Infectious have plagued humans since ancient era. Infection is often the direct cause of mortality especially in elderly population. Management of infectious diseases is very important for physicians in Japan, which rate of elderly has become higher than other countries rapidly. There are some clues to manage infectious diseases in the elderly. 1) Afebrile does not mean non-infectious cause. 2) Have to check the difference from everyday life. 3) Perform a physical examination carefully. 4) Do not use broad spectrum antibiotics just because of the patients’ age. 5) Do not forget tuberculosis. 6) Prevent infectious diseases as much as possible. These clues must be helpful for physicians when they manage infectious diseases in the elderly.

  Isolation of leprosy patients beginning in the Middle Ages of Europe was a religious isolation based on the doctrine of Christianity. It was terminal care with compassion for the purpose of protecting the patient, but the patient had to finish his life in Lazaretto. This aspect deeply engulfed people the image of leprosy as diseases isolated, diseases of fear, dark and dusky. A plague epidemic starting in the 14th century became the greatest tragedy in European history, and one third of the population died out. Pest epidemic continued until the 18th century, and cholera also became popular from the 19th century. In the epidemic of plague and cholera, in Europe, developed public health policies mainly against measures against infectious diseases and opposed it. As a result, the European public health policy was forced to sacrifice minorities with the aim of maximizing maximum happiness, and was established in the 19th century with the development of bacteriology.

  Leprosy was prevalent in the 19th century in Canada, Hawaii, Norway and Germany. It began with management as a genetic disease at the beginning, became to be considered as an infection eventually, Mycobacterium leprae (Lepidoptera) was discovered by Hansen in 1873, and then overcome by overcrowding as a public health policy I was tried. Isolation was strict, but protection was also secured by Christian missions and isolation aimed at terminal care was also done. The former strongly aimed at transition from religion to science mainly in the United States, scientific measures were taken based on the “International Conference”. The latter was centered on British Christianity mission, with the dignity and compassion of human being the center of its activities. Two isolation became the tide of the world in the modern age, eventually leading to the trial of the isolation policy based on science and compassion.

  Chemotherapy starting with Promine in 1943 changed Hansen’s disease from incurable disease to diseased disease, science learned from the spirit of religion, changed the isolation as public health policy, religion was a remedy for patients who respect scientism , Aiming to escape from the concept of isolation in the Middle Ages. Eventually, this result fruited as WHO’s measures against leprosy, isolation policy shifted to outpatient treatment, and WHO policy of multidrug therapy (MDT) began in 1981. With the progress of this policy, the number of leprosy patients worldwide has drastically decreased, and in 2010 only one country where leprosy is a public health problem became one country. It was also the end of the history of the tragedy of leprosy for thousands of years.

  The history of leprosy gave humanity a number of tragedies, but the way to overcome it has given us a lot of lessons. Today, utilizing what we learn from the history of leprosy to the future will be our mission living in the era when leprosy is about to be overcome. In this paper, while examining the process of religion and science overcoming leprosy, I will clarify the history of leprosy and I would like to think about the significance of telling the history as archives as a history.

  Multidrug Drug Therapy (WHO/MDT) has always been a basic strategy of WHO’s Global campaign for leprosy elimination since 1991. WHO/MDT played different roles according to WHO’s global strategies. From 1991 to 2005 WHO/MDT was introduced into general health services to achieve national level elimination to reduce sources of infection in order to break chains of infection from man to man. Since prevention of disabilities/impairment became more highlighted after achievement of national level eliminations, early case detection and proper treatment with WHO/MDT was most effective strategy. Active case-finding was promoted to get as many numbers of new cases as possible, but after some time it was not recommended because it would induce more stigma and discrimination against patients and their families in a local society. Voluntary reporting through health education became an alternative strategy. WHO’s current global strategy promotes early case detection targeting detection among higher risk groups through campaigns in highly endemic areas or communities and screening all close contacts of persons affected by leprosy. According to the experiences of a NGO’s leprosy program in Khulna city, Bangladesh from 1986 to 1998, where a systematic active case-finding started in the middle of the period, the annual number of new cases increased about three times after active case-finding started and the rate of disability grading 2 decreased from around 30% to 5% accordingly, but the number of MB cases which were supposed to be sources of infection did not increase. Therefore active case-finding might contribute to the prevention of disabilities, not to the detection of sources of infection. It is also supposed that repeated active case-finding in the same community might induce stigma and discrimination against leprosy, because “The campaign for Leprosy-Free Prefectures”, a combined social movement of the nation and local communities, which was conducted nationwide under the national segregation policy in Japan from 1930’s, created awful feelings of stigma and discrimination against leprosy and huge human rights violations were followed up to now. Japan should share these lessons and learns with other countries.