Transmission of the disease is by direct human-to-human contact. The source of the organisms is mainly nasal secretions of a lepromatous case, which transport M. leprae to mucous membranes or skin abrasions of another individual. Although leprosy bacilli readily infect people exposed to a case of lepromatous leprosy, the disease develops in only a tiny minority, being controlled by body defenses in the rest. Hansen's disease is no longer a much feared contagious disease, and the morbid days when lepers were forced to carry a bell or horn to warn others of their presence are fortunately past.

Natural infections with M. leprae occur in wild nine-banded armadillos and in mangabey monkeys. An epidemiological study appears to exclude armadillos as an important source of human leprosy, but occasional transmissions to humans have not been ruled out.

Figure 26.11 Armadillo The discovery that Mycobacterium leprae from people with leprosy grows well in the nine-banded armadillo made it possible to obtain large quantities of the bacteria for scientific studies.

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