Oh, this is lovely—a report from the Centers for Disease Control (Emerging Infectious Diseases) tells us that as many as one fifth to one quarter of refugees from Burundi, Burma, Bhutan and Laos show antibodies for a disease that comes from the larval stage of tapeworms.
Whew! It is a good thing we now have Obamacare so we can pay for all the medical problems coming in through the immigrant population!
Here is the abstract (emphasis mine):
Neurocysticercosis (NCC) is a disease caused by central nervous system infection by the larval stage of the pork tapeworm, Taenia solium. In developing countries, NCC is a leading cause of adult-onset epilepsy. Case reports of NCC are increasing among refugees resettled to the United States and other nations, but the underlying prevalence among refugee groups is unknown. We tested stored serum samples from the Centers for Disease Control and Prevention Migrant Serum Bank for antibodies against T. solium cysts by using the enzyme-linked immunoelectrotransfer blot. Seroprevalence was high among all 4 populations tested: refugees from Burma (23.2%), Lao People’s Democratic Republic (18.3%), Bhutan (22.8%), and Burundi (25.8%). Clinicians caring for refugee populations should suspect NCC in patients with seizure, chronic headache, or unexplained neurologic manifestations. Improved understanding of the prevalence of epilepsy and other associated diseases among refugees could guide recommendations for their evaluation and treatment before, during, and after resettlement.
How do refugees get these tapeworms and the resultant disease?
Cysticercosis is a disease caused by infection with the larval stage of the pork tapeworm, Taenia solium. Humans and pigs acquire cysticercosis by ingesting T. solium eggs shed in the feces of humans with taeniasis (i.e., infected with an adult intestinal tapeworm). Upon ingestion, tapeworm eggs release oncospheres, which invade the intestinal wall and disseminate through the bloodstream to form cysts throughout the body. The natural lifecycle of T. solium tapeworms completes when a human eats pork contaminated by T. solium larval cysts because these can then develop into adult egg-producing intestinal tapeworms. This endemic lifecycle occurs primarily in regions where sanitation is poor and where pigs are allowed to roam and access raw human sewage.
What does the disease do?
Neurocysticercosis (NCC) occurs when cysts develop within the central nervous system (CNS); NCC is the primary cause of illness in T. solium infection. The clinical features of NCC cover a diverse range of neurologic manifestations, including seizures, headache, intracranial hypertension, hydrocephalus, encephalitis, stroke, cognitive impairment, and psychiatric disturbances (1,2). In areas in which T. solium infection is endemic, it is a major cause of epilepsy, with 30% of seizure disorder attributable to NCC.
What refugee groups in the US did they test?
We demonstrated that exposure to T. solium parasitic infection is common among refugees from Burma, Laos, Burundi, and Bhutan who resettled to the United States. All 4 populations had seroprevalence of antibodies against T. solium cysts comparable to or higher than the seroprevalence in well-characterized T. solium–endemic communities in Latin America where illness attributable to NCC is common (4,5,19,20). The widespread exposure among these groups has clinical and public health implications because these populations are resettling to the United States, where the infection is not endemic and where many clinical providers are not familiar with the disease manifestations, diagnosis, or treatment.
Is it transmittable to others? YUP! (Keep away from the feces!)
Although human cysticercosis is considered a dead end in the T. solium life cycle, a person with taeniasis can transmit infection to others by shedding infective eggs in feces. An adult-stage tapeworm can live for several years within the human intestine and intermittently releasing proglottids containing tens of thousands of potentially infective eggs.
Just for your information, in the last two years we didn’t bring too many refugees from Burundi (FY2010—530 and FY2011—110) and Laos (36 and 211 respectively), but Burma and Bhutan (really Nepal) is where the motherload of refugees came from in the last few years. See stats here. In FY 2010 we resettled 16,693 from Burma and 12,363 from Bhutan/Nepal and FY 2011 saw an even larger number resettled to your towns— 16,972 from Burma and 14,999 from Bhutan/Nepal. I guess this means that 3000-4000 refugees a year from Burma and Bhutan may have been exposed to tapeworms. Doesn’t it make you wonder where they have left all those eggs?
(Let’s see tens of thousands of eggs per tapeworm x 3000 refugees = 30 million eggs!)