Published Date: 2010-12-14 11:00:04
Subject: PRO/AH/EDR> Cysticercosis - Argentina
Archive Number: 20101214.4435

CYSTICERCOSIS - ARGENTINA
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Date: Sun 12 Dec 2010
Source: Diario El Chubut [trans. Mod.JG, edited]
<http://www.elchubut.com.ar/despliegue-noticias.php?idnoticia=146158>


4 cases of cysticercosis have been confirmed. This parasitic disease
is not endemic for this region. There are more (suspected) cases under
observation, and there is a general recommendation for being quite
careful when eating fresh fruits and vegetables.

One of the infected persons is from Puerto Madryn, and the 3 remaining
are from Virch. All cases had been detected nearly one month ago by
the Infectious Diseases, Neurology, and Pediatrics Service in Adolfo
Margara Local Hospital in Trelew, and central Public Health
authorities have been notified about these cases.

The condition is currently affecting 2 adults and 2 8-year old
children, all of them foreign-born. "In the case of the girl, she was
admitted because of seizures, and the CT scan revealed the presence of
parasitic cysts in her brain," explained Dr. Juan Carlos Villalba, one
of the physicians in charge of the Infectious Diseases Division in the
Local Hospital.

Dr. Villalba pointed out that there has been at least one case of
"neurocysticercosis," which corresponds to central nervous system
involvement by the parasite, and it is one of the most severe
consequences of this infection.

He also indicated that this is a real concern from the epidemiological
point of view, since persons infected belong to families working in
the field growing vegetables and fruits in the rural areas. The flood
irrigation method used in the valley may be an aggravating factor,
since this may lead to the dissemination of the parasite's eggs in the
ground and in vegetables, and these eggs may be viable for a long
period of time, since they are quite resistant.

"This situation is very important from an epidemiological point of
view, since this infection was not present in our community,"
emphasized Dr. Villalba, and he added that "the population must be
warned about this," in order to take proper precautions.

It is worth mentioning that there are no drugs available in the
country for fighting this infection. Albendazol and Praziquantel are
not available in Argentina.

This parasitic disease (taeniasis) is acquired by ingesting poorly
cooked pork meat, and the larval form (cysticercosis) is caused in
humans by the ingestion of _Taenia solium_ (also known as solitary
worm) eggs, which are eliminated in feces of infected persons. The
transmission cycle is anus-hands-mouth.

Cysticercosis is a parasitic infection caused by migration of the
parasite, which may locate itself in different organs, and it is most
severe when there is invasion of the central nervous system and the
eyes. The CNS invasion is called neurocysticercosis, and sometimes
patients may undergo surgery, since this condition is potentially
lethal, and there are no drugs available against it in this country.
If the eye involvement is severe, then the condition leads to blindness.

Extreme care is advised when consuming fresh fruits and vegetables
from the valley. These must be submerged for 20 minutes in a recipient
containing 10 cc liquid detergent diluted in 10 liters of water. Once
the time is over, vegetables and fruits must be rinsed, and they will
be ready for use. In the case of cooked fruits and vegetables, there
is no risk, since high temperature destroys the eggs.

Dr. Villalba requested immediate coordination between sanitary and
political authorities in order to stop the transmission. He explained
that "proper waste disposal" measures must be implemented, and, for
achieving this, it is necessary that households should have sanitary
services available.

It is impossible to obtain proper samples under the current
conditions. Dr. Villalba stated that discussion must take place in the
municipality, and "candidates must also participate because, since
they are about to make new laws, they must be familiar with our
community's problems. An urgent discussion is needed in order to
establish preventive measures and cut the transmission chain." He
added that "the eggs may remain on the floor, and they are quite
resistant, so appropriate measures must be taken immediately," to
prevent the occurrence of new cases.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[A few cases of cysticercosis have been described from Argentina
(Villa AM et al. Neurocysticercosis in a hospital of the city of
Buenos Aires: study of 11 cases Arq Neuropsiquiatr. 1993;51:333-6).
The paper reports 11 cases, of which 8 probably were infected in
Bolivia. The present report says that at least one patient was
"foreign born" which means that the person could have been infected
outside Argentina. Cysticercosis is an invasive infection with _Taenia
solium_ (swine tapeworm), and the infection comes either from infected
pork meat, in which the person is infected with the eggs produced by
the tapeworm, or by embryonated eggs from human or pig feces in the
environment.

If the patients here were infected locally, investigation of the pigs
raised in the area and surveys of eggs in feces in the local
population will allow an estimation of local risk of infection. -
Mod.EP]

[Life cycle at:
<http://www.medindia.net/patients/patientinfo/images/Life_cycle_pork.gif>
Infected brain:
<http://24.media.tumblr.com/tumblr_l7jsyu1j381qciwy5o3_500.jpg>
- Mod.JW]

See Also

2007
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Cysticercosis - USA 20070212.0530
2005
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Cysticercosis - South Africa (Eastern Cape)(03) 20050521.1407
Cysticercosis - South Africa (Eastern Cape)(02) 20050508.1270
Cysticercosis - South Africa (Eastern Cape) 20050506.1254
2003
----
Cysticercosis - India (03) 20031006.2507
Cysticercosis - India (02) 20031005.2501
Cysticercosis - India 20030929.2454
1998
----
Cysticercosis serology, apology 19980425.0772
Cysticercosis serology - RFI 19980421.0743
1997
----
Cysticercosis - USA (California) 19970811.1663
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