The changing distribution of helminthic diseases in the United States.

Abstract

• Trichinosis exemplifies the importance of helminthic diseases in this country; the number of cases of trichinosis in the United States exceeds that in any other country in the world. Tropical diseases are brought to the United States by people returning or immigrating from other countries; an example is American trypanosomiasis, the first case of which in the United States was reported in Texas in 1955. Schistosoma mansoni and Wuchereria bancrofti are being brought to the mainland of the United States from the West Indies, especially from Puerto Rico. Many cases of schistosomiasis have been reported since 1950, especially in northern cities such as New York and Chicago. Parasites endemic in one area within the United States are carried occasionally into other areas, as is illustrated by an outbreak of infestation with Strongyloides in a school in Illinois after the arrival of children from New Mexico. The authors give many other examples, and the fact that these problems are not peculiar to the United States is illustrated by recent migrations of Jamaicans to England, Indonesians to Holland, and Algerians to France. Two million American tourists have visited foreign countries since World War II. Increased attention to the principles of sanitation and hygiene is urgently needed in order to reduce the disability now caused by parasites and to prevent parasites from establishing themselves in new areas.