Application of molecular biological techniques to the epidemiological study of leprosy is described. Studies of detecting Mycobacterium leprae DNA in samples of the nasal mucus are discussed in terms of the epidemiology and the significance of high prevalence. Epidemiological studies on the transmission of leprosy and correlation between geographic distribution of different M. leprae rpoT genotypes and prehistoric spread of the leprosy by genotyping based on the genomic polymorphism are introduced.

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The deciphering of the genomic sequence of Mycobacterium leprae has made possible to predict the possible lipoproteins. The consensus sequence at the N-terminal region of the protein, including the cysteine residue to which the lipid moiety gets attached, provides a clue to the search. As such, more than 20 putative lipoproteins have been identified from Mycobacterium leprae genomic sequence. Lipoprotein LpK (Accession no. ML0603) which encodes for 371 amino acid precursor protein, was identified. Expression of the protein, in Escherichia coli revealed a 33 kD protein, and metabolic labeling experiments proved that the protein was lipidated. The purified lipoprotein was found to induce production of IL-12 in human peripheral blood monocytes which may imply that M. leprae LpK is involved in protective immunity against leprosy. Pursuit of such lipoproteins may reveal insights into the pathogenesis of the disease.

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Leprosy causes several ocular disorders, and it also causes aftereffect with high frequency in various ways. Primary impairment is the ocular disturbance caused with direct invasion of nerve and ocular tissue by Mycobacterium leprae. Secondary impairment is the complication of nerve paralysis and residual inflammation due to primary disorder. Main work at Japanese national leprosariums has been the control of primary and secondary impairment in recent years.
Clinical ophthalmic study in the leprosarium revealed a increase of age-related ocular disease in addition to aftereffect of leprosy. Severe sequelae due to sensory and functional disturbance will require suitable applications of advanced clinical technologies.

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Recent discovery of genetic diversity of Mycobacterium leprae such as variable number of tandem repeats opened a new era in molecular epidemiology of leprosy infection. It was revealed that the leprosy bacillus in residential environment of endemic villages is an important source of infection. The global elimination strategy will be revised taking new molecular epidemiological knowledge into account. Responsibility of leprosy specialist is to propose feasible control program to local administration based on the epidemiological analysis on transmission of the disease.

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There was a village which was called Yunosawa, lots of leprosy patients lived, existed from 1887 to 1941, Kusatu town, Gunnma Prefecture, Japan. It was the only place continued securing self-government to the last as area was free from the isolation policy of State in prewar days there.
The aim of this study will make clear the dynamism of “The protection from the tension of the society of leprosy patient currently persecuted” to “The defense of the society from the leprosy patient who is a source of infection”.
In this study, explained the factor of confusion to a National Leprosarium Kuryu Rakusen-en during World War II and considered relation between patient movement and residents of Yunosawa village at the postwar period.

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Ofloxacin(OFLX) is often applied today as a substitution drug of MDT for drug resistance to dapsone, rifampicin or clofazimine. However, OFLX resistance is also becoming a great concern. Low and/or irregular administration are considered to be the major causes of OFLX resistance. OFLX should be used as a combined therapy, and minimal daily dose of 400mg of OFLX or 200 ?? 300mg of levofloxacin is required. Quinolone resistance should be considered when no improvement of clinical and/or bacterial index is observed after the treatment for 6 months. In such cases, resistance gene detection is necessary.

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