Donna
Donna asked:

How did Elsie get leprosy?

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Insperia Given Elsie's background, potential sources of exposure could include growing up near Saint Bridget's - The leprosarium, visiting Rune who worked at the leprosarium, or just general community exposure as Leprosy was prevalent in certain regions of India during that time.
Layne Tisdel Martin Good question. I think it's pretty unknowable unfortunately. The CDC says:

"It is not known exactly how Hansen’s disease spreads between people. Scientists currently think it may happen when a person with Hansen’s disease coughs or sneezes, and a healthy person breathes in the droplets containing the bacteria. Prolonged, close contact with someone with untreated leprosy over many months is needed to catch the disease.

You cannot get leprosy from a casual contact with a person who has Hansen’s disease like:

Shaking hands or hugging
Sitting next to each other on the bus
Sitting together at a meal
Hansen’s disease is also not passed on from a mother to her unborn baby during pregnancy and it is also not spread through sexual contact.

Due to the slow-growing nature of the bacteria and the long time it takes to develop signs of the disease, it is often very difficult to find the source of infection."

I remember Digby telling Elsie in the book, "we're all exposed at some point or another but only some of us are susceptible."
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by Abraham Verghese (Goodreads Author)
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