International Leprosy Association -
History of Leprosy

  • International Leprosy Association -
    History of Leprosy


    Dr Stefaan R Pattyn

    Status Medical Researcher
    Country Belgium


    Dr Stefaan R Pattyn's first contact with leprosy was during the course in Tropical Medicine at the Institute of Tropical Medicine in Antwerp in 1953, when he learnt that M. leprae was an uncultivable bacterium. During his subsequent training in virology in Leiden (NL), he witnessed the introduction of cell culture and the first arrival of HeLa cells on the continent. This gave rise to the idea that the uncultivability of M. leprae would now be rapidly solved: tissue culture would be the solution.

    Upon arrival in Lubumbashi 1954-55, he was confronted with an epidemic of poliomyelitis among the local African and immigrant European population. After many difficulties he and his colleagues succeeded in maintaining HeLa cells imported from Leiden and later on successfully organised massive cultures of primary human amnion cells. He was involved in research with enteroviruses until the end of his stay in Lubumbashi in 1960.

    In the meantime, the idea of culturing M. leprae in cell cultures was not forgotten. HeLa cells were tried but during their short time maintenance, no multiplication of M. leprae was evident. Human amnion cells could be maintained in a nonmultiplying state for 4 to 6 weeks. This was more suitable, but also unsuccessful. In two instances, tissue cultures from skin biopsies from lepromatous patients were initiated and kept for many weeks, with gradually decreasing numbers of bacilli.

    In 1958, Dr Pattyn went to the US with a WHO grant and studied, amongst other things, the histopathology of leprosy at the Armed Forces Institute of Pathology in Washington, DC and met CC Shepard at a CDC lab in Montgomery, Alabama. They spoke about Dr Pattyn's negative cultivation efforts, and Dr Shepard had just written a paper on the negative results for M. leprae in a series of different cell lines. They spoke about M. ulcerans which Dr Pattyn had also observed in Katanga.

    In 1960, having returned to Antwerp, and being in a leprosy free country, Dr Pattyn assumed that his activities in leprosy would definitely belong to the past, when a few weeks later, he read Shepard's publication on the mouse foot pad. Dr Pattyn wrote to ask for a strain, and Dr Shepard sent four. He also obtained biopsies from patients in Kinshasa, isolated the strains and confirmed Dr Shepard's work at the Leprosy Congress in Rio de Janeiro in 1963.

    From then on experimental chemotherapy was a main laboratory activity as well as detection of DDS resistant strains and isolation of strains from occasional cases of imported leprosy, of which there were in those days 2 per year in Belgium. Experimental drugs from different pharmaceutical firms, particularly Bayer, were tested. But the great revelation came once more from Dr Shepard, who showed the extraordinary activity of rifampicin on M. leprae.

    Dr Pattyn's laboratory worked on all mycobacteria known at that time, except M. tuberculosis - but he followed the literature and congresses on this organism very closely - he realised that the future of the treatment of multibacillary leprosy would be combined chemotherapy to avoid the selection of resistant mutants, and shortening the duration of treatment to a minimum to attain maximum compliance.

    Because RMP was available in small amounts because of its expense, in the late 1970's, the question about its correct use appeared. He learned that the Belgian NGO, Damien Foundation (DF), sent RMP to Zaïre - Congo without instructions on its use, thinking that the doctors there would know how to use it. But hardly any information was available. In those days, the Damien Foundation had the responsibility of leprosy and tuberculosis control in the North East of Congo. Expatriate nurses supervised local nurses for detection and treatment. The plan was to cover, by gradual extension in this way, the whole country. He organised, together with this organisation, treatment trials. Protocols were written, training sessions organised, the rationale of the treatment schedules explained, diagnoses confirmed by histopathology of the skin biopsies done in Antwerp, and when communications were very deficient, the results were communicated for some time in code by Belgian International Radio. It was a combination of help to developing countries and scientific studies to improve the efficacy of the help. Collaboration with the Institut Marchoux in Bamako, Mali, was also very intense.

    In the meantime, he had become a member of the steering committee of THELEP and was heading the subgroup on the treatment of paucibacillary leprosy during the famous meeting of the Study Group on the Chemotherapy of Leprosy in 1982. By 1986 the WHO regimens were gradually introduced everywhere and the studies on alternative regimens, particularly on short duration, came to an end. A practical solution for a mass short term treatment of MB leprosy, was not achieved, in his view; on the other hand, several alternative, including single dose regimens for PB were shown to be effective.

    New drugs, such as quinolones, were tested in the laboratory in mice. In 1992, he retired, but continued to work in the section of his previous collaborator and successor, Prof Françoise Portaels, at the Institute, monitoring leprosy activity in one area: Anjouan island in the Commores Archipelago. He passed away in 2008.

    Information supplied by Dr Stefaan R Pattyn, 2003

    Entry updated February 2016


    Pattyn SR, Yada A, Sansarricq H, van Loo L. "Prevalence of secondary dapsone-resistant leprosy in Upper Volta." Lepr Rev 55.4 (1984): 361-7.

    Pattyn SR, Andre PS, Ferracci C, Baquillon G. "Comparative study of two regimens of combined chemotherapy of one year duration in multibacillary leprosy. Results after four and five years' follow-up." Int J Lepr Other Mycobact Dis 52.3 (1984): 297-303.

    Silva MT, Macedo PM, Portaels F, Pattyn SR. "Correlation viability/morphology in Mycobacterium leprae." Acta Leprol 2.2-4 (1984): 281-91.

    Portaels F, De Ridder K, Pattyn SR. "Cultivable mycobacteria isolated from organs of armadillos uninoculated and inoculated with Mycobacterium leprae." Ann Inst Pasteur Microbiol 136A.2 (1985):181-90.

    Onsun N, Saylan T, Pattyn SR. "Combined chemotherapy of multibacillary leprosy of 6 months' duration." Lepr Rev 57 Suppl 3 (1986):124-6.

    Pattyn SR. "Activity of ofloxacin and pefloxacin against Mycobacterium leprae in mice." Antimicrob Agents Chemother 31.4 (1987):671-2

    Pattyn SR. "Rifabutin and rifapentine compared with rifampin against Mycobacterium leprae in mice." Antimicrob Agents Chemother 31.1 (1987):134.

    Husser JA, Pattyn SR. "Suspicion of paucibacillary leprosy resistant to dapsone: importance of follow-up." Acta Leprol 5.2 (1987):147-50.

    Pattyn SR. "Activity of ofloxacin and pefloxacin against Mycobacterium leprae in mice." Antimicrob Agents Chemother 31.4 (1987): 671-2.

    Leysen DC, Haemers A, Blanchaert L, Van Assche I, Bollaert W, Schoenmaekers K, Pattyn SR "The mycobacterial cell-wall as target for antimycobacterial drugs. I--Synthesis and activity of some diphenylalkylanalogues of mycolic acids." Farmaco [Sci] 42.11 (1987): 823-31.

    Colemont LJ, Pattyn SR, Michielsen PP, Pen JH, Pelckmans PA, Van Maercke YM, Portaels F. "Acid-fast bacilli in Crohn's disease." Lancet 1.8580 (1988): 294-5.

    Pierard D, De Meyer A, Rosseel P, Glupczynski Y, Struelens MJ, Delmee M, Pattyn SR, Verschraegen G, Melin P, Lauwers S. "In vitro activity of amoxycillin plus clavulanic acid and ticarcillin plus clavulanic acid compared with that of other antibiotics against anaerobic bacteria." Acta Clin Belg 44.4 (1989): 228-36.

    Pattyn SR, Bourland J, Grillone S, Groenen G, Ghys P. "Combined regimens of one year duration in the treatment of multibacillary leprosy--I. Combined regimens with rifampicin administered during one year." Lepr Rev 60.2 (1989): 109-17.

    Tonglet R, Pattyn SR, Nsansi BN, Eeckhout E, Deverchin J. "The reduction of the leprosy endemicity in northeastern Zaire 1975/1989." Eur J Epidemiol 6.4 (1990): 404-6.

    Pattyn SR, Bourland J, Kakeze C. "Evolution of the leprosy endemicity in Burundi during the years 1981-88." Ann Soc Belg Med Trop 71.1 (1991):57-61.

    Pattyn SR, Grillone S. "Leprosy in the Comores 1981-88." Ann Soc Belg Med Trop 71.1 (1991): 51-5.

    de Wit MY, Faber WR, Krieg SR, Douglas JT, Lucas SB, Montreewasuwat N, Pattyn SR, Hussain R, Ponnighaus JM, Hartskeerl RA, et al. "Application of a polymerase chain reaction for the detection of Mycobacterium leprae in skin tissues." J Clin Microbiol 29.5 (1991): 906-10.

    Pattyn SR, Groenen G, Janssens L, Kuykens L, Mputu LB. "A controlled therapeutic trial in paucibacillary leprosy comparing a single dose of rifampicin with a single dose of rifampicin followed by one year of daily dapsone. The Collaborative Study Group for the Treatment of Leprosy in Zaire." Lepr Rev 62.2 (1991): 179-85.

    Pattyn SR, Bourland J, Kazeze. "Ambulatory treatment of multibacillary leprosy with a regimen of 8 months duration." Lepr Rev 63.1 (1992): 36-40.

    Pattyn SR, Groenen G, Janssens L, Kuykens L, Mputu LB. "Treatment of multibacillary leprosy with a regimen of 13 weeks duration." Lepr Rev 63.1 (1992): 41-6.

    Ieven M, Vael K, De Mayer M, De Schepper A, Pattyn S. "Three cases of Fusobacterium necrophorum septicemia." Eur J Clin Microbiol Infect Dis 12.9 (1993): 705-6.

    Pattyn SR, Ghys P, Janssens L, Tshilumba K, Kuykens L, Karibushi N, Denis P. "Plague in Zaire." Verh K Acad Geneeskd Belg 56.4 (1994): 281-360; discussion 360-1.

    Pattyn SR, Ghys P, Janssens L, Tshilumba K, Kuykens L, Karibushi N, Denis P. "A randomized clinical trial of two single-dose treatments for paucibacillary leprosy."
    Lepr Rev 65.1 (1994): 45-57.

    Schoemaker IE, Sys SU, Andries LJ, Meyers JM, Pattyn SR, Brutsaert DL. "Positive inotropic effect of Streptococcus faecalis in isolated cardiac muscle." Am J Physiol 267.6 Pt 2 (1994): H2450-61.

    Ieven M, Verhoeven J, Pattyn SR, Goossens H. "Rapid and economical method for species identification of clinically significant coagulase-negative staphylococci."
    J Clin Microbiol 33.5 (1995):1060-3.

    Portaels F, Serruys E, De Beenhouwer H, Degraux J, De Ridder K, Fissette K, Gomez-Marin J, Goossens H, Muhlberger F, Pattyn SR, Nturanye F, Pouthier F, Van Deun A. "Evaluation of the Gen-Probe amplified Mycobacterium tuberculosis direct test for the routine diagnosis of pulmonary tuberculosis." Acta Clin Belg 51.3 (1996):144-9.

    "Infectious diseases, the veritable pandora's box" Verh K Acad Geneeskd Belg 59.2 (1997): 61-71.

    Guimaraes-Peres A, Portaels F, de Rijk P, Fissette K, Pattyn SR, van Vooren J, Fonteyne P. "Comparison of two PCRs for detection of Mycobacterium ulcerans." J Clin Microbiol 37.1 (1999): 206-8.

    Pattyn S, Grillone S.A 6 week quadruple drug regimen for the treatment of multibacillary leprosy. Lepr Rev 71.1 (2000):43-6

    Van Dyck E, Ieven M, Pattyn S, Van Damme L, Laga M. "Detection of Chlamydia trachomatis and Neisseria gonorrhoeae by enzyme immunoassay, culture, and three nucleic acid amplification tests." J Clin Microbiol 39.5 (2001):1751-6.

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