Chinoy John George Chacko (7 September 1931 - 17 April 2014) was an Indian pathologist and researcher who made many important discoveries and contributions to the knowledge of the pathology of leprosy, most importantly demonstrating that the mucosal layer of the nasal passages were the primary portal of entry of M.leprae into the human body.
Dr. Chacko underwent his basic medical education at the Christian Medical College (C.M.C.) in Vellore in south India and was an alumnus of the batch of 1950 of that institution. After completing his M.B.,B.S. degree in 1956, he joined the M.D. post-graduate degree course in Pathology at the same institution, and completed it in 1961. He joined the Department of Pathology the same year as a member of the faculty. Later he completed his Ph.D. from Madras University in 1971.
Dr. Chacko held two appointments simultaneously during his professional career of about three decades. He was a Professor in the Department of Pathology at C.M.C. Vellore, rising to become the Head of the Department in the year 1988. He was also a Pathologist and then subsequently Head of the Branch of Laboratories of the Schieffelin Leprosy Research and Training Centre (S.L.R. & T.C.) in Karigiri. He retired from both institutions in the year 1991.
In his time at S.L.R. & T.C. (which was one of the leading leprosy hospitals and research centres in India), Dr. Chacko was responsible for providing basic pathology support to the clinical leprosy services in the hospital, as well as the large leprosy control field area (covering a population of nearly 700,000). These services included bacteriological (skin smear examination) as well as histopathological facilities, and were made use of by other leprosy hospitals in the region as well as in neighbouring countries. The Radda Barnen Laboratories of S.L.R. & T.C. were designated reference laboratories for histopathology of leprosy, by the World Health Organization. Research activities at S.L.R. & T.C. which Dr. Chacko led, included pathological and histopathological changes in leprosy, mouse foot-pad cultivation of M.leprae to assess drug resistance, drug and immunology assays, laboratory collaboration for assessment of compliance, other drug resistance studies, genetic aspects of leprosy and response to treatment.
From his long studies of the nasal mucosa in leprosy cases arose Dr. Chacko’s main contribution to the understanding of the transmission of leprosy - the primary portal of entry into the human body of M.leprae being the nasal mucosa.
The Laboratories of S.L.R. & T.C. also conducted refresher and in-service training for doctors and technicians, in the microbiological and pathological aspects of leprosy. Dr. Chacko was able to persuade several research-oriented medical students - under-graduate, graduate and post-graduate – to take up research in different aspects of leprosy.
Dr. Chacko was a simple, modest, unassuming, self-effacing and gentle person who played many informal roles in the institutions he worked in. To his students, he was a mentor and counsellor, seeking out the academically poor and insecure among them. He then counselled, motivated and encouraged them, instilling confidence and self-assurance. He kept in touch with these students subsequently for many years, continuing to mentor and counsel them. To his colleagues, Dr. Chacko offered constant support, encouraging them to adopt modern or more effective approaches in diagnosis, research or teaching, and to participate regularly in workshops and conferences. In these efforts, his aim was always to bring out the best in others, and this was aided by his cheerful and optimistic nature. He had no ill feelings towards those who differed from or even opposed him. At a personal level, Dr. Chacko was a devout Christian and a socially conscious teacher and doctor. He would often offer rides in his car to poor leprosy patients visiting the S.L.R. & T.C. hospital at Karigiri.
In his spare time, Dr. Chacko had many different interests and hobbies. An avid reader, he was well-read on politics and current affairs, both national and international. He was interested in new technologies, especially those concerning non-conventional energy. His interest in school education led him, with a group of like-minded persons, to establish the Ida Scudder School, which is now one of the leading English-medium schools of Vellore. He was a devoted family man and gave much time to his own and the extended family.
Following his professional retirement, Dr. Chacko settled down in his family home in Pallom, in Kottayam district of Kerala. He continued to be active, supporting various initiatives and institutions in his neighbourhood. Among these were the local mission hospital, and programmes to aid senior citizens. Responding to the endemic alcoholism in the neighbouring communities, he started an Alcoholics Anonymous group, attending its meetings regularly, personally counselling and helping many persons to recover from the addiction and with their subsequent rehabilitation. His long experience in counselling and guiding his students and colleagues helped him to set up counselling programmes for married couples and adolescents. Apart from health related activities, Dr. Chacko also supported schools and an orphanage in the neighbourhood. He raised funds for their development and for purchase of equipment.
(Contributed by Dr. Ravi D'Souza, M.D.)
Formerly Senior Medical Officer, Schieffelin Leprosy Research & Training Centre, Karigiri, Tamil Nadu State, India.
Job CK, Chacko CJG, Verghese R, Singh SP. Enhanced growth of M. leprae in the foot pads of thymectomized irradiated mice. Lepr India 1974; 46:216-221.
Job CK, Chacko CJG, Verghese R, Singh SP. Leproma of the mouse foot. Lepr Rev 1975; 46:39-49.
Jesudasan K, George B, Chacko CJG, Taylor PM, Kurian PV, Job CK. An evaluation of the self-administration of DDS in Gudiyatham Taluk. Lepr India 1976; 48:668-76.
Job CK, Chacko CJG, Taylor PM, Daniel M, Jesudian G. Evaluation of cell-mediated immunity in the histopathological spectrum of leprosy using lymphocyte transformation test. Int J Lepr 1976; 44:256-66.
Taylor PM, Chacko CJG, Job CK. Study of sulphone resistance in leprosy patients in India. Lepr Rev 1976; 47:5-11.
Job CK, Chacko CJG, Taylor PM. Electromicroscopic study of histoid leprosy with special reference to its histogenesis. Lepr India 1977; 49:467-71.
Job CK, Victor DB, Chacko CJG. Progressive nerve lesion in a disease – arrested leprosy patient. An electron microscopic study. Int J Lepr1977; 45:255-60.
Nirmala V, Chacko CJG, Job CK. Tuberculoid leprosy and tuberculosis skin: a comparative histopathological study. Lepr India 1977; 49:65-9.
Hiramalini S, Joseph NA, Chacko CJG. Concentration and persistence of bacilli in the fingers and toes of patients with lepromatous leprosy. Lepr Rev 1978; 49:223-9.
Chacko CJG, Bhanu T, Victor V, Alexander R, Taylor PM, Job CK. The significance of changes in the nasal mucosa in indeterminate, tuberculoid and borderline leprosy. Lepr India 1979; 51:8-22.
Fine PE, Wolf E, Pritchard J, Watson B, Bradley DJ, Festenstein H, Chacko CJG. HLA linked genes and leprosy: a family study in Karigiri, South India. J Infect Dis 1979; 140:152-61.
Balraj V, Jesudasan K, Chacko CJG, Christian M, Taylor PM, Fritschi EP, Job CK. Prevalence of secondary dapsone resistance in Gudiyatham Taluk. 1. Preliminary report. Int J Lepr 1980; 48: 397-401.
Chandi SM, Chacko CJG, Fritschi EP, Job CK. Segmental necrotizing granulomatous neuritis of leprosy. Int J Lepr 1980; 48:41-7.
Kotteeswaran G, Chacko CJG, Job CK. Skin adnexa in leprosy and their role in the dissemination of M. leprae . Lepr India 1980; 52:475-81.
Mathias C, Chacko CJG, Sundar Rao PSS, Job CK. T-cell depletion of spleen in patients with longstanding lepromatous leprosy. Lepr India 1980; 52:366-73.
Thomas J, Joseph M, Ramanujam K, Chacko CJG, Job CK. The histology of the Mitsuda reaction and its significance. Lepr Rev 1980; 51:329-39.
Wolf E, Fine PE, Pritchard J, Watson B, Bradley DJ, Festenstein H, Chacko CJG, Stevens A. HLA – A, B and C antigens in South Indian families with leprosy. Tissue Antigens 1980; 15:436-46.
Christian M, Chacko CJG. Prevalence of secondary and primary dapsone resistance in Gudiyatham taluk. Lepr Rev 1981; 54:185-91.
Thomas J, Joseph M, Ramanujam K, Chacko CJG, Job CK. Histology of the Fernandez reaction – an appraisal. Int J Lepr 1981; 49:1-8.
Job CK, Chacko CJG. A simplified 6 group classification of leprosy. > Lepr India
Almeida JG, Chacko CJG, Christian M. The significance of dapsone resistant Mycobacterium leprae in untreated patients. Int J Lepr 1983; 51:374-7.
Almeida JG, Christian M, Chacko CJG, Taylor PM, Fritschi EP. Studies on dapsone-resistant Mycobacterium leprae in leprosy patients of Gudiyatham taluk 2. A progress report. Lepr Rev 1983; 54:185-91.
Almeida JG, Christian M, Chacko CJG. Follow-up of lepromatous (LL and BL) patients on dapsone (DDS) monotherapy after attainment of smear negativity in Gudiyatham Taluk, South India. Int J Lepr 1983; 51:382-4.
Almeida JG, Christian M, Chacko CJG. Response to dapsone (DDS) monotherapy in leprosy patients of Gudiyatham Taluk, South India: comparison between the 1960s and the 1970s. Int J Lepr 1983; 51: 378-80.
Almeida JG, Christian M, Chacko CJG. Results of long term domiciliary dapsone (DDS) monotherapy for lepromatous leprosy in Gudiyatham Taluk, South India. Int J Lepr 1983; 51:385-6.
Almeida JG, Chacko CJG, Christian M. The significance of dapsone (DDS) resistant Mycobacterium leprae in untreated patients. Int J Lepr 1983; 51:374-7.
Almeida JG, Chacko CJG, Christian M, Taylor PM, Fritschi EP. DDS-resistant infection among leprosy patients in the population of Gudiyatham Taluk, South India. 3. Prevalence, incidence, risk factors, and interpretation of mouse foot-pad test results. Int J Lepr 1983; 51:366-73.
Pannikar VK, Arunthathi S, Chacko CJG, Fritschi EP. A clinico-pathological study of primary neuritic leprosy. Lepr India 1983; 55:212-21.
Almeida JG, Chacko CJG. Non-compliance with treatment. Ind J Lepr 1984; 56:369.
Almeida JG, Jesudasan K, Christian M, Chacko CJG. Relapse rates in lepromatous leprosy according to treatment regularity. Int J Lepr 1984; 54:16-20.
Almeida JG, Chacko CJG. Dapsone resistant leprosy. Lepr Rev 1984; 55:183.
Almeida JG, Joseph PS, Sarangapani G, Chacko CJG. “Drug-resistant proportion test” for M. leprae to quantify the proportion of drug-resistant M. leprae in a sample using the mouse footpad. Int J Lepr 1984; 52:468-70.
Almeida JG, Joseph PS, Sarangapani G, Chacko CJG. The mouse footpad test – sensitive to small proportions of drug-resistant bacilli in a sample of M. leprae. Ind J Lepr 1984; 56:10-14.
Ramanujam K, Arunthathi S, Chacko CJG, Jacob M. “Neural histoid”. Histoid leproma in peripheral nerve; a case report. Lepr Rev 1984; 55:63-68.
Almeida JG, Chacko CJG. Computerized mathematical model of M. leprae population dynamics during multiple drug therapy. Ind J Lepr 1985; 57:780-9.
Jesudasan K, Christian M, Chacko CJG, Keystone JS. Comparative studies in human and armadillo derived Mitsuda lepromin. Lepr Rev 1985; 56:303-8.
Almeida JG, Jesudasan K, Christian M, Chacko CJG. Relapse rates in lepromatous leprosy according to treatment regularity. Int J Lepr 1986; 54:16-20.
Chandi SM, Chacko CJG. An ultrastructural study of the response of traumatized rabbit tibial nerve to epineural infection with Mycobacterium leprae.Int J Lepr 1986; 54:79-83.
Job CK, Chacko CJG. A modification of Fite’s stain for demonstration of M. leprae in tissue sections. Ind J Lepr 1986; 58:17-8.
Chandi SM, Chacko CJG. An ultrastructural study of dermal nerves in early human leprosy. Int J Lepr 1987; 55:515-20.
Job A, Chacko CJG. Reactional states in the nasal mucosa: a clinical and histopathological study. Int J Lepr 1988; 56: 523-6.
Chacko CJG. Early lesions of leprosy. Leprosy Research Review 1989; 22-29.
Abraham B, Cariappa A, Chacko CJG. Rifampicin in drug-incorporated diet: effect of duration and temperature of storage. Relevance to drug-susceptibility testing in mice inoculated with M. leprae. Int J Lepr 1991; 59:68-75.
Chacko CJG. Role of histopathology in the early diagnosis of leprosy. Ind J Lepr 1993; 65:23-7.
Suneetha S, Arunthathi S, Chandi S, Kurian N, Chacko CJG. Histological studies in primary neuritic leprosy: changes in the apparently normal skin. Lepr Rev 1998; 69:351-7.
Suneetha S, Arunthathi S, Job A, Date A, Kurian N, Chacko CJG. Histological studies in primary neuritic leprosy: changes in the nasal mucosa. >Lepr Rev
Suneetha S, Arunthathi S, Kurian N, Chacko CJG. Histological changes in the nerve, skin and nasal mucosa of patients with primary neuritic leprosy. Acta Leprol 2000-01; 12:11-8.
Leprous Rhinitis and its Sequelae (with C K Job) in Epidemiology & Clinical Manifestations of Leprosy in ENT Regions 1974.
Microbiology in A Manual of Leprosy - Edited by R H Thangaraj and published by The Leprosy Mission 1975.
Morbid Pathology & Pathogenesis in A Window on Leprosy – Edited by B R Chatterjee and published by the Gandhi Memorial Leprosy Foundation 1978.
Leprosy: Pathology in IADVL (Indian Association of Dermatologists, Venereologists and Leprologists) Textbook and Atlas of Dermatology Ed R G Valia, published by Bhalani Publishing House, Bombay 1994.