Neglected Infections of Poverty in the United States of America

[Gert van der Hoek]

Neglected Infections of Poverty in the United States of America

Peter J. Hotez*

Department of Microbiology, Immunology, and Tropical Medicine, The George Washington University and Sabin Vaccine Institute, Washington, D.C., United States of America

Abstract

In the United States, there is a largely hidden burden of diseases caused by a group of chronic and debilitating parasitic, bacterial, and congenital infections known as the neglected infections of poverty.

Like their neglected tropical disease counterparts in developing countries, the neglected infections of poverty in the US disproportionately affect impoverished and under-represented minority populations.

The major neglected infections include the helminth infections, toxocariasis, strongyloidiasis, ascariasis, and cysticercosis; the intestinal protozoan infection trichomoniasis; some zoonotic bacterial infections, including leptospirosis; the vector-borne infections Chagas disease, leishmaniasis, trench fever, and dengue fever; and the congenital infections cytomegalovirus (CMV), toxoplasmosis, and syphilis.

These diseases occur predominantly in people of color living in the Mississippi Delta and elsewhere in the American South, in disadvantaged urban areas, and in the US–Mexico borderlands, as well as in certain immigrant populations and disadvantaged white populations living in Appalachia.

Preliminary disease burden estimates of the neglected infections of poverty indicate that tens of thousands, or in some cases, hundreds of thousands of poor Americans harbor these chronic infections, which represent some of the greatest health disparities in the United States.

Specific policy recommendations include active surveillance (including newborn screening) to ascertain accurate population-based estimates of disease burden; epidemiological studies to determine the extent of autochthonous transmission of Chagas disease and other infections; mass or targeted treatments; vector control; and research and development for new control tools including improved diagnostics and accelerated development of a vaccine to prevent congenital CMV infection and congenital toxoplasmosis.

The complete article:

http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0000256

See also this thread on a Dengue Fever surveillance study at the Mexico Texas border:

http://www.flutrackers.com/forum/showpost.php?p=108864&postcount=1

[Gert van der Hoek]

Re: Neglected Infections of Poverty in the United States of America

Tropical disease still common in poor areas in the US

By Sue Mueller

Jun 25, 2008


WEDNESDAY June 25, 2008 (foodconsumer.org) -- A group of germs, viruses and parasites that are typically associated with tropical developing countries are still plaguing poor areas of the United States, according to a new study published in the Public Library of Science journal PLoS Neglected Tropical Diseases.

In the group are 24 "neglected infections of poverty" including schistosomiasis, a parasitic infection found in Africa; brucellosis, a bacterial infection from tainted dairy products; and dengue fever, a viral infection commonly seen in tropical Asia and South America, Los Angles Times reports.

These 24 diseases affect possibly up to million people in the country, according to Dr. Peter Hotez, the study author and professor in the Department of Microbiology, Immunology, and Tropical Disease of George Washington University, cited by the times.

Ascariasis, caused by the parasitic roundworm Ascaris lumbricoides living in the intestine alone, affects 4 million people in the South and Appalachia in 1974, according to the last survey, cited by Reuters.

Other notable infections include Strongyloidiasis caused by a threadworm that lives throughout the body and affects 68,000 to 100,000 people, Cysticercosis caused by the pork tapeworm and giardiasis caused by a common parasite.

These 24 diseases can cause trouble to child development and reduce worker productivity, and worsen poverty, the study says.

For instance, toxoplasmosis, a parasitic infection that can pass from mother to infant at birth, causes mental retardation in the child. The disease is mostly found in inner cities and poor Southern areas posing a 10 times higher risk to many newborns than phenylketonuria.

Another risk for newborns comes from cytomegalovirus, which is estimated to infect 27,002 newborns each year, causing deafness and mental retardation.

The commonly neglected diseases often result from poor sanitation or inadequate healthcare and they may be brought to the country from overseas or have been existent in the country for a long time.

They primarily affect people in the poverty-stricken regions such as Appalachia, inner cities, Mississippi Delta and the border with Mexico, the report says.

http://foodconsumer.org/7777/8888/A_ffluent_D_iseases_52/062511132008_Tropical_disease_still_common_in_poor_areas_in_the_US.shtml