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Taenia solium Tapeworm Infection, Oregon, 2006-2009.

ABSTRACT: Neurocysticercosis (NCC) is a parasitic infection of the central nervous system caused by Taenia solium larval cysts. Its epidemiology in cysticercosis-nonendemic regions is poorly understood, and the role of public health institutions is unclear. To determine the incidence of NCC and to pilot screening of household contacts for tapeworms, we conducted population-based active surveillance in Oregon. We screened for T. solium infection by examining hospital billing codes and medical charts for NCC diagnosed during January 1, 2006-December 31, 2009 and collecting fecal and blood samples from household contacts of recent case-patients. We identified 87 case-patients, for an annual incidence of 0.5 cases per 100,000 general population and 5.8 cases per 100,000 Hispanics. In 22 households, we confirmed 2 additional NCC case-patients but no current adult intestinal tapeworm infections. NCC is of clinical and public health concern in Oregon, particularly among Hispanics. Public health intervention should focus on family members because household investigations can identify additional case-patients.

SUBMITTER: O'Neal S

PROVIDER: S-EPMC3320238 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundTaenia solium, a parasite that affects humans and pigs, is the leading cause of preventable epilepsy in the developing world. Geographic hotspots of pigs testing positive for serologic markers of T. solium exposure have been observed surrounding the locations of human tapeworm carriers. This clustered pattern of seropositivity in endemic areas formed the basis for geographically targeted control interventions, which have been effective at reducing transmission. In this study, we further explore the spatial relationship between human tapeworm carriers and infected pigs using necroscopic examination as a quantitative gold-standard diagnostic to detect viable T. solium cyst infection in pigs.Methodology/principal findingsWe performed necroscopic examinations on pigs from 7 villages in northern Peru to determine the number of viable T. solium cysts in each pig. Participating humans in the study villages were tested for T. solium tapeworm infection (i.e., taeniasis) with an ELISA coproantigen assay, and the distances from each pig to its nearest human tapeworm carrier were calculated. We assessed the relationship between proximity to a tapeworm carrier and the prevalence of light, moderate, and heavy cyst burden in pigs. The prevalence of pig infection was greatest within 50 meters of a tapeworm carrier and decreased monotonically as distance increased. Pigs living less than 50 meters from a human tapeworm carrier were 4.6 times more likely to be infected with at least one cyst than more distant pigs. Heavier cyst burdens, however, were not more strongly associated with proximity to tapeworm carriers than light cyst burdens.Conclusion/significanceOur study shows that human tapeworm carriers and pigs with viable T. solium cyst infection are geographically correlated in endemic areas. This finding supports control strategies that treat humans and pigs based on their proximity to other infected individuals. We did not, however, find sufficient evidence that heavier cyst burdens in pigs would serve as improved targets for geographically focused control interventions.

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Taenia solium Tapeworm Infection, Oregon, 2006-2009.

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