The American Journal of Tropical Medicine and Hygiene just released a special supplement all about neglected parasitic infections (NPIs) in the U.S. Coordinated by the Centers for Disease Control and Prevention (CDC) and the American Society of Tropical Medicine and Hygiene, the series closely examines each of the five NPIs afflicting the poorest Americans – Chagas disease, cysticercosis, toxocariasis, toxoplasmosis, and trichomoniasis – and recommends the policy and public health measures needed to build awareness and support for these largely ignored diseases.

In the opening editorial, “Neglected Parasitic Infections in the United States: Needs and Opportunities,” Dr. Peter Hotez, Sabin President; Dr. Monica Parise, CDC Chief of the Parasitic Diseases Branch of the Division of Parasitic Diseases and Malaria; and Dr. Laurence Slutsker, CDC Director for the Division of Parasitic Diseases and Malaria for the CDC Center for Global Health, highlight the key overlapping characteristics of the five NPIS:

1.The surprisingly large number of persons infected or at risk, especially those living in poverty;

2.The potential for underreporting and missed diagnoses, largely because of lack of clinician awareness and poor availability of optimal diagnostic tests;

3.The dearth of interventions that can prevent or cure illness.

As the authors explain, these challenges only exacerbate the impact of NPIs. For instance, a lack of Chagas disease screening slows down or prevents people exhibiting classic but under-recognized symptoms from getting the necessary treatment, but it also means that their families who could potentially have the disease ­– especially children through mother-to-child transmission – are less likely to find out if they have it. Targeted screening in communities more prone to Chagas disease – those with dilapidated living conditions and with large immigrant populations from Mexico and Central and South America – could ultimately thwart later stage or perinatal transmission from occurring.

In the immediate future, Drs. Hotez, Parise, and Slutsker call for “interventions we can and should make right now to attack these diseases,” such as deworming dogs and cats and covering sandboxes to reduce animal fecal contamination, among other actions.

In the longer term, they recommend working to advance the following to ultimately reduce suffering caused by NPIs among some of the poorest populations in the U.S.: 

1.Better estimates of disease burden and a understanding of how to reduce the risk of acquiring NPIS;

2.Improved diagnostic and treatment methods;

3.Programmatic expansion of currently available, proven interventions.

Just as global health experts are now applying strategies and lessons learned from successful hookworm eradication efforts in the U.S. to the international fight against NTDs, our country can lead on NPI elimination efforts and then share those experiences to reduce the burden of parasitic infections in other countries. With greater attention and commitments, this can be a reality.

To read the full CDC press release on the NPI special supplement, please click here.

To see the CDC’s digital press kit on NPIs, please click here

Photo credit: Jim Gathany