lntrafamily leprosy outbreak

Abstract

Leprosy is five to ten times more frequent among household contacts of multibacillary patients within their households than in the general public. A study of a 22 year-old woman with lepromatous leprosy is presented, along with its occurrence among her children and relatives. Clues to contacts were provided by the woman's clinical history, examination of her close contacts and medical visits to her family As a consequence, 9 new cases of leprosy were discovered clinically and confirmed histopathologically among the children and close relatives of the patient. All were living together in a single room house. Seven of 10 children, aged between 3-10 years old, had leprosy. A 30 year-old sister of the index case and her husband had indeterminate leprosy (IL). The afflicted children consisted of a son and two daughters of the index case, an 8 year-old sister and 3 nephews. Five children had paucibacillary leprosy. The two multibacillay borderline leprosy cases were both children of the lepromatous index case. All patients indicated a moderate degree of malnutrition and were part of a displaced, extremely poor population. Only one of the children had the scarring indicative of BCG vaccination. All the patients received polychemotherapy. Contacts without disease were vaccinated with BCG. The intrafamily outbreak of leprosy was a product of prolonged contact with a multibacillar lepromatous mother under conditions of extreme poverty and overcrowded living conditions. These conditions led to unusually advanced disease development in several children. The case study presented here demonstrates the value of searching for additional cases arnony associates of every positively diaynosed case. This permits an early detection, opportune treatment and, consequently, the prevention of disabilities, al1 important objectives of the Colombian National Leprosy Control Program.