Neurocysticercosis, an avoidable ailment transmitted by pigs, kills 50,000 people per year.
When the emergency team of the ESIC Medical Institute in Faridabad, the most populated Indian city in the state of Hyderabad, received the patient, he already showed episodes of spasms of up to three minutes. The 18-year-old complained of headaches and his parents reported a constant discomfort in his groin for a week. Medical tests detected inflammation in the left eye and unusual sensitivity in the right testicle. Given the symptoms, Dr. Nishanth Dev performed an MRI whose images showed a brain plagued by larvae.
Neurocysticercosis – The worst nightmare
“We gave him medication to control seizures. It was then that we performed brain imaging to find the reasons for the spasms and saw that it was full of worms, “explained Nishant Dev to the Indian Express newspaper. “An ultrasound of the eye showed that he was infested. Later studies revealed that he also had them in the testicles. ” In the face of the continuous spasms, they administered anti-inflammatories and anti-epileptics, avoiding a medication against parasites that aggravated the seizures. The patient died weeks later due to massive neurocysticercosis.
“It was quite extraordinary because we did see three or four larvae in the brain in some cases, but it had thousands of cysts. I have not seen anything like it in my entire career and I guess it’s weird in other parts of the world; why it was published in the magazine, “explains Nishanth Dev, referring to the article on the case that he himself and his colleague S. Zafar Abbas published in the New England Journal of Medicine at the end of last March. Although the event occurred four years ago, the magnitude of the infection underscores the lack of sanitary control of food to avoid a disease as preventable as common in poor countries.
Neurocysticercosis is a disease of the central nervous system caused by Taenia solium, the same parasite that leads to intestinal tapeworm, a solitary pig that can infect muscle tissue and produce cysts in various areas of the body. The infection is derived from the ingestion of parasite eggs located in foods contaminated by the animal’s feces. Although it can be asymptomatic and has a good prognosis if it is treated in time, neurocysticercosis is the most frequent infection in the world and the first preventable cause of epilepsy, an affliction suffered by 50 million people, 80% in developing countries. , according to the World Health Organization (WHO).
Neurocysticercosis was described by Aristotle as the “smallpox of the pig”, affects between three and eight million patients worldwide and entails, at least, 50,000 deaths per year. It was thought to be contracted by people who had ingested human excrement. Later it was shown that the disease was contracted by those who ate meat from pigs that had fed on human feces.
“This disease develops when someone ingests tapeworm eggs, which pass through the faeces of organisms infected by tapeworms. Normally, it happens as a result of eating poorly cooked pork. But the unusual thing about this case is that the patient was a vegetarian, “explains Dr. Nishanth Dev, who deduces:” In such a situation, we suspect that the eggs entered the [nervous] system of the patient after consuming water, vegetables or fruits that They were contaminated. ”
In fact, the WHO warns that the disease is not only contracted by the consumption of pork – an animal whose meat is not traditionally appreciated by the more than 1,250 million Indians, neither Muslims nor Hindus – but by waters contaminated by the lonely or in conditions of lack of hygiene. Although last year India stopped being the country in which more number of people live below the poverty line (with less than 1.6 euros a day), advanced by Nigeria, the Asian subcontinent is still affected by very poor conditions sanitary Its economic capital, Bombay, for example, is the city with the largest number of shanty towns and barracks without a sewerage system where more than nine million people are crowded: almost half of the 20 million people who live in the most populated and unequal city in the world. country.
WHO and the World Food and Agriculture Organization (FAO) have established a joint program involving health, education and veterinary services to control the spread of a neglected disease whose symptoms include chronic headaches, blindness, seizures, meningitis and dementia. Endemic in South and Southeast Asia, neurocysticercosis infections have also been a serious problem for health systems in Latin American countries for decades and its incipient transmission is reported in countries in the sub-Saharan Africa region.