Published Date: 2007-02-12 00:00:00
Subject: PRO/AH/EDR> Cysticercosis - USA
Archive Number: 20070212.0530

CYSTICERCOSIS - USA
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Date: Sat 10 Feb 2007
From: Brent Barrett <salbrent@sbcglobal.net>
Source: Washington Times [edited]
<http://washingtontimes.com/national/20070207-111134-1360r.htm>


Neurocysticercosis plagues states along Mexico border
-----------------------------------------------
Federal researchers say neurocysticercosis, a brain infection caused
by a pork tapeworm, is a "growing public health problem in the United
States," especially in states bordering Mexico, where the disease is
endemic. Neurocysticercosis is the "most common parasitic disease of
the central nervous system," according to a study jointly conducted
by the federal Centers for Disease Control and Prevention and
California public health officials, who reported that "international
travel and immigration are bringing the disorder to areas where it is
not endemic," such as this country. "Neurocysticercosis is the
primary cause of epilepsy in endemic areas. This brain worm is very
serious," Victor C. Tsang, chief of the immunochemistry laboratory in
the Parasitic Disease Division of the CDC said in a telephone
interview. "Oral-fecal contamination is the standard route of
transmission," he said of the condition.

Neurocysticercosis refers specifically to nervous-system disorders
caused by cysticercosis, an infection which can also harm eyes and
muscles. "Recent data indicate cysticercosis is an important cause of
death in California," Mr. Tsang and other authors wrote in a recent
report on the disease published in the European medical journal Acta
Neurologica Scandinavica. A separate report in this month's [February
2007] issue of the journal Emerging Infectious Diseases found that
nearly 60 percent of the 221 U.S. deaths from cysticercosis between
1990 and 2002 involved California residents. "Most patients [187, or
85 percent] were foreign-born, and 137 [62 percent] had emigrated
from Mexico. The 33 U.S.-born persons who died of cysticercosis
represented 15 percent of all cysticercosis-related deaths" during
the study period, said University of California researchers who wrote
the latest report.

Although neurocysticercosis is "especially" a problem in the
Southwest, it has also surfaced in other places, such as New York,
Philadelphia and Charlotte, N.C., data from other studies show.

"In Hispanics and Latinos, neurocysticercosis accounts for 13.5
percent of [U.S.] emergency-room visits for seizures," federal and
California investigators wrote in their report in Acta Neurologica
Scandinavica published late last year [2006]. "The growth is mainly
due to immigration from endemic developing countries," they reported.

Neurocysticercosis occurs when the larvae of a pork tapeworm known as
_Taenia solium_ enter and infect the brain and spinal cord and form
cysts. A person infected with the intestinal tapeworm stage of the
infection will shed tapeworm eggs in bowel movements. Tapeworm eggs
that are accidentally swallowed by other people can cause infection,
the CDC says in information about the disease at its website,
<http://www.cdc.gov>.
These eggs are spread through food, water or surfaces contaminated
with feces. So if you have people cooking for you or handling your
food who are tapeworm carriers and don't have good personal hygiene,
you will be exposed to the eggs of the tapeworm and become infected
by swallowing food they touch, Mr. Tsang explained.

Carriers tend to be people from rural developing countries with poor
hygiene, where pigs are allowed to roam freely and eat human feces.
Mr. Tsang said the condition is rife in Mexico and other parts of
Latin America and Central America and "in a large part of China and
Africa."

Infection with neurocysticercosis most often causes headaches and
seizures, but it can also result in mental confusion, balance
difficulties and brain swelling that can kill. Norma Arceo, a
spokeswoman for the California Department of Health Services, said 65
cases of neurocysticercosis were reported in that state in 2004,
compared with 44 cases in 2005 and 45 cases in the 1st 10 months of
2006.

Another parasitic disease related to consumption of undercooked pork
-- trichinellosis -- was relatively common in the U.S. before meat
freezing became routine. But that disease is caused by a different
type of worm, the roundworm _Trichinella spiralis_.

[Byline: Joyce Howard Price, Amy Baskerville]

--
ProMED-mail
<promed@promedmail.org>

[The incubation period for neurocysticercosis can be years, and it
is, therefore, important to estimate the probability of infection in
the United States or another country if the patient recently
immigrated to the US. As reported here, 85 percent of patients had
immigrated from an endemic country, and the increasing numbers
therefore most probably reflect increasing immigration and not an
increased risk of infection with _T. solium_ within the United
States. Background information can be found at:
<http://www.cdc.gov/ncidod/dpd/parasites/cysticercosis/factsht_cysticercosis.htm>.

The report mentioned in Emerging Infectious Diseases is probably
Sorvillo et al. EID 2007,13 (February 2007) available at:
<http://www.cdc.gov/eid/content/13/2/230.htm>

The paper in Acta Neurol Scand by Tsang could be identified as
follows: DeGiorgio C, Pietsch-Escueta S, Tsang V, Corral-Leyva G, Ng
L, Medina MT, Astudillo S, Padilla N, Leyva P, Martinez L, Noh J,
Levine M, del Villasenor R, Sorvillo F. Sero-prevalence of Taenia
solium Cysticercosis and Taenia solium Taeniasis in California, USA.
Acta Neurol Scand 2005: 111: 84-88.
<http://www.blackwell-synergy.com/doi/abs/10.1111/j.1600-0404.2005.00373.x>
- Mod.EP]

See Also

2005
----
Cysticercosis - South Africa (Eastern Cape)(03) 20050521.1407
2003
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Cysticercosis - India (03) 20031006.2507
................................ep/msp/lm


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