Chapter 9 : The Neglected Tropical Diseases of North America

Abstract:

Although the neglected tropical diseases (NTDs) are not as prominent in the United States, Canada, Mexico, and the Caribbean as they are in the low-income countries of Africa, Asia, and Central and South America, these infections are nonetheless significant among the poorest people living in North America. Many of the North American NTDs are also zoonoses, meaning that they are transmitted from animals to people. Populations at particular risk for acquiring these NTDs include minority populations such as African-Americans and Hispanics, as well as many of North America’s Native Americans. A serious NTD problem resulting from endemic hookworm infection, lymphatic filariasis (LF), and schistosomiasis also occurs in the Caribbean region, where it has been argued that these diseases represent a glaring legacy of the Atlantic slave trade. The major U.S. NTDs include soil-transmitted helminth infections, especially toxocariasis and strongyloidiasis, cysticercosis, Chagas’ disease, and toxoplasmosis. Cysticercosis may be the single leading cause of epilepsy in the Southwestern United States, and toxoplasmosis is a major cause of birth defects. The Inuit of the Canadian Arctic and Alaska also suffer from several NTDs, including toxoplasmosis, trichinellosis, and echinococcosis. Several NTDs, including onchocerciasis, soil-transmitted helminths, trachoma, and cutaneous leishmaniasis (CL), occur frequently in rural southern Mexico, especially in Chiapas, and Chagas’ disease is still focally endemic.