My article  about the new rapid diagnostic test for leprosy is now up on Slate.

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.

According to a study published in the journal Cell today, the leprosy mycobacterium can reprogram cells, turning adult cells into stem-like cells that are able to infiltrate the body’s muscle and nervous system. This mechanism explains one of the great mysteries of leprosy — how it spreads throughout the body–and could pave the way for early intervention to stop the disease in its tracks. Lead researcher Anura Rambukkana, a regeneration biologist at the he University of Edinburgh, UK, tells Nature, “This is a very sophisticated mechanism — it seems that the bacterium knows the mechanistic interaction of the Schwann cell better than we do.”

While somewhat light on science, the recent New York Times Magazine cover story “The Hazards of Growing Up Painlessly” is a fascinating profile of Ashlyn Blocker, a girl who suffers from a rare, harrowing, and little-understood condition known as “congenital insensitivity to pain.” Although not mentioned in the article, one of the only other diseases that rob patients of the ability to feel pain is leprosy. Although the stereotype persists that leprosy makes parts of your body fall off, what actually happens is that nerve damage from the Mycobacterium leprae causes the extremities to lose sensation and then atrophy. The inability to feel pain leads to chronic sores, gangrene, blindness, and destruction of flesh. Continued bruising, without sensation of pain, can result in absorption of bone, which is responsible for the foreshortening of leprosy patients’ fingers and toes. Only if you are diagnosed with leprosy and treated quickly with a cocktail of powerful antibiotics and steroids can you be cured and stave off the worst of the damage. But at least there is a cure for leprosy, which is more than can be said for the genetic mutation that makes day-to-day living for patients like Ashlyn so complicated.