Blake L A, West B C, Lary C H, Todd J R
Rev Infect Dis. 1987 May-Jun;9(3):562-77. doi: 10.1093/clinids/9.3.562.
Leprosy has been considered to occur only after exposure to a human case. However, evidence has been accumulating that this conventional view is wrong and that an environmental nonhuman source is critical to some human infections with Mycobacterium leprae. Observations, some of which date back to the nineteenth century, support soil, vegetation, water, arthropods, and armadillos (Dasypus novemcinctus) as environmental sources of leprosy. Disparate clinical, epidemiologic, and microbiologic evidence has been critically reviewed in light of the fact that 50%-70% of sporadic cases of leprosy in well-studied populations occur in persons who have had no known contact with human leprosy. Historical data and current information alike substantiate the concept of nonhuman sources of the disease; recent observations with monoclonal antibody have shown that phenolic glycolipid-I antigen, which is unique to the M. leprae cell wall, is present in soil. In the absence of a technique for in vitro cultivation, indirect methods and the body of observations reviewed here persuasively favor but do not prove the existence of environmental nonhuman sources of M. leprae.
麻风病一直被认为只有在接触人类病例后才会发生。然而，越来越多的证据表明，这种传统观点是错误的，环境中的非人类来源对于某些人感染麻风分枝杆菌至关重要。一些可追溯到19世纪的观察结果支持土壤、植被、水、节肢动物和犰狳（九带犰狳）作为麻风病的环境来源。鉴于在经过充分研究的人群中，50%-70%的散发性麻风病例发生在与人类麻风病无已知接触的人身上，已对不同的临床、流行病学和微生物学证据进行了严格审查。历史数据和当前信息都证实了该疾病存在非人类来源的概念；最近用单克隆抗体进行的观察表明，麻风分枝杆菌细胞壁特有的酚糖脂-I抗原存在于土壤中。由于缺乏体外培养技术，这里所回顾的间接方法和观察结果有说服力地支持但并未证明存在麻风分枝杆菌的环境非人类来源。
