli into the pads, and after he had waited patiently for months, they multiplied.

Last week, for this achievement, Shepard received the first annual World Leprosy Day Award at a San Francisco gathering of leprologists. In the decade since his bacilli began to grow, and as a direct result of his work, the lot of leprosy patients in many countries has markedly improved and at least two promising new drug treatments have been developed. The prospect is for rapid progress in the next few years.

While it has long been known that leprosy is one of the most difficult diseases to catch, nevertheless some people still catch it.-Shepard's footpad test, involving the injection of disease material into mice to see whether bacilli grow out, has enabled U.S. Public Health Service physicians to show that after a few months of treatment with a sulfone drug (Dapsone), most patients are virtually noninfectious. Then they can safely be released from hospitals to live at home with their families and go to work. And it is now possible to determine in a few months what used to take several years: whether a new drug treatment is effective.

Help from Thalidomide. This is important because Dapsone must be taken either every day by mouth or injected twice a week, which is both costly and troublesome. But now a new sulfone, acronymically named DADDS, is being tested by PUS doctors in a long-lasting injection form. Its protective effect appears to endure for months.

A second medication also being hailed for certain leprosy patients is the drug that has been more thoroughly damned than any other in history: thalidomide. Of course it is not being given to women of childbearing age, but at the PHS Hospital in Carville, La., and at several other centers in the U.S. and elsewhere, it has been shown to arrest some phases of the disease process, although it is no cure. What encourages leprosy specialists most is the fact that the number of patients regularly attending clinics is increasing. Not because the disease is becoming more common, but because, with fear reduced and hope increased, proportionately more victims are presenting themselves for treatment. New York City, with three clinics already serving more than 100 patients, has now added a fourth, more specialized unit in lower Manhattan. The name over the door was designed to be disarming--"HD Clinic," for Hansen's disease. The word leprosy is still considered too alarming, but the disease is losing some of its terror.

-There are an estimated 15 million victims around the world, mostly in the tropics but some as far away as Scandinavia; the U.S. has about 3,000 known victims.

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