Volume 78, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


It is generally held that dissemination of is from nasal mucosa and not through the skin of infected patients. In this study, we evaluated in the unbroken skin and nasal secretions of multibacillary (MB) leprosy patients and their contacts. Specimens were examined by direct microscopy and polymerase chain reaction (PCR) for DNA. Results showed that 60% of untreated MB leprosy patients examined histologically had acid-fast bacilli in the keratin layer. By PCR studies it was found that 80% of the patients had DNA in skin washings and 60% had DNA on swabs obtained from the nasal mucosa. Ninety-three contacts of the untreated MB cases were also tested for exposure to by analyzing skin washings and nasal secretions by PCR. PCR analysis showed significant skin (17% positive) and nasal muscosal (4%) exposure in contacts before instituting treatment of the index cases. After 2 months of treating the index cases, all contacts tested were negative for DNA. These data suggested that both skin and nasal epithelia of untreated MB leprosy patients contribute to the shedding of into the environment and contacts of untreated MB cases are at risk for contact with through both the nasal mucosa and exposed surfaces of their skin.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Fine P, 2007. Leprosy: what is being “eliminated.” Bull World Health Organ 85 : 2–4. [Google Scholar]
  2. Meima A, Richardus JH, Habbema JD, 2004. Trends in leprosy case detection worldwide since 1985. Lepr Rev 75 : 19–33. [Google Scholar]
  3. Anonymous, 2006. Global leprosy situation, 2006. Wkly Epidemiol Rec 81 : 309–316. [Google Scholar]
  4. Job CK, Chehl S, Hastings RC, 1990. New findings on the mode of entry of M. leprae in nude mice. Int J Lepr 58 : 726–729. [Google Scholar]
  5. Chan PC, Reyes LM, Demerre-Lopez B, Gonzaga EM, De los Santos MFA, Gillis TP, 1997. Leprosy infection and disease in the national capital region. Philippine J Microbiol Infect Dis 26 : 159–162. [Google Scholar]
  6. Klatser PR, van Beers S, Madjid B, Day B, de Wit MY, 1993. Detection of Mycobacterium leprae nasal carriers in populations for which leprosy is endemic. J Clin Microbiol 31 : 2947–2951. [Google Scholar]
  7. Smith WC, Smith CM, Cree IA, Jadhav RS, Macdonald M, Edward VK, Oskam L, van Beers S, Klatser P, 2004. An approach to understanding the transmission of Mycobacterium leprae using molecular and immunological methods: results from the MILEP2 study. Int J Lepr Other Mycobact Dis 72 : 269–277. [Google Scholar]
  8. Chatterjee BR, 1976. Carrier state in leprosy. Lepr India 48 : 643–644. [Google Scholar]
  9. Abraham S, Mozhi NM, Joseph GA, Kurian N, Rao PS, Job CK, 1998. Epidemiological significance of first skin lesion in leprosy. Int J Lepr Other Mycobact Dis 66 : 131–139. [Google Scholar]
  10. Williams DL, Gillis TP, Booth RJ, Looker D, Watson JD, 1990. The use of a specific DNA probe and polymerase chain reaction for the detection of Mycobacterium leprae. J Infect Dis 162 : 193–200. [Google Scholar]
  11. Williams DL, Gillis TP, Fiallo P, Job CK, Gelber RH, Hill C, Izumi S, 1992. Detection of Mycobacterium leprae and the potential for monitoring antileprosy drug therapy directly from skin biopsies by PCR. Mol Cell Probes 6 : 401–410. [Google Scholar]
  12. Pedley JC, 1970. Summary of the results of a search of the skin surface for Mycobacterium leprae. Lepr Rev 41 : 167–168. [Google Scholar]
  13. Hosokawa A, 1999. A clinical and bacteriological examination of Mycobacterium leprae in the epidermis and cutaneous appendages of patients with multibacillary leprosy. J Dermatol 26 : 479–488. [Google Scholar]
  14. Hatta M, Van Beers SM, Madjid B, Djumadi A, de Wit MY, Klatser PR, 1995. Distribution and persistence of Mycobacterium leprae nasal carriage among a population in which leprosy is endemic in Indonesia. Trans R Soc Trop Med Hyg 89 : 381–385. [Google Scholar]
  15. Gelber RH, Humphres RC, Fieldsteel AH, 1986. Superiority of the neonatally thymectomized Lewis rat (NTLR) to monitor a clinical trial in lepromatous leprosy of the two regimens of rifampin and dapsone. Int J Lepr Other Mycobact Dis 54 : 273–283. [Google Scholar]
  16. Fieldsteel AH, Levy L, 1976. Neonatally thymectomized Lewis rats infected with Mycobacterium leprae: response to primary infection, secondary challenge, and large inocula. Infect Immun 14 : 736–741. [Google Scholar]
  17. Wakade AV, Shetty VP, 2006. Isolation of Mycobacterium leprae from untreated borderline tuberculoid, mid-borderline and indeterminate cases using the mouse foot pad technique—a study of 209 cases. Lepr Rev 77 : 366–370. [Google Scholar]
  18. Franzblau SG, Chan GP, Garcia-Ignacio BG, Chavez VE, Livelo JB, Jimenez CL, Parrilla ML, Calvo RF, Williams DL, Gillis T, 1994. Clinical trial of fusidic acid for lepromatous leprosy. Antimicrob Agents Chemother 38 : 1651–1654. [Google Scholar]
  19. Levy L, Shepard CC, Fasal P, 1976. The bactericidal effect of rifampicin on M. leprae in man: a) single doses of 600, 900 and 1200 mg; and b) daily doses of 300 mg. Int J Lepr Other Mycobact Dis 44 : 183–187. [Google Scholar]
  20. Anonymous, 1997. Action Program for the Elimination of Leprosy: Status Report. Geneva: World Health Organization.
  21. Sehgal VN, Rege VL, Vadiraj SN, 1970. Inoculation leprosy subsequent to small-pox vaccination. Dermatologica 141 : 393–396. [Google Scholar]
  22. Sehgal VN, 1971. Inoculation leprosy appearing after seven years of tattooing. Dermatologica 142 : 58–61. [Google Scholar]
  23. Seghal VN, 1986. Leprosy following mechanical trauma. Lepr Rev 57 : 272. [Google Scholar]

Data & Media loading...

  • Received : 16 Aug 2007
  • Accepted : 07 Dec 2007

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error