Leprosy and tuberculosis: the epidemiological consequences of cross-immunity

Am J Public Health. 1997 Dec;87(12):1923-7. doi: 10.2105/ajph.87.12.1923.

Abstract

Objectives: This study tested the hypothesis, first proposed by Chaussinand, that individual-level immunity acquired from exposure to tuberculosis may have contributed to the disappearance of leprosy from western Europe.

Methods: The epidemiological consequences of cross-immunity were assessed by the formulation of a mathematical model of the transmission dynamics of tuberculosis and leprosy.

Results: The conditions under which Mycobacterium tuberculosis could have eradicated Mycobacterium leprae were derived in terms of the basic reproductive rates of the two infections and the degree of cross-immunity.

Conclusions: If the degree of cross-immunity between two diseases within an individual is known, then the epidemiological consequences of this cross-immunity can be assessed with transmission modeling. The results of this analysis, in combination with previous estimates of the basic reproductive rate of tuberculosis and degree of cross-immunity, imply that tuberculosis could have contributed to the decline of leprosy if the basic reproductive rate of leprosy was low.

MeSH terms

  • Cause of Death
  • Comorbidity
  • Cross Reactions
  • Disease Progression
  • Europe
  • Humans
  • Immunity, Active
  • Incidence
  • Leprosy* / epidemiology
  • Leprosy* / immunology
  • Leprosy* / transmission
  • Models, Statistical*
  • Reproducibility of Results
  • Time Factors
  • Tuberculosis* / epidemiology
  • Tuberculosis* / immunology
  • Tuberculosis* / transmission