The Biology of Leprosy Bacteria and How they are Transmitted to Humans
This chapter considers the nature of the bacterial causes of leprosy, Mycobacterium leprae and Mycobacterium lepromatosis, including research on their genomes. Paucibacillary leprosy is the high-resistance form of leprosy and multibacillary leprosy is the low-resistance form. It is clear that genomic research, including the documentation of different strains of the bacterium and identifying susceptibility and resistance genes, is providing knowledge that is helping to track transmission and identify areas within regions of countries that remain challenges for management. While it is concluded that leprosy is transmitted through the exhalation and then inhalation of bacteria-laden droplets (droplet infection), other reported mechanisms have been discussed, and there are environmental sources of the bacteria. Leprosy in children is rare, and males are affected more than females. The wide range of intrinsic (e.g., age, sex) and extrinsic (e.g., diet, living conditions) factors that make people more or less susceptible to leprosy provide a complex picture to manage when thinking about why any particular person contracts the infection. The wild nine-banded armadillo and the red squirrel natural endemic hosts for M. leprae, but while non-human primates may be affected there is no evidence of them being infected in the wild.