Lepra Conyugal

Abstract

Conjugal leprosy Objectives Determining the occurrence of leprosy amongst couples and establishing the type of leprosy in index and secondary cases. Methods The characteristics of leprosy were studied between 1980 and 2000 in Atlántico Department located on the Colombian Caribbean Coast. Clinical histories of patients registered in the Leprosy Control Programme were reviewed. Clinical exams were performed and personal interviews carried out with couples suffering from leprosy. Results Twenty-six married couples were found to be suffering from leprosy, representing 5,4 % of leprosy cases detected during the study period. They were aged from 20 to 89. 65,4 % of the index cases were men and 22 (84,6 %) were multibacillary, lepromatous cases; two had indeterminate leprosy and two were suffering from tuberculoid leprosy. Sixty-one percent of the secondary cases were paucibacillary patients, 42 % of them being tuberculoid. No paucibacillary cases were associated with multibacillary leprosy in the couples. Only two couples had consanguinity. None of the couples had had leprosy at the time of being married. The time between leprosy being detected in index cases and the disease being detected in secondary patients varied from 5 to 40 years. Disabilities were more common in the feet and to a higher degree in lepromatous index cases who had had the disease for a longer time than the secondary cases because these were more frequently paucibacillary patients who had a disease having shorter evolution. Conclusions In spite of ongoing, prolonged contact, conjugal leprosy is not frequent and requires several years to develop in the second person. Lepromatous leprosy in index cases was more frequently associated with leprosy in the couple. When the primary case was paucibacillary, no multibacillary leprosy occurred in the secondary case.

Historic aspects of human susceptibility to leprosy and the risk of conjugal transmission

“…A Brazilian study in 1957 found conjugal transmission in 7.8%, occurring in 50 of 638 cases (Quagliato 1957). Meléndez et al (2006) described a conjugal rate of 5.4% in Columbian patients, with consanguinity in two of 26 couples studied; furthermore the pairs were married five-40 years before the second spouse developed clinical symptoms. Chaussinand et al (1960), in France, reported a single case in which the spouse had five years of marital exposure before clinical symptoms developed.…”

Afectación familiar de la enfermedad de Hansen en Costa Rica.

“…9 Para infectarse con el bacilo de Hansen y desarrollar la enfermedad, hay entonces mayores posibilidades cuando existe un contacto íntimo y repetido, muy evidente en los casos de EH infantil, especialmente, el contacto madrehijo y el contagio entre parejas. 10,11 La predisposición innata a la infección parece ser particularmente crucial para la EH: se estima que solo una pequeña fracción (del 5 al 12%) de las personas expuestas a M. leprae se infecta con éxito. 12 Durante el periodo 2012-2017, se registraron en Costa Rica 51 casos nuevos de EH con prevalencia a nivel nacional de 0,06 casos por diez mil habitantes.…”