Worms, parasites drain US poor, expert says

Last Updated: 2008-06-24 14:59:02 -0400 (Reuters Health)

By Maggie Fox

WASHINGTON (Reuters) - Diseases caused by worms and parasites are
draining the health and energy of the poorest Americans, an expert
said on Tuesday.

And diseases associated with the developing world, such as dengue
fever and Chagas disease, may become a bigger problem for the United
States as the climate changes, said Dr. Peter Hotez of George
Washington University and the Sabin Vaccine Institute in Washington.

"The message is a little tough because they are not killer diseases --
they impact on child development, intellectual development, hearing
and sometimes even heart disease," Hotez said in a telephone
interview.

He said the diseases help to keep people mired in poverty, as
infections may last years, decades or even lifetimes.

"Throughout the American South during the early twentieth century,
malaria combined with hookworm infection and pellagra (a vitamin
deficiency) to produce a generation of anemic, weak, and unproductive
children and adults," Hotez wrote.

The parasitic diseases are having similar effects now, he said.

Hotez reviewed nine diseases affecting at least 10 million Americans
for a report in the journal Public Library of Science Neglected
Tropical Diseases, which he also edits.

"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 U.S.-Mexico borderlands, as well
as in certain immigrant populations and disadvantaged white
populations living in Appalachia," he wrote.

They include ascariasis, the most common human worm infection. It is
caused by a parasitic worm that lives in the intestine, and infected
just under 4 million people in 1974 according to the last survey, in
the South and Appalachia.

DOG DROPPINGS

Toxocariasis, a roundworm parasite transmitted in dog droppings,
infected up 2.8 million poor black children living in inner cities,
the South and Appalachia, Hotez said. The U.S. Centers for Disease
Control and Prevention estimates these roundworms, which can cause
intestinal illness and blindness, infect up to 14 percent of the U.S.
population.

Strongyloidiasis is caused by a threadworm that lives throughout the
body and infects 68,000 to 100,000 people. It may cause a hyper-immune
reaction in some people.

Cysticercosis caused by the pork tapeworm and giardiasis, a diarrheal
illness caused by a one-celled parasite, are also common, Hotez said.

One threat to babies is cytomegalovirus, which infects 27,002 newborn
annually, causing deafness and mental retardation.

"It's amazing what we tolerate," Hotez said. He noted the United
States spends $1 billion a year preparing for outbreaks of diseases
that have not occurred, including smallpox, anthrax and avian
influenza.

"But these (other) diseases are occurring among voiceless people," he
said. "It's an unintended form of racism in a sense. We need to make
these disease household words."

Chagas disease, caused by the parasite Trypanosoma cruzi, infects as
many as 8 to 11 million people in Latin America and may become a U.S.
threat, Hotez said. "In Louisiana, almost 30 percent of the armadillos
and 38 percent of the opossums are infected with T. cruzi, and a case
of Chagas disease was recently reported in post-Katrina New Orleans,"
he wrote.

"In the coming decade, global warming and increased flooding in the
region could combine to promote dengue and Chagas disease epidemics
among the poor in Louisiana."

Dengue, carried by mosquitoes, can sometimes cause a deadly
hemorrhagic fever and has been reported in Texas.

Copyright © 2008 Reuters Limited

URL: http://www.reutershealth.com/archive/2008/06/24/eline/links/20080624elin012.html