Abstract
Estimates of genetic susceptibility to leprosy were made in the past from observational reports in familial settings using descriptive epidemiologic data. Risk of conjugal transmission of leprosy (from one spouse to another) has been estimated between 1-10% and is thought to occur in 3-5% of spouses exposed to untreated lepromatous disease in the partner. Risk of secondary transmission is presumed higher in other family members than for the conjugal partner. This belief has become dogma to many leprologists who may no longer know the basis for this estimation. This article reviews the historic epidemiologic descriptions of risk for leprosy transmission in married couples compared to other family members. Although uncommon, conjugal leprosy occurs and at higher rates in populations with traditional familial intermarriage and consanguinity.
Highlights
Estimates of genetic susceptibility to leprosy were made in the past from observational reports in familial settings using descriptive epidemiologic data
Worth (1968) reported 37 spouses in Hong Kong followed for 10 years: three individuals (8.1%) developed leprosy, the consanguinity of the couples was not stated
In a large series of 5,626 cases from Mexico between the years 1953-1986, Aguirre-Negrette and Ramirez-Soltero (1990) described 90 men and 44 women who were diagnosed with leprosy presumed transmitted from their conjugal partners
Summary
Estimates of genetic susceptibility to leprosy were made in the past from observational reports in familial settings using descriptive epidemiologic data. Assuming that a conjugal bed partner of an untreated lepromatous patient is the most highly exposed member of a household and is most at risk for secondary infection, the rate of leprosy in a spouse should be proportional to the risk of susceptibility in a population. This assumption is made even though the mycobacterial load of the spouse, the partner’s contact time with the spouse and the incubation period in the partner, cannot be controlled in any descriptive epidemiologic studies
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