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Dr. Andrew Rynne

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Pregnant. Had a visit to leprosy rehabilitation center. Any harmful effect on unborn?

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Dr. Ivan R. Rommstein

General Surgeon

Practicing since :2008

Answered : 9792 Questions

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Posted on Sat, 2 Mar 2013 in Infections
Question: Hello Dr.
My mother-in-law had a short trip with her friends to “Anandvan” in India, which is a Leprosy cure and rehabilitation center for Leprosy afflicted people. They also ate food prepared by cured leprosy people and saw projects/small businesses run by them. I think they spent a day at the "ashram". I also read that many visitors visit this place on a regular basis etc. However, eversince I got this news I am terrified about any possibility of her catching the infection there.

I am 28 weeks pregnant with twins living in the US, and I am stressed out thinking about this day and night; which is extremely harmful for me and my babies. I read that this disease is difficult to catch and 95% of people have a natural immunity towards it etc. But I would like to know if there should be any concern and if we should do anything at this time.
I am really looking for an answer that will relieve my stress as soon as possible and I can concentrate on my pregnancy again.

Thank you doctor for your answer.


doctor
Answered by Dr. Ivan R. Rommstein 55 minutes later
Hi XXXXXXX,

First, there is absolutely no need to worry. Even if your mother-in-law has been in contact with affected people the chance of transmission is extremely small and even more than 95% of people are naturally immune.

Today leprosy is seen only in a a few countries. Most people are immune and only those with seriously low immune system will get sick(these 5%) and I dont think you are one of them.

If she doesn't have symptoms of infection such as fever or coughing then you don't need to "avoid" her. If you even on some way catch infection, it is easily treated in every developed country. I hope that you are convinced that there is no reason to be concerned as you are not concerned about odds of being struck by lightning.

The only thing which is bad for your baby is stress and worrying.

Hope I have answered your query. If you have any further questions I will be happy to help

Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Ivan R. Rommstein 1 hour later
Dr. Romic,

Thank you very much for your answer. I have a couple of follow up questions for your-

1. I read online that prolonged intimate contact with the untreated patient is required for the transmission to occur. Is that true? She wasn't there for a long time, anyway.


2. Also, can the infection be transmitted to other person during the incubation period of the infected (when no symptoms are seen) patient? (I am worried about this because my MIL comes and stays with us for quite sometime, and if she was infected and under incubation period, there is no way for us to know).


Thanks for your answers.

doctor
Answered by Dr. Ivan R. Rommstein 2 hours later
Hi again.

I wish that my patients are educated and tenacious as you are. It is very good that you care about your baby and your health.

This is still not well investigated but infection is thought to be spread person to person by secretions or droplets. it means that it is not spread by air or respiratory tract such as flu or other viral/bacterial respiratory infections. Much higher amount of infective material is needed to cause infection(not just sneezing or coughing). They call it intimate contact, but I would translate this as saliva or bigger nasal droplets which comes into mouth or nose of other person or during sexual intercourse or kissing. In history, people were living in bad sanitary conditions and in crowded places so epidemics were usual thing. Today in era of soap, antiseptics and antibiotics, this is almost eradicated.

2. Yes. incubation period can be as short as 2 days or as long as few years. But if you think of it you will never be calm. Let me explain like this:

You can get this infection only if:
You and your MIL(both) are not BCG vaccinated+ you and your(both) MIL are in those 3-5% of non-immune+ you and your MIL are kissing every day+ your MIL
didnt take single dose of rifampicin. what are the chances of it ?

If you think there are some, then convince your MIL to do microbio. lab tests. Hope I had been able to make it clear.

Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. Ivan R. Rommstein 6 hours later
Thank you Doctor for the wonderful explanation. It made me laugh a little after a week of stress.

So basically, only 3 to 5 % of susceptible population upon " intimate" contact can contract the disease correct?

Thanks again for your time. This makes me feel so much better.

Much appreciated.
XXXXXXX
doctor
Answered by Dr. Ivan R. Rommstein 5 hours later
Yes, that is right. However, there is no use of thinking about odds and possibilities.
If you get this infection in USA then you can be a subject of scientific article.
Just don’t worry and enjoy in your pregnancy and baby.
And next time recommend to your MIL to visit Croatia :)

Above answer was peer-reviewed by : Dr. Shanthi.E
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