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==Overview== | ==Overview== | ||
Risk factors for contracting leprosy include close contact with an untreated, active [[bacilli|multibacillary]] disease patient with the subtype of lepromatous leprosy, living in an endemic region (Angola, Brazil, Central African Republic, Democratic Republic of Congo, Federated States of Micronesia, India, Kiribati, Madagascar, Mozambique, Nepal, Republic of Marshall Islands, United Republic of Tanzania), age between 5 and 15 as well as over 30, Armadillo contact, tattoos, and genetic variants of the [[NOD2]]-mediated signaling pathway. | |||
===Close Contact=== | ===Close Contact=== | ||
Close contacts | Close contacts with leprosy patients increases the risk of contracting the disease.<ref name="pmid10472363">{{cite journal| author=van Beers SM, Hatta M, Klatser PR| title=Patient contact is the major determinant in incident leprosy: implications for future control. | journal=Int J Lepr Other Mycobact Dis | year= 1999 | volume= 67 | issue= 2 | pages= 119-28 | pmid=10472363 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10472363 }} </ref> | ||
===Subtype=== | ===Subtype=== | ||
''lepromatous leprosy'' patients have a higher risk of transmitting the disease.<ref name="pmid10472363">{{cite journal| author=van Beers SM, Hatta M, Klatser PR| title=Patient contact is the major determinant in incident leprosy: implications for future control. | journal=Int J Lepr Other Mycobact Dis | year= 1999 | volume= 67 | issue= 2 | pages= 119-28 | pmid=10472363 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10472363 }} </ref><ref name="pmid11826475">{{cite journal| author=Eiglmeier K, Parkhill J, Honoré N, Garnier T, Tekaia F, Telenti A et al.| title=The decaying genome of Mycobacterium leprae. | journal=Lepr Rev | year= 2001 | volume= 72 | issue= 4 | pages= 387-98 | pmid=11826475 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11826475 }} </ref> | |||
===Immunosuppresion=== | ===Immunosuppresion=== | ||
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===Armadillo Contact=== | ===Armadillo Contact=== | ||
Armadillo's serve as a reservoir for disease, and armadillo contact increases the risk of transmission of disease.<ref name="TrumanSingh2011">{{cite journal|last1=Truman|first1=Richard W.|last2=Singh|first2=Pushpendra|last3=Sharma|first3=Rahul|last4=Busso|first4=Philippe|last5=Rougemont|first5=Jacques|last6=Paniz-Mondolfi|first6=Alberto|last7=Kapopoulou|first7=Adamandia|last8=Brisse|first8=Sylvain|last9=Scollard|first9=David M.|last10=Gillis|first10=Thomas P.|last11=Cole|first11=Stewart T.|title=Probable Zoonotic Leprosy in the Southern United States|journal=New England Journal of Medicine|volume=364|issue=17|year=2011|pages=1626–1633|issn=0028-4793|doi=10.1056/NEJMoa1010536}}</ref> | |||
===Genetic Risk Factors=== | ===Genetic Risk Factors=== | ||
The [[immune response]] mounted against the [[mycobacteria]] has both [[innate immunity|innate]] and [[acquired immunity|acquired]] components. It has been noted that variants of the [[NOD2]]-mediated signaling pathway, a regulator of the [[innate immunity|innate]] component, have a higher [[Risk factor|risk]] of developing leprosy.<ref name="pmid18247059">{{cite journal| author=Alter A, Alcaïs A, Abel L, Schurr E| title=Leprosy as a genetic model for susceptibility to common infectious diseases. | journal=Hum Genet | year= 2008 | volume= 123 | issue= 3 | pages= 227-35 | pmid=18247059 | doi=10.1007/s00439-008-0474-z | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18247059 }} </ref><ref name="pmid20018961">{{cite journal| author=Zhang FR, Huang W, Chen SM, Sun LD, Liu H, Li Y et al.| title=Genomewide association study of leprosy. | journal=N Engl J Med | year= 2009 | volume= 361 | issue= 27 | pages= 2609-18 | pmid=20018961 | doi=10.1056/NEJMoa0903753 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20018961 }} </ref> | |||
===Age=== | ===Age=== | ||
There is a bimodal distribution in the [[incidence]] of leprosy, with an increased incidence between the ages of 5 and 15 years, and than another increase after the age of 30.<ref name="pmid16388481">{{cite journal| author=Moet FJ, Pahan D, Schuring RP, Oskam L, Richardus JH| title=Physical distance, genetic relationship, age, and leprosy classification are independent risk factors for leprosy in contacts of patients with leprosy. | journal=J Infect Dis | year= 2006 | volume= 193 | issue= 3 | pages= 346-53 | pmid=16388481 | doi=10.1086/499278 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16388481 }} </ref> | |||
===Endemic Regions=== | ===Endemic Regions=== | ||
People living in [[endemic]] regions | People living in [[endemic]] regions along with poor-higiene and poor [[nutritional]] status are at increased risk of contracting leprosy.<ref name="BhatPrakash2012">{{cite journal|last1=Bhat|first1=Ramesh Marne|last2=Prakash|first2=Chaitra|title=Leprosy: An Overview of Pathophysiology|journal=Interdisciplinary Perspectives on Infectious Diseases|volume=2012|year=2012|pages=1–6|issn=1687-708X|doi=10.1155/2012/181089}}</ref> | ||
These countries include: | |||
* Angola | |||
* Brazil | |||
* Central African Republic | |||
* Democratic Republic of Congo | |||
* Federated States of Micronesia | |||
* India | |||
* Kiribati | |||
* Madagascar | |||
* Mozambique | |||
* Nepal | |||
* Republic of Marshall Islands | |||
* United Republic of Tanzania | |||
===Tattooing=== | ===Tattooing=== | ||
The bacteria have been transferred during tattooing in India.<ref name="WalkerLockwood2007">{{cite journal|last1=Walker|first1=Stephen L.|last2=Lockwood|first2=Dina N.J.|title=Leprosy|journal=Clinics in Dermatology|volume=25|issue=2|year=2007|pages=165–172|issn=0738081X|doi=10.1016/j.clindermatol.2006.05.012}}</ref><ref name="pmid19126044">{{cite journal| author=Ghorpade A| title=Ornamental tattoos and skin lesions. Tattoo inoculation borderline tuberculoid leprosy. | journal=Int J Dermatol | year= 2009 | volume= 48 | issue= 1 | pages= 11-3 | pmid=19126044 | doi=10.1111/j.1365-4632.2009.03767.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19126044 }} </ref> | |||
===Vertical Transmission from Mother=== | ===Vertical Transmission from Mother=== | ||
Cases of [[vertical transmission]] from the mother have been reported.<ref name="WalkerLockwood2007">{{cite journal|last1=Walker|first1=Stephen L.|last2=Lockwood|first2=Dina N.J.|title=Leprosy|journal=Clinics in Dermatology|volume=25|issue=2|year=2007|pages=165–172|issn=0738081X|doi=10.1016/j.clindermatol.2006.05.012}}</ref><ref name="pmid6683260">{{cite journal| author=Duncan ME, Melsom R, Pearson JM, Menzel S, Barnetson RS| title=A clinical and immunological study of four babies of mothers with lepromatous leprosy, two of whom developed leprosy in infancy. | journal=Int J Lepr Other Mycobact Dis | year= 1983 | volume= 51 | issue= 1 | pages= 7-17 | pmid=6683260 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6683260 }} </ref> | |||
==References== | ==References== | ||
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[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Dermatology]] | [[Category:Dermatology]] | ||
[[Category:Tropical disease]] | [[Category:Tropical disease]] | ||
[[Category:Leprosy]] | [[Category:Leprosy]] | ||
Latest revision as of 18:10, 18 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Risk factors for contracting leprosy include close contact with an untreated, active multibacillary disease patient with the subtype of lepromatous leprosy, living in an endemic region (Angola, Brazil, Central African Republic, Democratic Republic of Congo, Federated States of Micronesia, India, Kiribati, Madagascar, Mozambique, Nepal, Republic of Marshall Islands, United Republic of Tanzania), age between 5 and 15 as well as over 30, Armadillo contact, tattoos, and genetic variants of the NOD2-mediated signaling pathway.
Close Contact
Close contacts with leprosy patients increases the risk of contracting the disease.[1]
Subtype
lepromatous leprosy patients have a higher risk of transmitting the disease.[1][2]
Immunosuppresion
Immunosuppressed patients have a higher risk of being infected by the mycobacteria. In the particular case of HIV patients, the infection by the HIV has not been noted to increase vulnerability for development of leprosy. Additionally some studies have reported activation of latent mycobacteria leprae with exacerbation of previous lesions, once the antiretroviral therapy is started, possibly due to reconstitution of the immune response against the bacteria.[3][4][5][6][7]
Armadillo Contact
Armadillo's serve as a reservoir for disease, and armadillo contact increases the risk of transmission of disease.[8]
Genetic Risk Factors
The immune response mounted against the mycobacteria has both innate and acquired components. It has been noted that variants of the NOD2-mediated signaling pathway, a regulator of the innate component, have a higher risk of developing leprosy.[9][10]
Age
There is a bimodal distribution in the incidence of leprosy, with an increased incidence between the ages of 5 and 15 years, and than another increase after the age of 30.[11]
Endemic Regions
People living in endemic regions along with poor-higiene and poor nutritional status are at increased risk of contracting leprosy.[12]
These countries include:
- Angola
- Brazil
- Central African Republic
- Democratic Republic of Congo
- Federated States of Micronesia
- India
- Kiribati
- Madagascar
- Mozambique
- Nepal
- Republic of Marshall Islands
- United Republic of Tanzania
Tattooing
The bacteria have been transferred during tattooing in India.[13][14]
Vertical Transmission from Mother
Cases of vertical transmission from the mother have been reported.[13][15]
References
- ↑ 1.0 1.1 van Beers SM, Hatta M, Klatser PR (1999). "Patient contact is the major determinant in incident leprosy: implications for future control". Int J Lepr Other Mycobact Dis. 67 (2): 119–28. PMID 10472363.
- ↑ Eiglmeier K, Parkhill J, Honoré N, Garnier T, Tekaia F, Telenti A; et al. (2001). "The decaying genome of Mycobacterium leprae". Lepr Rev. 72 (4): 387–98. PMID 11826475.
- ↑ Trindade MA, Palermo ML, Pagliari C, Valente N, Naafs B, Massarollo PC; et al. (2011). "Leprosy in transplant recipients: report of a case after liver transplantation and review of the literature". Transpl Infect Dis. 13 (1): 63–9. doi:10.1111/j.1399-3062.2010.00549.x. PMID 20678090.
- ↑ Martiniuk F, Rao SD, Rea TH, Glickman MS, Giovinazzo J, Rom WN; et al. (2007). "Leprosy as immune reconstitution inflammatory syndrome in HIV-positive persons". Emerg Infect Dis. 13 (9): 1438–40. doi:10.3201/eid1309.070301. PMC 2857291. PMID 18252138.
- ↑ Sarno EN, Illarramendi X, Nery JA, Sales AM, Gutierrez-Galhardo MC, Penna ML; et al. (2008). "HIV-M. leprae interaction: can HAART modify the course of leprosy?". Public Health Rep. 123 (2): 206–12. PMC 2239330. PMID 18457073.
- ↑ Deps PD, Lockwood DN (2008). "Leprosy occurring as immune reconstitution syndrome". Trans R Soc Trop Med Hyg. 102 (10): 966–8. doi:10.1016/j.trstmh.2008.06.003. PMID 18639911.
- ↑ Couppié P, Domergue V, Clyti E, El Guedj M, Vaz T, Sainte-Marie D; et al. (2009). "Increased incidence of leprosy following HAART initiation: a manifestation of the immune reconstitution disease". AIDS. 23 (12): 1599–600. doi:10.1097/QAD.0b013e32832bb5b7. PMID 19487911.
- ↑ Truman, Richard W.; Singh, Pushpendra; Sharma, Rahul; Busso, Philippe; Rougemont, Jacques; Paniz-Mondolfi, Alberto; Kapopoulou, Adamandia; Brisse, Sylvain; Scollard, David M.; Gillis, Thomas P.; Cole, Stewart T. (2011). "Probable Zoonotic Leprosy in the Southern United States". New England Journal of Medicine. 364 (17): 1626–1633. doi:10.1056/NEJMoa1010536. ISSN 0028-4793.
- ↑ Alter A, Alcaïs A, Abel L, Schurr E (2008). "Leprosy as a genetic model for susceptibility to common infectious diseases". Hum Genet. 123 (3): 227–35. doi:10.1007/s00439-008-0474-z. PMID 18247059.
- ↑ Zhang FR, Huang W, Chen SM, Sun LD, Liu H, Li Y; et al. (2009). "Genomewide association study of leprosy". N Engl J Med. 361 (27): 2609–18. doi:10.1056/NEJMoa0903753. PMID 20018961.
- ↑ Moet FJ, Pahan D, Schuring RP, Oskam L, Richardus JH (2006). "Physical distance, genetic relationship, age, and leprosy classification are independent risk factors for leprosy in contacts of patients with leprosy". J Infect Dis. 193 (3): 346–53. doi:10.1086/499278. PMID 16388481.
- ↑ Bhat, Ramesh Marne; Prakash, Chaitra (2012). "Leprosy: An Overview of Pathophysiology". Interdisciplinary Perspectives on Infectious Diseases. 2012: 1–6. doi:10.1155/2012/181089. ISSN 1687-708X.
- ↑ 13.0 13.1 Walker, Stephen L.; Lockwood, Dina N.J. (2007). "Leprosy". Clinics in Dermatology. 25 (2): 165–172. doi:10.1016/j.clindermatol.2006.05.012. ISSN 0738-081X.
- ↑ Ghorpade A (2009). "Ornamental tattoos and skin lesions. Tattoo inoculation borderline tuberculoid leprosy". Int J Dermatol. 48 (1): 11–3. doi:10.1111/j.1365-4632.2009.03767.x. PMID 19126044.
- ↑ Duncan ME, Melsom R, Pearson JM, Menzel S, Barnetson RS (1983). "A clinical and immunological study of four babies of mothers with lepromatous leprosy, two of whom developed leprosy in infancy". Int J Lepr Other Mycobact Dis. 51 (1): 7–17. PMID 6683260.