The Burden of Neurocysticercosis at a Single New York Hospital.

Amy Spallone,Roberta Seidman,Luis A Marcos,Keith Sweeney,Luboslav Woroch

doi:10.1155/2020/8174240

Abstract

Neurocysticercosis (NCC), a disease caused by the larval pork tapeworm Taenia solium, has emerged as an important infection in the United States. In this study, we describe the spectrum of NCC infection in eastern Long Island, where there is a growing population of immigrants from endemic countries. A retrospective study was designed to identify patients diagnosed with NCC using ICD-9 and ICD-10 codes in the electronic medical records at Stony Brook University Hospital between 2005 and 2016. We identified 52 patients (56% male, median age: 35 years) diagnosed with NCC in the only tertiary medical center in Suffolk County. Twenty-five cases were reported in the last three years of the study. Forty-eight (94%) patients self-identified as Hispanic or Latino in the electronic medical record. Twenty-two (44%) and 28 (56%) patients had parenchymal and extraparenchymal lesions, respectively. Nineteen (41.3%) patients presented with seizures to the emergency department. Six patients (11.7%) had hydrocephalus, and five of them required frequent hospitalizations and neurosurgical interventions, including permanent ventriculoperitoneal shunts or temporary external ventricular drains. No deaths were reported. The minimum accumulated estimated cost of NCC hospitalizations during the study period for all patients was approximately 1.4 million United States dollars (USD). In conclusion, NCC predominantly affects young, Hispanic immigrants in Eastern Long Island, particularly in zip codes correlating to predominantly Hispanic communities. The number of cases diagnosed increased at an alarming rate during the study period. Our study suggests a growing need for screening high-risk patients and connecting patients to care in hopes of providing early intervention and treatment to avoid potentially detrimental neurological sequelae.

Highlights

Neurocysticercosis (NCC) is an infection of the central nervous system with the larval pork tapeworm Taenia solium [1]. e infection is acquired by the ingestion of an adult tapeworm’s ova released in the feces of an infected tapeworm carrier [2, 3]
Forty-eight (94%) patients were selfidentified as ethnically Hispanic or Latino. e remaining three patients were identified as non-Hispanic white, Haitian, and South Asian, respectively. e record of the country of birth was available for 36 patients; the majority emigrated from Latin American countries (Guatemala n = 10, El Salvador n = 11, Honduras n = 4, Ecuador n = 7, Peru n = 1, Haiti n = 1, and Dominican Republic n = 1), and one patient was from the United States (US). e average time since immigrating to the US was documented in 28 cases, and the median time from immigration into the US until a diagnosis of NCC was 9.0 years
We found 52 cases of NCC in a 12-year period at Stony Brook University Hospital. e vast majority (88%) were young, Hispanic adults who were residents primarily in two large Hispanic communities in Suffolk County, New York (NY). e number of cases admitted to SBUH with a diagnosis of NCC has increased dramatically during the last three years of this study, which is likely due to the growth of the Hispanic community in Long Island, in addition to the widespread use of neuroimaging in emergency departments (Figure 6)

Summary

Introduction

Neurocysticercosis (NCC) is an infection of the central nervous system with the larval pork tapeworm Taenia solium [1]. e infection is acquired by the ingestion of an adult tapeworm’s ova released in the feces of an infected tapeworm carrier [2, 3]. Neurocysticercosis (NCC) is an infection of the central nervous system with the larval pork tapeworm Taenia solium [1]. E infection is acquired by the ingestion of an adult tapeworm’s ova released in the feces of an infected tapeworm carrier [2, 3]. NCC is one of the most common parasitic infections of the nervous system, and it is the most common cause of acquired, preventable adult-onset epilepsy and neurological disability worldwide [3,4,5,6]. Is parasitic infection mainly affects disadvantaged people in endemic regions, which include Latin America, sub-Saharan Africa, and Asia, among others. NCC can be present in industrialized countries where those affected are usually immigrants from endemic areas [8,9,10]. It has been estimated that between 1,320 and 5,050 new cases of NCC occur every year in the US, mainly in the Hispanic population, and the calculated annual age-adjusted mortality rate for NCC is 0.06 per million US population [9].

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Results

Conclusion