SEROLOGICAL REACTIVITY TO A SYNTHETIC ANALOG OF PHENOLIC GLYCOLIPID-IAND EARLY DETECTION OF LEPROSY IN AN AREA OF LOW ENDEMICITY

A total of 23,863 individuals living in an area of low endemicity for leprosy were tested by enzyme-linked immunosorbent assay with a semisy nthetic analogue of the phenolic glycolipid I antigen of Mycobacterium lepine. The proportion found positive was 3 . 86% which was significa ntly higher than that in a sample of a population known to be free of leprosy. Clinical examinations as well as Mitsuda and skin smear tests were organized for those defined as seropositive. The proportion of i ndividuals with lepromin reactions of less than 3 mm increased 18 . 9% per serological interval as antibodies rose though it was not statist ically significant. As a result of the clinical and bacteriological ex aminations, 2 cases with clinical signs and heavy bacillary load were found, whereas acid-fast bacilli were demonstrated in 2 other individu als without clinical manifestations of leprosy. The usefulness of the system for control purposes is discussed.