It has been assumed in the past that attack-rates for leprosy are lower than those for tuberculosis, that leprosy is spread by direct person-to-person contact, and that in leprosy the skin is the most likely route of infection. However, the numbers of Mycobacterium tuberculosis in sputum from open cases of tuberculosis and of M. leprœ in the nasal secretions of patients with lepromatous leprosy are similar; in addition, attack-rates in family or household contacts for the two diseases in comparable populations in South India are of the same order. While these findings do not prove that modes of spread and routes of infection are identical for the two diseases, they are consistent with this possibility.
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