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Worried of contracting leprosy infection. Will it be safe to take rifampicin?

Apr 2013
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Answered by

General Surgeon
Practicing since : 2009
Answered : 3057 Questions
Dear XXXXXXX Romic,

This is XXXXXXX again following up regarding my MIL's visit to the leprosarium.

Is there any harm if my mom takes a prophylactic drug (Rifampicin) just to address any concern about any possible infection (may be sharing contaminated utensils at the Anandwan canteen, Leprosy patients also probably eat there).

We read somewhere that taking Rifampicin as a prophylaxis is effective.

We understand that the chances of infection are extremely low, but we are thinking about this just for our peace of mind.

Posted Fri, 8 Mar 2013 in Infections
Answered by Dr. Ivan R. Rommstein 4 hours later
O hi again XXXXXXX

Well, I ll try to explain. A single dose of rifampin is used for prophylaxis. It means that tourists which goes to suspect areas can take it and then they are protected in about 70% of cases. Next time she goes there she can take it. Usually epidemiologist can prescribe it.

Treatment of patients with confirmed infection last between 6-12 months and rifampin with 1 other drug is used.
Leprosy is not usually infectious after two weeks of treatment with rifampicin.
It is also true that single dose of rifampicin given to contacts of patients with leprosy is effective at preventing of transmission.

So my conclusion is: If your MIL has leprosy(which is almost impossible) then single dose of rifampin would be helpful for you and household, but isnt enough for her. And you shouldnt even think of taking rifampin in pregnancy!!!
So healthy people take single dose, and those with confirmed diagnosis take it for 6 months. People with unconfirmed diagnosis need to confirm it first by lab and microbio tests and then treatment can be considered. Generally antibiotics shouldnt be used with no indications so I recommend you to be more optimistic. You are really looking the bad side always :))
I am here if you have more questions.
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Follow-up: Worried of contracting leprosy infection. Will it be safe to take rifampicin? 18 minutes later

Thanks for the explanation about the prophylaxis. So basically, she can't take it now?

Please let us know what microbio/lab tests can we do now just to confirm that everything is fine? She went there a couple of weeks back.

Your response is much appreciated.

Answered by Dr. Ivan R. Rommstein 8 hours later
She can, but it wont be very helpful for her. If you think that you re gonna be close to her and share items or food than she can take it for 2 weeks just to prevent further transmission. But it is better to confirm diagnosis first.

Try to look for hypopigmented or reddish skin lesions and loss of sensation in hands and legs. If you find it that skin smear or biopsy can be done.

Laboratory studies should start with:
CBC count, creatinine level, liver function tests and Inflammatory markers
More sophisticated tests which probably can be done at some immunology centre are: serologic assays and molecular probes.
But I am doubtful if all this is necessary, my opinion is that you shouldnt hurry with tests and therapy. It is maybe better to see are you going to get ill and then treat it, than do tests and all kind of prevention and worry about it all the time.
I really think you shouldnt worry. I know this disease sounds terrible because in history it was fatal, but today it is curable in the earliest stage, and it is problematic only in undeveloped countries where cures are unavailable.

If the infection will ever be confirmed for you or your MIL please let me know.
Above answer was peer-reviewed by
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