Nervous System Infections

Gerhard Henrik ArmauerHansen (1841-1912) was a burly Norwegian physician who lived in the southern part of that country in the bustling seaport of Bergen. He was a man of many interests, ranging from music, religion, and polar exploration, to marine biology. A vigorous trade of goods and ideas with other countries was going on at the time, especially with Germany and England, and like many of the city's inhabitants Dr. Hansen was fluent in several languages. He was well aware of the scientific advances of the day, including Darwin's studies, and Pasteur's proof that bacteria could cause fermentation. His Norwegian contemporaries included such luminaries as his friend, Edvard Grieg, the famous composer, Henrik Ibsen, a world-renowned playwright, and Bjornstijerne Bjornson, a Nobel Prize-winning writer and poet, a leader in the movement for an independent Norway.

When he was 32 years old, Hansen decided to go into medical research, and was named assistant to Dr. Daniel C. Danielson, a leading authority on leprosy. He married Danielson's daughter, Stephanie, but she died of tuberculosis some months later. In honor of his love, Hansen named a new marine organism that he had discovered Stephanostoma hansenii. Danielson had developed the theory that leprosy was a disease of the blood, that once acquired, was hereditary. He had discarded the idea that the disease was contagious as a "peasant superstition," and, to "dispose of this foolish notion," injected himself with material from leprosy patients. Fortunately for him and others who had done the same thing, no disease developed, because effective treatment of leprosy did not become available for another three-quarters of a century. Luckily, Danielson and Hansen had great mutual respect, because Hansen in a meticulous series of 58 studies over a number of years, disproved Danielson's theory and showed that a unique bacillus was associated with the disease in every leprosy patient he studied. His findings, finally reported in 1873, almost a decade before Koch's proof of the cause of tuberculosis, linked for the first time a specific bacterium to a disease. His studies forever changed the way people looked at leprosy, overturning a viewpoint that had existed for many centuries.

Today it is hard to appreciate the fear and loathing formerly attached to leprosy. In the Greek translation of the Bible from Hebrew, a variety of disfiguring skin diseases, including leprosy, are covered by the word lepros, meaning "scaly," but having the connotation of being disgustingly filthy, outcast, condemned by God for sin. In the Bible, Moses calls lepers "unclean" and proclaims that they must live away from others. In the Middle Ages, lepers wore bells to warn others of their presence, and attended a symbolic burial of themselves

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TEM of West Nile Virus, a virus introduced into the United States in 1999

before being sent away. Because the English word leprosy carries these innuendoes, many people prefer to use the term Hansen's disease after the discoverer of the causative organism. Even in the United States during the first half of the twentieth century, persons diagnosed with leprosy risked having their houses burned to destroy contagion. Their names were changed to avoid embarrassing the family, and they were whisked off to a leprosarium such as the one at Carville, Louisiana, surrounded by a 12-foot fence topped with barbed wire. They were separated from spouses and children, and denied the right to marry or to vote. Those who attempted to escape were captured and brought back in handcuffs. The story of the Carville leprosarium is told by one who did escape, Betty Martin, in her wonderful book, Miracle at Carville. The leprosarium was finally closed and converted to a military-style academy for high school dropouts in 1999.

—A Glimpse of History

INFECTIONS OF THE NERVOUS SYSTEM ARE APT TO be serious because they threaten a person's ability to move, to feel, and to think normally. Just consider poliomyelitis, in which nerve cells are destroyed, leaving the victim with a paralyzed arm or leg, or unable to breathe without mechanical assistance. In Hansen's disease, nerve damage can result in complete loss of fingers or toes,

664 Chapter 26 Nervous System Infections or deformity of the face, while infections of the brain or its covering membranes can render a child deaf or mentally retarded. Fortunately, nervous system infections are uncommon. Examples given in this chapter, however, reveal a multiplicity of causes, including bacteria, viruses, fungi, and even some protozoa.

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