Lepra familiar (influência da lepromatose cumulativa na expansão endêmica) / Familial lepra (influence of cumulative lepra on the endemic expansion

ABSTRACT

In spit of the liberal regime instituted by the Belo Horizonte Seminar (1958), our sanatoria shall preceed for many years to come with their humanitarian and social purposes, taking in socially maladjusted patients, invalids (blind, paralytic, and mental), provinding medical and surgical care for needy patients with acute intercurrent diseases, or requiring physical rehabilitation; these institutions are indispensable for therapeutic investigations in the field of new drugs or trying to perfect the existing methods of treatment. The high fugure of 85% represents patients interned in our State Institutions for leprosy, poly-infectious and incurable form, of chronic evolution and low mortality, invading the organism slowly and progressively during decades, causing social maladjustment and physical inability; this irreversible residue of leprosy hides behing the weight of mystic and millenary popularbeliefs, making it thus a plumbeoum onus sanatorium. This lepromatous population, the result of deficient control of the endemic disease in 40 years, is even more serious in view of the influence of cumulative leprosy on the expansion of the endemic disease, acting through a contagious chain, perpetuating itself throughout the decades of intra-familiar contagion (occult cases). James A. Doull, the noted American epidemiologist, after amny years of study of leprosy in the Philippines (Cebu) thus concludes "It is thus evident that a great proportion of lepromatous ulcers of the nasal septum and the skin are cured within 48 weeks of treatment. The inference that leprosy coud not subsist but for the infectivity, spread over long periods of time, of the lepromatous cases discharging large numbers of bacilli, seems to be justified". Since the present prophylactic program is based on the figures of undetermined cases and correlated breach of the chain of familiar contagion, the preventive medicine program for leprosy views the endemic control by preventing leprosy this i...