The Infectious Science Podcast
Welcome to the Infectious Science Podcast – Your source for cutting-edge insights on infectious diseases and the power of the One Health approach!
Our mission? To empower YOU with the knowledge to better understand the spread of emerging diseases. Whether you're a researcher, clinician, student, or simply curious about public health, we bring experts and thought leaders together to spark innovation, collaboration, and critical thinking.
Join us as we dive into the latest research, share inspiring stories, and make complex science accessible to everyone. Let’s build a healthier, more resilient world—one episode at a time!
Subscribe now and become part of the global community driving a safer future! #OneHealth #PublicHealth #InfectiousDiseases
The Infectious Science Podcast
Decoding Leprosy: Stigma, Science, and Godzilla
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
Curious about how armadillos and ancient diseases intersect? Prepare to be captivated as we unravel the fascinating mysteries surrounding Hansen's disease, more commonly known as leprosy. We start this season with some fresh faces: Christina Rios, a first-year medical student with a veterinary background, and Camille Ledoux, a third-year PhD candidate specializing in infectious disease biology. They join us for a lively discussion that seamlessly transitions from humorous pop culture references to the serious history of leprosy. With expert insights from Dr. Dacso, we uncover the history, clinical presentations, and treatments of this age-old disease.
Ever wondered if Godzilla could be a carrier of leprosy? We tackle this amusing hypothesis head-on, while focusing on the real-life connection between armadillos and Hansen's disease. Discover how armadillos, unlike our reptilian movie monsters, play a pivotal role in scientific research due to their susceptibility to Mycobacterium leprae. Learn about the ways armadillos are used as laboratory models to replicate human symptoms, helping us understand critical aspects of nerve damage and skin lesions in leprosy patients. We'll also discuss the methods of transmission and the historical stigma that has long surrounded this misunderstood disease, plus essential safety precautions for those who might encounter armadillos in the wild.
Stigma has always clouded diseases, like leprosy, TB, and HIV, but can compassion and education pave the way for change? We explore this complex issue by examining the history of Hansen's disease, including possible origins and the evolution of human resistance. Drawing parallels with the stigma surrounding other infectious diseases, we emphasize the importance of empathy and higher-order thinking in overcoming fear and prejudice. Our conversation aims to foster a more inclusive society where health care is accessible and free of stigma, proving that understanding the interconnectedness of global health can lead to a more compassionate world. Join us for an episode rich in science, history, and heartfelt discussion.
Thanks for listening to the Infectious Science Podcast, we hope you enjoyed this episode. You can find more cool science content on infectiousscience.org.
Please leave us a review and share this episode with others who may be interested, and don’t hesitate to ask us questions or tell us which topics you want to hear covered in future episodes.
The Ongoing Impact of Hansen's Disease
Speaker 2This is a podcast about One Health the idea that the health of humans , animals , plants and the environment that we all share are intrinsically linked .
Speaker 3Coming to you from the University of Texas Medical Branch and the Galveston National Laboratory .
Speaker 2This is Infectious Science , where enthusiasm for science is contagious . Hey everybody , welcome back to another episode of Infectious Science and , dare I say , another season , a new season , a new season Season two we're born , born anew Season two . We have a couple of new faces helping us out here today and I'm going to let them introduce themselves . Christina , do you want to introduce yourself ?
Speaker 1Yes , my name is Christina Rios . I am a first year medical student here at UTMB and I'm so happy to be working with you guys this season on the podcast . I just really wanted to join in because I found our block of infectious disease studies to be incredibly interesting , and I previously worked in veterinary medicine before I came to medical school . Actually , I've always wanted to go into human medicine . Really funny story how I got into veterinary medicine , but I loved it regardless , and so when I first had a presentation from Dr Benta really resonated with me the interaction between veterinary and human medicine and sciences . So , so , so grateful to be helping out this season .
Speaker 4And Christina , you know well , first of all , welcome right . But you know that real doctors study more than one species .
Speaker 5Yes they do , yes , they do .
Speaker 2As you were mentioning that , christina , I was thinking about the first Terminator movie . When Arnold Schwarzenegger lands , I think he actually gets treatment in the veterinary clinic From a vet .
Speaker 1I mean , I appreciate that .
Speaker 5Growing up in a rural area . Sometimes the vet clinic was probably a better bet than the local hospital .
Speaker 1I was going to say probably shouldn't share it , but definitely done some human CTs , Some veterinary CTs .
Speaker 4But Arnold Schwarzenegger is a robot . Why would a robot go to ? I don't know .
Speaker 5Isn't he a cyborg ? Isn't he a cyborg ? Isn't he like part robot ? Yeah , so that's you know , a cyborg . Another species , technically .
Speaker 4Well , I'm excited we're going to talk about Godzilla today . Yes , we digress .
Speaker 5We get a veterinarian's opinion on Godzilla Camille . I'm Camille Adu . I am a third-year PhD candidate here at the University of Texas Medical Branch . I grew up on a livestock farm and shadowing a vet and that's how I got interested in infectious disease biology and when I went to college , that was my concentration . So I've worked with all kinds of pathogens . I've worked with cholera , completely antibiotic-resistant flesh-eating bacteria . I've worked with bacteriophages , which are very neat and I hope we do an episode on them and currently I work in a lab that studies viruses that infect the brain in the context of infectious diseases , the social and the economic and the geopolitical things that shift how health changes across the globe , and I think that this is a really cool opportunity to dive more into them and also to talk to some of my favorite people and get their ideas and get their answers to all my questions .
Speaker 4So I'll be coming with lots of people .
Speaker 5Definitely definitely Dr Dasha , dr Bente . Definitely definitely Dr Dasha , dr Bente . My favorite professors , definitely . So I'm glad to be here and get to just have a chance to chat and learn more .
Speaker 2Straight .
Speaker 5A's , camille , you get it .
Speaker 3Thank you , there's your PhD .
Speaker 4So , Matt , tell us real quick what are we supposed to expect from the new season .
Speaker 2New season , everybody be looking for some new faces , new discussions . We're going to have a lot of really great guests . We're going to be trying to continue to get people excited about One Health and about science and all the great things that are going on around us and destigmatize the world around us . Sounds good . That's our plan . Dennis Benta Dr Benta is here as well , Myself , Matt Dasho and yeah , today we're going to be launching into a discussion about one of the oldest , one of the wisest pathogens in human existence .
Speaker 4Can pathogens be wise . I mean , they don't have a brain , you're anthropomorphized Been around for a while .
Speaker 2Yes , and that is Anson's disease or mycobacteria M leprae . So we'll get into that discussion shortly .
Speaker 5Excited to be here for our episode of Infectious Science . Today we'll be talking about Hansen's disease , also known as leprosy . According to the CDC , the risk of getting Hansen's disease is quite low for most adults in the world , and that's because more than 95% of all people have natural immunity to the disease . The only real risk is being in prolonged contact with someone who has untreated Hansen's disease . It's caused by mycobacterium leprae , and what's interesting is that this is a disease that's been with humans for a very long time . The earliest skeletal evidence of leprosy that I found in literature was actually from more than 4,000 years ago , and the earliest written evidence we have is 2,000 years old . So this has been with humanity for a very long time , and so with us today we have Dr Dasho , who has actually seen a patient with Hansen's disease . Dr Dasho , could we hear a bit about the clinical presentations of M leprosy that physicians see and how it's treated ?
Speaker 2Yeah , thanks , camille . This is Matt Dasho , and welcome to the podcast . Hello everybody . Yeah , thanks , camille . This is Matt Dasho , and welcome to the podcast , hello everybody . Yeah , thanks for that , camille .
Speaker 2Obviously , leprosy has been around for a very long time . It's something that it dates back , as you mentioned , millennia . I think the earliest documented cases were from even 4000 BCE . It was in the Bible , right . Lepers were people who were suffering from this condition , were ostracized , stigmatized and often separated in very profound ways from their families and from their loved ones . And I think you mentioned it really well before .
Speaker 2This is a chronic cutaneous disease and it's caused by bacteria . It's a mycobacterium . We know mycobacteria are very , very slow growing bacteria and it's caused by one of two strains of that bacteria , called either M leprae or mycobacterium leprae or mycobacterium lepromatosis , and they're pretty much clinically indistinguishable . I've had two brushes or encounters with leprosy . I've not myself treated someone . We're going to be lucky enough to speak with a clinician who has spent a lot of her career studying leprosy and especially the pathologic elements of leprosy , who happens to be my sister , dr Mara Dasho , and so she will be on with us a little later to talk about some of her experience . But most often it presents as a chronic cutaneous condition that mostly affects the digits , the extremities and the parts of the skin that are at the distal ends . You'd often see it on the nose , the earlobes , the cheeks . The route of infection is actually not cutaneous , it's probably aerosol and , as you mentioned , you can be around people with leprosy many times and not get leprosy So- .
Speaker 4So , matt , sorry to interrupt you , but what I heard , the reason why they prefer areas like the nose and the cheeks and finger and the digits and so on , as you said , it's because the bacteria really like a lower temperature and that's obviously where the body temperature is a little bit lower , right , yeah ?
Speaker 2I have heard that and that also makes a lot of sense . So , as Camille was mentioning , this is a really fascinating condition , hansen's disease . It has a very , I think , variable clinical spectrum , but most of the time people are coming in with years of cutaneous infections . They have a highly varied appearance . We'll ask Dr Dasho other Dr Dasho to maybe comment in a more knowledgeable way . As a dermatopathologist she can describe those things in much greater detail . But yeah , that's the clinical presentation and the epidemiology . It's really interesting because it's a disease that's not seen all around the world . It's really only in certain countries and in certain clusters of populations .
Speaker 5I actually found some interesting research on why that is so . First and foremost , something that's cool from a One Health perspective is I actually found some research where they were looking at both archaeological data and then data from basically genetic samples from people that are living in urban areas , and what they found is that basically living in urban areas which is something that we've sort of recently started to do as a species has basically allowed us to develop a resistance to things like tuberculosis and leprosy . So if your ancestors were in a much more urban environment , they were more likely to be exposed to a lot of different pathogens . Ancient cities were not the cleanest . That's something really interesting that we're now finding out . It's relatively new that we live in cities , and so that has changed how and why people might be resistant to some diseases like leprosy .
Speaker 5But something else that I found , particularly if we think about a population that does have a really high proportion of leprosy , which is the Marshallese population , and just to give you an idea of how much higher it is , so in the United States it's 0.0083 per 10,000 people , which is a very low prevalence , but for the people from the Marshall Islands it's 12 per 10,000 people , which is a very low prevalence , but for the people from the Marshall Islands it's 12 per 10,000 people , which is incredibly high , and I found that there's a couple different reasons that are speculated for that . Some of it is housing , but some of it's also there's a hesitancy to seek medical care , and the longer it's untreated , the more likely you are to have more severe complications from it things like nerve damage and stuff like that .
Speaker 2Yeah , no , and I think one of the things you mentioned is really important is that , because it's so uncommon in the US , it's often not something that clinicians are looking for . We see chronic skin diseases we're thinking allergic problems , malignancies , other cutaneous infections , and Hansen's disease doesn't always jump to the top of the list . But , as you mentioned , there are certain populations . This is where I think your knowledge of the world and of epidemiology is really important . You know we're a globalized society , right ? This is the human migration , the migration of people , for all the reasons that people migrate , has put us in contact , I think , in the US and around the world , with diseases we may not have previously thought to look for . So you mentioned the Marshall Islands . I mean , marshall Islands is a very , very interesting particular case .
Speaker 2Many people don't know much about the Marshall Islands , but they're an archipelago , it's a nation of islands that are run about 70 miles and they're in the South Pacific . And if anybody has seen the movie Godzilla , the opening sequence is of a nuclear test and this is actually footage from a nuclear test that was conducted in Bikini Atoll in the Marshall Islands . So I can nerd out for hours and hours about the strategic importance of the Marshall Islands . But the US found the Marshall Islands to be of strategic interest , especially during and in the aftermath of World War II , when there was active war with Japan , and so having military presence in the South Pacific was seen as quite important . We know we have military bases in Hawaii , et cetera .
Speaker 2Marshall Islands were deemed to be a good place for nuclear testing in the years following World War II , and so obviously this exposed a lot of Marshallese to toxic levels of radiation . There were certain parts of the islands that were rendered uninhabitable , and so it pushed populations of people closer and closer together and resulted , through a series of agreements with the US government , that Marshallese could actually come live and work in the United States without visas . So they were given sort of a special status through something called the COFA agreement , which we won't go into . But the Marshallese also have a much higher incidence , continued incidence , of mycobacterium leprosy or M leprae , and MTB . So mycobacterial infections are highly prevalent in that population .
Speaker 4As well , I guess this brings us back to the topic that we've discussed many times displaced populations and the influence on density and diseases and
The Connection Between Armadillos and Leprosy
Speaker 4stuff like that . But I think for me the most important question is does Godzilla have leprosy , or is Godzilla a reservoir ? Is ?
Speaker 2he a reservoir ? Is Godzilla a reservoir ?
Speaker 5As the veterinarian in the room , could you tell us a little more about reservoirs for ?
Speaker 2I feel like Godzilla could have some armadillo in him . Yes , yeah , because it's really armadillos , right , dennis ? That are some of the more common reservoir hosts . Yeah , you don't have to go nerd out on armadillos yet . I know we're going to get to your armadillos .
Speaker 4No , but I want to nerd out on Godzilla , because I think Godzilla is a reptile . That's what I was always told and I think for me , the perception was always that armadillos , they're actually mammals and they're actually closely related to anteaters and sloths . So they are placental mammals and they just so happen to be very susceptible to mycobacterium leprae and that's why they've been traditionally used as a laboratory animal to study the disease . And the key thing here is that the reason why they are being used as an animal model is because they mimic the human disease very well . So what you see in a human disease and I hope Matt will get into that in a second the myopathy , the nerve damage , the neuropathologies and so on are very similar to what's seen in humans . So in terms of face value , it's a very good model that mimics human disease . So what are the clinical signs ?
Speaker 2Yeah , so I talked a little about the skin lesions , which remember that people get exposed and they may not manifest disease for many , many years . Anywhere from one up to 30 years have been described , but usually four to eight years from exposure people will start to manifest skin lesions . But really the reason all that comes about is , as you mentioned , dennis , because the disease affects Schwann cells and histiocytes and things like that . There's nerve damage , especially peripheral nerves , and so it's often said that people with Hansen's disease just don't feel pain in those extremities and so they're constantly injuring them , bumping them into things , they're getting burned , and so those get secondarily infected and there are erosive damages that happen .
Speaker 2There's all kinds of stuff that you do , unconsciously , your brain does to keep your extremities intact and to keep your skin intact and keep your bones from getting hurt . You will feel pain , you will feel discomfort , you will say I'm going to sit down or I'm going to put on shoes . People with Hansen's disease do not have those natural responses and so they start to develop a lot of erosive changes of both the skin and then of the nerves and then ultimately of the bones as well . So you'll see digits missing , you'll see neural digits , you'll see often pretty erosive changes of those extremities and then on the skin you'll see these ulcerative lesions that pop up on the ears , on the nose , on the cheeks and then obviously on the surface of the skin .
Speaker 4So you're saying and I'm stealing a lot of Camille's questions here it's ulcerative , but it's not contagious though . Right , so we don't have to be afraid if we see somebody with leprosy and they touch us or give us the hand . That's not a way of transmission . Right , that's correct .
Speaker 2That's correct . I think that was one of the things is , prior to the elaboration of this pathogen as a respiratory pathogen mostly respiratory there was a huge amount of stigma . I remember germ theory is a relatively new innovation for our species , so people thought it was miasmas , they thought it was genetic and it wasn't until Norwegian scientist Gerard Armer Hansen , who lived from 1841 to 1912 , checks notes . In the late 1800s he characterized the infectious Asian as a mycobacterium and that let them make the name of what was previously called leprosy , which was a very stigmatizing name . They called it Hansen's disease .
Speaker 5And , if I can just jump in , something you mentioned was that this particular bacteria has a bit of a tropism for a certain type of cells . So Schwann cells and for those listening who might not be familiar with these , I had to look them up myself and I work in a neuroscience lab they're glial cells and they form the myelin sheath on axons outside the brain , which is really important . But what's really interesting is that the bacterium actually promotes a nuclear reprogramming and de-differentiation of these host Schwann cells and they become progenitor stem-like cells that are more vulnerable to infection , which I think is a really fascinating mechanism by which it's infecting . And , dr Pente , I also had a clarifying question for you on what you said about armadillos . So if , as Dr Daschow has mentioned we've talked about , it's primarily a respiratory pathogen , are there any precautions the public should take when dealing with armadillos ? We certainly have them here in Texas . Should people avoid contact with armadillos and how many armadillos are really carrying amblaprae ?
Speaker 4Yeah , before I answer your question , I want to go back to what I said previously . I think we talked about the stigma of humans and I think that's the stigma with armadillos . The bacterium can be carried by a range of different animals , so it can be wild rodents , it can be a range of different mammals , non-human primates In certain areas we have different species , even chimpanzees or manga bees , that can carry the disease . But I think the reason why armadillos are always so in the focus is because they show disease and so they have an active , ongoing infection , and that obviously makes them more relevant to transmit the disease to humans .
Speaker 4And I'm not a hunter , but I was always told that these armadillos are considered a pest and so if you shoot them because they are digging holes and they're destroying your crops and your agricultural components , you shoot them because they're a pest . And I don't know what the meat tastes like , but I could assume that certain people will also try to harvest the meat and eat the meat and in this process of butchering the animal or handling the animal , I think that's where some of the transmission is happening . And if you think about that , maybe one in six armadillos in Texas or in Louisiana are positive or carry the infection . That's quite a high risk .
Speaker 1I just wanted to interject here , dr Benta . Does leprosy or Hansen's disease manifest in armadillos the same way that it manifests in humans ? Could you tell that an armadillo has leprosy or Hansen's disease ?
Speaker 4When I was doing my literature research and I was looking into these animal models and how good armadillos are to mimic human disease , I had the same question and I didn't really find the answer . If the Amadillo comes down with some sort of a muscle disease , some sort of a neuropathy of some sorts , they might be impaired in their locomotion or in some sort of stuff . And if an animal is sick , the question is always is it easier prey and is it easier to hunt the animal ? To be honest with you , I'm not sure if they show any sign of ulcerative cutaneous lesions or not . I don't know . Do you know ?
Speaker 5I do not know , but I wonder if part of the problem is studying them is that they're , from my understanding , mainly nocturnal animals . So if you're trying to get a sample in the wild , that might be difficult for researchers . But going off of that , thinking about ulcerative lesions , things like that , dr Tasho , I wanted to ask when I was looking in clinical literature why are dermatologists the ones who often diagnose Hansen's disease ? It's not really infectious disease docs , from my understanding . Is it just that skin checks are not like a normal part of seeing a patient ?
Speaker 2That's a good question . I mean , I think there is obviously the part of it that , in order to make the diagnosis , you often need a sample , and it's often dermatologists that are taking the biopsies or taking the samples . Many times , when there are these chronic lesions , we will push for a biopsy or push for some kind of tissue diagnosis , in which case dermatologists can be involved . Some people , when they have chronic skin issues , will primarily go to a dermatologist , so I think that'll be a good thing for us to also review with Mara , because , as you mentioned , yeah , dermatologists are going to be the ones that may actually pick these things up first , but those of us who are out in the world , I think I'm always curious as to why we don't have more of
Unpacking the Stigma of Leprosy
Speaker 2it in Texas . If we have so many armadillos , so many armadillos , we should all be on the lookout for it .
Speaker 4Yeah , that's a good question . I can only speculate . I guess Probably like 100 or 200 years ago , I think , there's more need for the meat of armadillos and nowadays they're just being shot and then just left to die and decay . I don't know how the armadillo population has changed over time , but I think it's also the exposure , the density of the animals in the area and the exposure to humans .
Speaker 5I do wonder how armadillos originally became infected . Is this something that humans gave armadillos ? Which way did the zoonosis go ?
Speaker 4The chicken and the egg question . I don't think that anybody will ever find out .
Speaker 2With so many species potentially susceptible to it , I don't think that you can ever find out what the origins and I think you mentioned Camille at the beginning but 95% of the human population is immune to it . So when you have these pathogens that have been around for literally thousands of years , with generations of people exposed , and it's a slow-growing bacterium I don't know much about the genetics but it seems all very conserved , so probably the strains and the evolution of the bacterial pathogen is not very fast , so it gives us an opportunity to develop immunity for it .
Speaker 4I actually have a quick question for you , camille . You said that there's resistance has built in humans . Over time , you said , from the agricultural development into the urbanization of things and humans being exposed over and over again , they became less susceptible to the disease . Do you know anything about that ? What makes humans now more resistant to it ?
Speaker 5Oh , that's a really good question . They were talking about tuberculosis and leprosy . They do have loci in the paper but I don't have them written down . But yeah , I'm not a geneticist so unfortunately I can't answer that now , but I can send it to you this will be the next episode .
Speaker 2Stay tuned , everybody yeah .
Speaker 4Deep dive on the genetics of the embassy . Go to the show notes .
Speaker 5But what is interesting about thinking about Hansen's disease is that I did find a paper talking about when was it introduced to Pacific islands . So if you're thinking about , like the Marshallese population , things like that , it was really interesting . I would have assumed it was with colonialism , whether that was Japanese imperialism or European colonialism . It was not . Actually , they refute that . They analyzed basically nine different samples and they found that it was with the first migration of people there . So this has been with us potentially even longer than we have 4,000-old skeleton evidence , but much longer than that . If it has gone everywhere in the world , it might have been reintroduced at different times and they talk about that a bit in the paper , but that subsequent migrations can move it around , but that it was already there and I think that that's a really fascinating thing to think about , particularly if we're thinking about animal reservoirs . Was this just sort of on all continents ?
Speaker 4if it was in the islands . And I think if there's something we can learn from Mycobacterium tuberculosis , which is also worldwide and it's in so many different species and it's probably also found in the soil it's very tenacious in the soil and you have again the range of mammals that are involved . So I don't think this is really just a very easy zoonotic transmission one-to-one , but maybe there's certain reservoirs in the soil . I know , for example , for mycobacterium tuberculosis in Europe , badgers are a big issue . They can transmit that and they dig and root around and all kinds of things . Cows get infected with mycobacterium and so on . So I don't think it's easy to pinpoint the source of something like that . It's been probably around for a much longer time than what ? 4,000 years .
Speaker 5Yeah , that's a really good point and I would say the stigma surrounding it has also been around for an exceptionally long time and I would really like us to talk about that , because I think there's always a danger , as someone who works in the field of infectious diseases , in suggesting that it's a very us-versus-them rhetoric to say , oh , most cases are acquired outside of the United States , because the reality is our health is so globally interconnected and if anyone thought that wasn't the case , covid-19 proved us wrong .
Speaker 5Every individual's health on this planet , whether they're animal or human , is so interconnected and anything that happens in one place can eventually kind of shift around , and it's something we've chosen to be so globalized . But could we talk about more on why does this always pop up , particularly in regards to leprosy ? There's this idea of the stigma of being morally unclean , and that's something that has popped up with other diseases as well . I think of things like HIV and even people just making judgments about particularly any infectious disease . So could we talk about why that is in the context of leprosy or other diseases ?
Speaker 4Yeah , I think that leprosy is kind of the poster child for this . The stigma , right . How many colonies and they're typically isolated islands or some sanitarium or some hospital on some remote islands , right , I think that's really the poster child for stigma in disease . Matt , do you have any thoughts on that ? Oh , man .
Speaker 2Why does it keep happening , camille ? I mean first of all the interconnectedness of human-animal environmental health migration . Someone should really make a podcast about that .
Speaker 4It's going to be the spinoff .
Speaker 2Someone should just really , really do that . I wish I had a good answer for why that is . It's the other , isn't it ? For a long time , I think it was lack of knowledge , lack of understanding , lack of compassion . Most of the people who were suffering from Hansen's disease that were uprooted from their communities and put into leper colonies . It was done against their will , but the people who cared for them were often faith-based communities . These were largely mission groups that took care of these populations because they were stigmatized and nobody else would , and they were in many ways out of the system . People didn't want to deal with them and this is a problem of marginalized groups around the world and you can look at it as a stigma of disease , a stigma of ethnicity , of cultural background , of race , whatever . The examples of otherizing are rife within society throughout human history . So tough one to answer , just specifically on infectious diseases .
Speaker 4And I think the reason why it's probably so stigmatizing is because the clinical presentation is so visible , right , and we see this with leishmania , for example , where you have the cutaneous things that everybody can see . Keep in mind the driver of when we go back to pox , for example , to the smallpox vaccinations , the initial idea . When the vaccination was done by the Chinese , they purposefully inoculated a less virulent version of smallpox in a part of the body that's not visible your arm or something like that , not your face , so that you don't have the blisters and the postules and stuff like that in your face later on . So I think the appearance aspect of leprosy is why it's so . Ostracizing is the word . I think it's the right word .
Speaker 5Yeah , I think that that's an excellent point and I wonder too if part of that's just the psychological aspect of if you can see something , you can imagine it happening to yourself , and that is something I think that makes people kind of resist , like an aversion to like I don't want that to happen to me . So there becomes this disconnect between seeing someone as another person who also is deserving of care and things like that . And speaking of care , up until fairly recently there were still leper colonies . Does anyone know if there's still any in existence ? I know there's remnants .
Speaker 2Yeah , I think there's remnants . I don't know that there's active places where people with leprosy have lived . It's interesting because I know in some countries people who are long-term sufferers of the disease . They've continued to live in the same communities because they're actually quite comfortable there . So I think some of it has been structural and some of it is just historic . But I don't think there's an active program right now that says okay , if you have leprosy you must go to this place because , as you mentioned before , it's really quite difficult to acquire .
Speaker 5Yeah , and then something that I had found that I just also wanted to mention . I actually found an interview from a nurse who works in the Marshall Islands , particularly in a clinic that deals with Hansen's disease , and the title of the article was actually Please Don't Tell my Husband I have Leprosy , and she actually details how . That wasn't on BuzzFeed no , it was not but it was fascinating because she's giving basically all of these examples of patients who don't even want to be seen going into a clinic that's associated with treating Hansen's disease and so healthcare workers sometimes like have to meet patients outside of the clinic , things like that , and it becomes a very difficult thing to end up treating because there ends up not being necessarily continuity of care , which can then put that person in more danger of developing the nerve damage and things like that . So what I guess I wanted to get at with this is what can we do as people who are working in the medical and science fields to help continue reducing stigma ? Is it just language ? Is it using Hansen's disease and not leprosy ?
Speaker 2I mean , I think it's becoming more familiar with it and , I think , becoming very comfortable with the idea that infectious pathogens are part of our ecosystem . And I think part of our job as communicators , as clinicians , as scientists , as people who are interested in this pushing the idea of One Health is that we do share this planet with all kinds of different species and what we want to do is we want to meet conditions and people and other animals with compassion . So that's kind of a cop-out theory question , camille , which is what do we do about it ? I think education is maybe one of the most important things that we can do , communicating with people , answering questions . I think people have legitimate fears and worries .
Speaker 2I didn't mean to imply earlier that people were wrong to fear leprosy . There was a time where we didn't know how it was transmitted and we didn't know that it was caused by who knows . But what we saw , even in those moments where we didn't know what it was , we saw compassion .
Overcoming Stigma Through Compassion and Education
Speaker 2And I think if we lead with compassion and we lead with the idea that there's always more to learn and understand , I think we can help with stigma , because you brought it up really well that it's not just Hansen's disease they surround the world .
Speaker 2People don't want to go to TB clinics to get treated . They used to have to go to special HIV clinics to get HIV medicines . It's very stigmatizing . So part of it is that our system can adapt to be a bit more inclusive and make it so that even getting people the treatment that they need where they need it , instead of having to go to specific places . So those are just some thoughts about how we can all work to decent . But there are people who work in the stigma area that have written entire books about approaches , which I could say more about .
Speaker 4So , camille and Christina , since you guys are new here , I'm known for always asking one philosophical question . So my question for you I think that some of the stigmas and the otherization and so on is also something that we probably carry as instincts inside of us . Like an infected animal will always separate itself from the group to avoid transmission . Or we have these mechanisms in place where , if you eat something that you think is toxic , your tongue will tell you it's bitter . We have these mechanisms in place to warn us about potential danger . It's bitter . We have these mechanisms in place to warn us about potential danger . Can we , as a human race , overcome this with our brain and then kick in empathy and overrule our instincts ?
Speaker 1I feel like we can and I'm only going to say this because isn't that supposed to be what sets us apart from other species and other animals , as is our higher order thinking and our ability to understand things and then act on that understanding . And I really liked what Dr Dasho said about education , because I really do think that education is the key to so much , to unlocking so much . And I think one important thing to know and please correct me if I'm wrong is to realize that so many of these diseases have treatments . There is treatment available for these things .
Speaker 1If you probably ask someone on the street , hey , if you develop leprosy , what do you think your prognosis is ? And I think that if you catch leprosy early on , of course that's really important . It's so important to know that there is actually treatment for these diseases and I think understanding that there is treatment kind of takes the fear of that disease process away . Of course , we still have light years to go to make sure that treatment is available for everyone . Of course we still need to overcome that stigmatization so that we can make sure that a lot of people have access to the treatment that they need . And also we need to overcome so many other social factors that we can go into for hours , but I do think just understanding that can strip away a lot of the fear of these infectious diseases .
Speaker 5Yeah , I think we can overcome it , but perhaps not unilaterally , because in order to have the bandwidth to do that , you have to have a lot of security in other areas of your life . In order to be able to have empathy for others , you need to have your needs met in so many ways , whether that's something like Maslow's hierarchy , or whether that's even just like having your mental and emotional health your needs met for that in order to in any way support someone else . And so I think that that , to me , would probably be the barrier to overcoming stigmatization is that in the world as it is now , I think so many people are very stressed and are very insecure on what's happening , whether in their local area or on a global scale , and I think that we kind of run into this empathy fatigue where it becomes very difficult to just constantly keep caring . So that , to me , is the only barrier we have to actually being able to overcome that . That would be my answer to this . But this has been really fascinating Migration , godzilla philosophy , leprosy Very cool , very cool .
Speaker 2Yeah , I think , guys , we're going to fix it One podcast episode at a time .
Speaker 3Thanks for listening to the Infectious Science Podcast . Be sure to hit subscribe and visit infectiousscienceorg to join the conversation , access the show notes and to sign up for our newsletter and receive our free materials .
Speaker 2If you enjoyed this new episode of Infectious Science , please leave us a review on Apple Podcasts and Spotify , and go ahead and share this episode with some of your friends .
Speaker 3Also , don't hesitate to ask questions and tell us what topics you'd like us to cover for future episodes . To get in touch , drop a line in the comments section or send us a message on social media .
Speaker 2So we'll see you next time for a new episode , and in the meantime , stay happy stay healthy , stay interested .
People on this episode
Podcasts we love
Check out these other fine podcasts recommended by us, not an algorithm.
This Podcast Will Kill You
Exactly Right and iHeartPodcasts
This Week in Virology
Vincent Racaniello