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12 : Immigrants, Imaging, and Immunoblots: the Emergence of Neurocysticercosis as a Significant Public Health Problem

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Abstract:

Taeniasis, or cysticercosis, caused by (often referred to as the pork tapeworm), is a classical zoonosis which has been recognized since antiquity. Cysticercosis is acquired by ingesting Taenia eggs shed in the feces of a human tapeworm carrier and may occur in humans who neither eat pork nor share environments with pigs. Although cysticerci may localize throughout the body, most clinical manifestations result from their presence in the central nervous system (neurocysticercosis (NCC)), where they can cause seizures, hydrocephalus, and other neurologic dysfunctions. 175 patients with active neurocysticercosis were randomly assigned to three treatment groups: (i) oral prednisolone alone, (ii) praziquantel (50 mg/kg for 15 days) with prednisolone, or (iii) albendazole (15 mg/kg) for 8 days with prednisolone. The results of this study suggest that still reliable criteria to determine which patients require treatment with either praziquantel or albendazole is lacking. Approximately half of the patients in this study had anticysticercal antibodies that recognized all seven of the diagnostic proteins. Although local persons are usually unaware of the threat to public health that this infection in pigs represents and do not relate the lesions in their animals to disease in humans, pig owners routinely check their live pigs for cysticercosis by direct examination of the tongue. Special studies reveal that morbidity caused by NCC is measurable and severe in areas where NCC is endemic.

Citation: Schantz P, Wilkins P, Tsang V. 1998. Immigrants, Imaging, and Immunoblots: the Emergence of Neurocysticercosis as a Significant Public Health Problem, p 213-242. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch12

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Infectious Diseases
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Enzyme-Linked Immunosorbent Assay
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Zoonotic Diseases
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Taenia solium
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Figure 1

Life cycle of .

Citation: Schantz P, Wilkins P, Tsang V. 1998. Immigrants, Imaging, and Immunoblots: the Emergence of Neurocysticercosis as a Significant Public Health Problem, p 213-242. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch12
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Image of Figure 2
Figure 2

Multiple cysticerci in the brain of a 12-year-old girl at autopsy. (Courtesy of Ana Flisser.)

Citation: Schantz P, Wilkins P, Tsang V. 1998. Immigrants, Imaging, and Immunoblots: the Emergence of Neurocysticercosis as a Significant Public Health Problem, p 213-242. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch12
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Figure 3

Radioimaging of neurocysiicercosis. MR (left) and CT (right) images of the brain of a patient with a .single cystic lesion are shown.

Citation: Schantz P, Wilkins P, Tsang V. 1998. Immigrants, Imaging, and Immunoblots: the Emergence of Neurocysticercosis as a Significant Public Health Problem, p 213-242. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch12
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Figure 4

Immunoblot showing reactivity of sera from patients with cysticercosis. Individual sera from patients with cysticercosis were analyzed by the immunoblot assay. Cysticercosis-specific antibodies react with glycoproteins derived from T. solium cysts. The positions of the seven diagnostic glycoproteins arc noted and designated according to their relative mobilities in SDS-PAGE.

Citation: Schantz P, Wilkins P, Tsang V. 1998. Immigrants, Imaging, and Immunoblots: the Emergence of Neurocysticercosis as a Significant Public Health Problem, p 213-242. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch12
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Image of Figure 5
Figure 5

Approximate geographic distribution of T. solium. ▪, high or moderate prevalence; IS, low or sporadic prevalence.

Citation: Schantz P, Wilkins P, Tsang V. 1998. Immigrants, Imaging, and Immunoblots: the Emergence of Neurocysticercosis as a Significant Public Health Problem, p 213-242. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch12
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Figure 6

The outside commons area of a household in Mexico where T. solium infection is endemic. The unrestrained sow and piglets have access to human fecal wastes deposited on the open ground or in a shallow pit latrine.

Citation: Schantz P, Wilkins P, Tsang V. 1998. Immigrants, Imaging, and Immunoblots: the Emergence of Neurocysticercosis as a Significant Public Health Problem, p 213-242. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch12
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Tables

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Table 1

Prevalence estimates of T. solium cysticercosis and taeniasis in people and pigs in Latin American communities

Citation: Schantz P, Wilkins P, Tsang V. 1998. Immigrants, Imaging, and Immunoblots: the Emergence of Neurocysticercosis as a Significant Public Health Problem, p 213-242. In Scheld W, Craig W, Hughes J (ed), Emerging Infections 2. ASM Press, Washington, DC. doi: 10.1128/9781555816957.ch12

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