Public Health Implications of Cysticercosis Acquired in the United States

Department of Epidemiology, School of Public Health, University of California, Los Angeles, California 90095, USA.
Emerging Infectious Diseases (Impact Factor: 6.75). 01/2011; 17(1):1-6. DOI: 10.3201/eid1701.101210
Source: PubMed


Cysticercosis has emerged as a cause of severe neurologic disease in the United States that primarily affects immigrants from Latin America. Moreover, the relevance of cysticercosis as a public health problem has been highlighted by local transmission. We searched the biomedical literature for reports documenting cases of cysticercosis acquired in the United States. A total of 78 cases, principally neurocysticercosis, were reported from 12 states during 1954-2005. A confirmed or presumptive source of infection was identified among household members or close personal contacts of 16 (21%) case-patients. Several factors, including the severe, potentially fatal, nature of cysticercosis; its fecal-oral route of transmission; the considerable economic effect; the availability of a sensitive and specific serologic test for infection by adult Taenia solium tapeworms; and the demonstrated ability to find a probable source of infection among contacts, all provide a compelling rationale for implementation of public health control efforts.

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Available from: Shira Shafir, Jan 09, 2014
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    • "Neurocysticercosis may be locally acquired. A recent review of all published U.S. data on locally acquired infection during 1954–2005 identified 78 cases reported from 12 states.56 Some of these infections had been linked to individual tapeworm carriers from disease-endemic countries36,40 although others could not identify such a link.39,57 "
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    ABSTRACT: Cysticercosis is a potentially fatal and preventable neglected parasitic infection caused by the larval form of Taenia solium. Patients with symptomatic disease usually have signs and symptoms of neurocysticercosis, which commonly manifest as seizures or increased intracranial pressure. Although there are many persons living in the United States who emigrated from highly disease-endemic countries and there are foci of autochthonous transmission of the parasite in the United States, little is known about burden and epidemiology of the disease in this country. In addition, despite advances in the diagnosis and management of neurocysticercosis, there remain many unanswered questions. Improving our understanding and management of neurocysticercosis in the United States will require improved surveillance or focused prospective studies in appropriate areas and allocation of resources towards answering some of the key questions discussed in this report.
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    • "NCC is the leading cause of adult-onset epilepsy in areas of the world where this parasitic infection is endemic, particularly in Latin America, Asia (India, China, and Korea) and Africa (South Africa, Togo, Madagascar, Zimbabwe and Burundi, which are all non-Muslim countries) [4,5]. In developed countries, imported cases have increased in parallel to the increased number of migrants and international travel [6,7]. Patients with NCC often experience a long asymptomatic period and can present with a variety of neurological manifestations, including focal neurological deficits and seizures. "
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    ABSTRACT: Patient: Male, 23 Final Diagnosis: Neurocysticerosis Symptoms: Diplopia • fever • headache • insomnia • neck stiffness • vomiting Medication: Albendazole Clinical Procedure: - Specialty: Neurology. Challenging differential diagnosis. Neurocysticercosis is a brain infection caused by the larval stage of the tapeworm Taenia (T.) solium. It is the most important parasitic disease of the human central nervous system and represents the most common cause of acquired epilepsy in developing countries. Here, we report the case of a 23-year-old Chinese man who presented to the emergency department with a 7-day history of helmet headache radiating to the nuchal region and associated with vomiting, confusion, and fever. Cerebrospinal fluid (CSF) was clear, with increased pressure, lymphocytic pleocytosis, decreased glucose, and increased protein levels. Bacterial antigen detection test on CSF was negative, as were CSF bacterial and fungal cultures. Despite broad-spectrum antibiotic and antiviral therapy, the patient still complained of insomnia, diplopia, headache, neck stiffness, and pain in the sacral region. A second LP was performed and CSF had the same characteristics as the first LP. A brain and spinal cord MRI revealed widespread arachnoiditis and small septated cysts with CSF-like signal in the cisterna magna, within the fourth ventricle, and at the level of L3-L4. Cysticercus-specific immunoglobin G antibodies were detected by ELISA in the CSF. The patient received albendazole (15 mg/kg/day) and dexamethasone (5 mg/day) for 4 weeks, with progressive resolution of neurological symptoms. This case shows that, even if rare, neurocysticercosis may be responsible for meningeal symptoms and should be included in the differential diagnosis, especially in patients from endemic countries.
    Preview · Article · Jan 2014 · American Journal of Case Reports
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    • "Consequently, the lack of knowledge on the epidemiology of porcine and human cysticercosis leads to practices that encourage the transmission and persistence of Taenia solium [10] [11]. For instance, traditional healers are believed to use a mixture of tapeworm segments and other medicine to treat severe intestinal tapeworm infections [12]. "

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