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OKAY BACK FROM THE NEUROLOGY CLINIC 🏥

Four People In New York City Were Diagnosed With A Brain Infection

The Cause Was Larvae Of The Pork Tapeworm

Doctors Made The Diagnoses From June 1990 Through July 1991

The Four Patients Were Not Related To Each Other

They Were Part Of An Orthodox Jewish Community In The City

None Of The Four Had Eaten Pork

Only One Had Traveled To A Country Where The Worm Is Common

All Four Had Brain Lesions Consistent With Tapeworm Cysts

Two Of The Diagnoses Were Confirmed With A Brain Biopsy

The Other Two Were Confirmed With Antibody Tests

Each Of The Four Also Had Recurrent Seizures

Epilepsy Is One Of The Most Common Signs Of The Infection

The Infection Is The Most Frequent Preventable Cause Of Epilepsy

Severe Headaches And Blindness Are Other Symptoms

In Some Cases The Infection Can Be Fatal

Outside Areas With The Worm It May Easily Be Missed

It May Also Be Found Only By Accident

The New York Cases Were Investigated As An Outbreak

The Investigators Turned To The Patients' Households

They Tested Blood From Family Members And Household Contacts

Those Tests Looked For Antibodies To The Tapeworm Cysts

Some Parts Of The Cysts Trigger Antibodies That Tests Can Detect

The Investigators Also Checked Stool From The Household Employees

In The Stool They Were Looking For Tapeworm Eggs

A Tapeworm Carrier Passes The Eggs In Their Feces

17 Immediate Family Members Had Their Blood Screened

7 Of Them Had Antibodies To The Cysts

Those 7 Came From Two Of The Families

Brain MRI Scans Showed Cystic Lesions In Two Of Those Relatives

A Seizure Had Occurred In One Of The Two

Six Domestic Employees From The Four Households Were Examined

One Of Them Had An Active Taenia Tapeworm Infection

Another Had A Positive Blood Test

Both Were Women Who Had Recently Moved From Countries With The Worm

The Investigators Named Them The Most Likely Sources In Those Homes

Current Criteria Count A Confirmed Carrier In The Home As Exposure

The Investigators Said Neurocysticercosis Should Be Considered

They Meant Seizure Patients Whose Scans Also Show Cystic Lesions

The Advice Applies Even To People Who Do Not Eat Pork

Travel To A Country With The Worm Is Not Required Either

A Review Says Most Who Had Not Traveled Caught It From A Carrier

Studies Found Patients' Household Contacts At Threefold Higher Risk

That Risk Was For A Positive Antibody Test Compared With Controls

Recent Studies Also Showed Cases Clustered Around Tapeworm Carriers

That Changed The Old View Of The Environment As The Main Source

The Same Review Considers The Infection Mostly Person To Person

In That View Infected Pork Keeps The Worm's Cycle Going

Another Paper Says The Disease Typically Centers On The Carrier

Where The Worm Is Common Poor Sanitation Is Still A Primary Cause

So Are Free Range Pig Farming And Local Social Conditions

Carriers Defecating In Open Areas Leave Eggs In The Environment

The Eggs Are Infectious Right Away

They Do Not Need Time To Develop Outside A Host

Eggs Spread To People Through Poor Hygiene Or Tainted Food And Water

The Same Eggs Can Also Infect Pigs

Finding And Treating Tapeworm Carriers Can Prevent Human Cysticercosis