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

Peter M. Schantz; Patricia P. Wilkins; Victor C. W. Tsang

doi:10.1128/9781555816957.ch12

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

Authors: Peter M. Schantz¹, Patricia P. Wilkins¹, Victor C. W. Tsang¹

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Affiliations: 1: Division of Parasitic Diseases. National Cenler for Infeclious Diseases, Centers for Disease Control and Prevention, Mailstop F22, 4770 Buford Highway, Atlanta, GA 30341

Content Type: Monograph

Publication Year: 1998

Category: Clinical Microbiology

Book DOI: 10.1128/9781555816957

Chapter DOI: 10.1128/9781555816957.ch12

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Abstract:

Taeniasis, or cysticercosis, caused by Taenia solium (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

Key Concept Ranking

Infectious Diseases: 0.52653545
Enzyme-Linked Immunosorbent Assay: 0.4620396
Zoonotic Diseases: 0.4533747
Taenia solium: 0.40688676

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

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Figure 1

Life cycle of T. solium.

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Figure 1

Life cycle of T. solium.

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Figure 2

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

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Figure 2

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

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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.

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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.

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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.

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Figure 4

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Figure 5

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

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Figure 5

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

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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.

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Figure 6

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Tables

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

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Table 1

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

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10.1128/9781555816957/tab12-1.gif

Table 1

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