Walking around Baltimore’s newly developed East Harbor yesterday, I was appalled by the slurry of bottles, plastic, and detritus floating in the water alongside the boardwalk. I wondered how this lone duck could stand it. Then I realized, with some relief, that the bird was swimming free and clear of the trash — which was contained by booms on the storm drains that flush into the harbor. Well, I thought, that’s one sign of progress. But, clearly, there’s much to be done upstream to protect the watershed. According to this interesting story in the Baltimore Sun a couple of years ago, more than 300,000 pounds of trash and debris a year flow down from the Jones Falls. While a little more than half is organic material (leaves, etc.), the rest is manmade: an estimated 189,000 plastic bottles, 160,000 foam cups, 58,000 grocery bags, and more than 1 million cigarette butts.
A bench? A pedestal? This clunky piece of furniture is a kind of medical lazy Susan — a rotating examination table from the leprosy colony on the island of Culion in the Philippines. Children born and raised within the colony, which opened in 1906, were regularly placed on this table and examined from almost every angle for suspicious lesions and numb patches of skin that might indicate an active leprosy infection. This exam was known as a “reconoser,” according to Dr. Arturo C. Cunanan, who waxes rather nostalgically about the routine in a recent Sasakawa Memorial Health Foundation/World Health Organization newsletter.
In case you missed it, Sunday was World Leprosy Day, which was started as a PR gimmick almost 60 years ago back when everyone thought sulfa drugs were about to bring an end to this chronic mycobacterial infection. Didn’t happen, thanks to mutations of genes and political agendas. But there is good news on the horizon.
The Seattle-based Infectious Disease Research Institute just announced that it is launching the first rapid diagnostic test to identify people with leprosy before symptoms appear. This could be a game-changer because one of the many weird things about leprosy is that symptoms vary widely and often take five to seven years before they become full-blown. During that ramp up, it is common for patients to be misdiagnosed and treated for things like acne, fungal infections, or even cancer. By the time they’re properly diagnosed, leprosy patients may develop skin lesions and loss of sensation, which lead to their becoming disfigured, blind, or maimed. Although a multi-drug cocktail of powerful drugs can arrest the disease, treatment does not confer life-long immunity, nor does it reverse crippling nerve, muscle, and bone damage.
While early treatment will help, the only true long-term solution to leprosy is a vaccine. This has been the holy grail for decades, but all attempts have failed because it is impossible to grow m. Leprae in a test tube. Now scientists have found a way around that. Later this year, IDRI, plans to begin clinical trials of a leprosy vaccine based on recombinant DNA. The goal is to create a vaccine that not only immunizes against leprosy but also intercepts the disease and prevents its development before patients become symptomatic.