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According to the World Health Organisation, 2.8 million people throughout the world are infected with leprosy, and each year about 750,000 new cases are recorded. Since the leprosy bacillus genome was sequenced in 2001 by the team directed by Stewart Cole of the Institut Pasteur , important advances have been made. New diagnostic tests and epidemiological tools are currently being developed in the Bacterial Molecular Genetics Unit of the Institut Pasteur.
"Controlling leprosy will only be possible with rapid identification of all infectious cases in order to treat them and thus prevent transmission of the disease", Cole stressed. "This is why the development of sensitive and reliable tests is vital. Thanks to analysis of the genome, we have already been able to identify, produce and purify about 40 proteins useful for diagnosis. Preliminary studies have shown that some proteins were recognized by the immune systems of the infected, which means that they could aid in the development of early diagnostic tests." These proteins will be tested this year on samples collected from a wide range of patients in Asia and Africa.
In addition, the Institut Pasteur researchers are presently studying strains taken from every continent in the goal of retracing the spread of the disease. Employing knowledge of the genomic sequence of the agent responsible for leprosy, Mycobacterium leprae, a number of tools are currently in development for epidemiology. As Cole explains it, "these tools will make it possible to differentiate the strains of Mycobacterium leprae taken from the infected, with a view to establishing epidemiological connections and to monitor leprosy by distinguishing the cases of relapses from new infections".
In the longer term, study of the leprosy bacillus could lead to new treatments that are less cumbersome than those currently in existence. The current treatment is effective, however it needs to be administered over several months, which makes its use difficult in developing countries where the infection is rife (such as Brazil, India, Madagascar, Mozambique, Myanmar, Nepal, etc.)
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