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Parasitic diseases plague poor in urban areas, specialist says

Problem expected to worsen amid climate change

Email|Print|Single Page| Text size + By Maggie Fox
Reuters / June 25, 2008

WASHINGTON - Diseases caused by worms and parasites are draining the health and energy of the poorest Americans, a specialist said yesterday.

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 20th 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 US-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.

Toxocariasis, a roundworm parasite transmitted in dog droppings, infected up to 2.8 million poor black children living in inner cities, the South, and Appalachia, Hotez said.

The US Centers for Disease Control and Prevention estimates these roundworms, which can cause intestinal illness and blindness, infect up to 14 percent of the US population.

Strongyloidiasis is caused by a threadworm that lives in 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 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 US threat, Hotez said.

"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.

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