Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 24, Number 5—May 2018

Mycobacterium lepromatosis Lepromatous Leprosy in US Citizen Who Traveled to Disease-Endemic Areas

On This Page
Article Metrics
citations of this article
EID Journal Metrics on Scopus

Cite This Article

To the Editor: The article by Virk et al. (1) highlighted that a person can acquire Mycobacterium lepromatosis infection without exposure to a person infected with leprosy or to known vectors during short stays (2 trips of 7 days each over 3 calendar years) in Mexico. The authors then concluded that M. lepromatosis lepromatous leprosy is a travel-related hazard for travelers to Mexico or other disease-endemic areas. We note that the exact source of acquiring the M. lepromatosis infection by the patient in this study was entirely uncertain, and experimental evidence was not enough to prove M. lepromatosis to be a travel-related hazard.

In contrast, Jessamine et al. (2) reported M. lepromatosis infection and leprosy-like illness in a patient in Canada who had no history of contact or travel to leprosy-endemic areas. Jessamine et al. indicated that transmission dynamics of M. lepromatosis infection is complex, and undiscovered mechanisms or unknown reservoir interactions may exist in such areas of nonendemic regions. Previous studies have also reported the roles of subclinical cases and environmental reservoirs in the transmission of leprosy (3,4). However, Virk et al. have not disentangled other possible sources (existence of unrecognized subclinical cases, contact with hidden leprosy cases, and environmental reservoir) of prolonged exposure of M. lepromatosis to the study patient in his vicinity. Thus, the assertion of Virk et al. (1) that United States citizens can acquire M. lepromatosis when traveling to Mexico or other leprosy-endemic areas as tourists is misleading and demands extensive research to prove it.

In addition, it is intriguing to note that host genetic determinants can influence the acquisition and onset of leprosy (5). Therefore, the inference of a single case study cannot be generalized for all citizens of the United States. The data from these reports suggest that the epidemiologic studies of leprosy in nonendemic areas should consider travel history to delineate this issue.


Ajay Vir SinghComments to Author  and Devendra Singh Chauhan
Author affiliations: ICMR-National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, India



  1. Virk  A, Pritt  B, Patel  R, Uhl  JR, Bezalel  SA, Gibson  LE, et al. Mycobacterium lepromatosis lepromatous leprosy in US citizen who traveled to disease-endemic areas. Emerg Infect Dis. 2017;23:18646. DOIPubMedGoogle Scholar
  2. Jessamine  PG, Desjardins  M, Gillis  T, Scollard  D, Jamieson  F, Broukhanski  G, et al. Leprosy-like illness in a patient with Mycobacterium lepromatosis from Ontario, Canada. J Drugs Dermatol. 2012;11:22933.
  3. Araújo  S, Lobato  J, Reis  EM, Souza  DO, Gonçalves  MA, Costa  AV, et al. Unveiling healthy carriers and subclinical infections among household contacts of leprosy patients who play potential roles in the disease chain of transmission. Mem Inst Oswaldo Cruz. 2012;107(Suppl 1):559. DOIPubMedGoogle Scholar
  4. Mohanty  PS, Naaz  F, Katara  D, Misba  L, Kumar  D, Dwivedi  DK, et al. Viability of Mycobacterium leprae in the environment and its role in leprosy dissemination. Indian J Dermatol Venereol Leprol. 2016;82:237. DOIPubMedGoogle Scholar
  5. Alter  A, Alcaïs  A, Abel  L, Schurr  E. Leprosy as a genetic model for susceptibility to common infectious diseases. Hum Genet. 2008;123:22735. DOIPubMedGoogle Scholar


Cite This Article

DOI: 10.3201/eid2405.171972

Related Links


Table of Contents – Volume 24, Number 5—May 2018

EID Search Options
presentation_01 Advanced Article Search – Search articles by author and/or keyword.
presentation_01 Articles by Country Search – Search articles by the topic country.
presentation_01 Article Type Search – Search articles by article type and issue.



Please use the form below to submit correspondence to the authors or contact them at the following address:

Ajay Vir Singh, Department of Microbiology and Molecular Biology, ICMR-National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, Pin-282001, India

Send To

10000 character(s) remaining.


Page created: April 17, 2018
Page updated: April 17, 2018
Page reviewed: April 17, 2018
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.