Neglected Infections of Poverty are 'Hidden Burden' in the U.S.

For example, Chagas disease is so widespread that most U.S. blood banks now screen organ and blood donations for the disease, which by some estimates affects almost a million people. Transmitted by the reduviid bug, the disease can cause severe heart damage if left untreated. Cysticercosis, caused by ingesting immature forms (larvae) of tapeworms that may damage the heart, lungs, and brain, is a leading cause of epilepsy in the at-risk population, affecting some 169,000 people. Dengue fever, a flu-like illness caused by a virus spread by mosquitoes, affects up to 200,000 people in the U.S. The eggs of toxocara, a worm usually found in cats and dogs, are widely found in the soil and sand pits where poor children often play. An estimated 10,000 new infections occur each year. Overall, some 37 million impoverished Americans are at risk for these types of infections.

Diagnosis of these ailments often depends on recognizing the signs and symptoms and determining possible exposure. Tests are available to help detect the infections. For example, doctors may be able to identify Chagas disease with tests that involve examining a specially stained blood smear under a microscope or with blood tests that detect antibodies to the parasite. Toxocara, cysticercosis, and Dengue fever may also be detected using blood antibody tests.

Diseases are probably more common than estimates
Despite the availability of tests, these infections may go unnoticed and unreported because physicians and hospitals have little experience with them. U.S. medical schools typically devote less than ten hours of training to tropical diseases and NIP, noted researchers who spoke at a March 2009 conference on neglected tropical diseases in the United States. Also contributing to the suspected low estimate of how many U.S. residents suffer from these diseases is the fact that limited reporting procedures are in place to track the existence and movement of these diseases. Another problem is that people infected with these diseases "don't always have the means or inclination to visit a doctor or hospital," added conference participant Peter Hotez, MD, PhD, president of the Sabin Vaccine Institute at George Washington University. "We need to step up measures in order to determine the number of people living in poverty who are affected by these conditions. These are not necessarily immigrant problems, and we know that transmission of these diseases actually occurs in the U.S. I believe the NIPs rank among the most important health disparities in our nation."

The U.S. Centers for Disease Control (CDC) is taking action. According to an August 22 Wall Street Journal article, CDC is working with private foundations to organize a national summit this fall for doctors, nurses, community activists, and politicians. Federal legislation also calls for a full report to Congress about these diseases, which threaten to increase U.S. health care costs, the article says.

Susan J. Landers. Conference explores tropical diseases being transmitted in U.S.: Good surveillance data are sought to put numbers on diseases that accompany poverty. AMNews. Available online at http://www.ama-assn.org/amednews/2009/04/20/hlsd0421.htm through http://www.ama-assn.org. Posted April 21, 2009. Accessed September 21, 2009.

Press Release. Adler School Summit the First of its Kind to Address Neglected Tropical Disease in the United States: Leading Researchers, Practitioners, Policy Makers Call for Increased Surveillance of Global Neglected Tropical Diseases (NTDs) and Neglected Infections of Poverty (NIP) in the U.S. Adler School of Professional Psychology. Available online at http://www.newsguide.us/health-medical/infectious-diseases/Adler-School-Summit-the-First-of-its-Kind-to-Address-Neglected-Tropical-Disease-in-the-United-States/ through http://www.newsguide.us. Accessed September 22, 2009.

Steve Sternberg. Analysis: U.S. poor are vulnerable to 'neglected' diseases. USA Today. Available online at http://www.usatoday.com/news/health/2008-06-23-neglected-diseases_N.htm through http://www.usatoday.com. Posted June 23, 2008. Accessed September 21, 2009.