A proposal to declare neurocysticercosis an international reportable disease

Neurocysticercosis is an infection of the nervous system caused by Taenia s olium. It is the most important human parasitic neurological disease and a common cause of epilepsy in Africa, Asia, and Latin America, representing e normous costs for anticonvulsants, medical resources and lost production. N eurocysticercosis is a human-to-human infection, acquired by the faecal-ent eric route from carriers of intestinal T. solium, most often in areas with deficient sanitation. Intestinal tapeworms cause few symptoms, but adult ta eniae carried by humans release large numbers of infective eggs and are ext remely contagious. Ingestion of poorly cooked pig meat infested with T. sol ium larvae results in intestinal taeniosis but not neurocysticercosis. With a view to hastening the control of taeniosis and neurocysticercosis we propose that neurocysticercosis be declared an international reportable di sease. New cases of neurocysticercosis should be reported by physicians or hospital administrators to their health ministries. An epidemiological inte rvention could then be launched to interrupt the chain of transmission by: (1) searching for, treating and reporting the sources of contagion, i.e. hu man carriers of tapeworms; (2) identifying and treating other exposed conta cts; (3) providing health education on parasite transmission and improvemen t of hygiene and sanitary conditions; and (4) enforcing meat inspection pol icies and limiting the animal reservoir by treatment of pigs. We believe th at the first step required to solve the problem of neurocysticercosis is to implement appropriate surveillance mechanisms under the responsibility of ministries of health. Compulsory notification also has the major advantage of providing accurate quantification of the incidence and prevalence of neu rocysticercosis at regional level, thus permitting the rational use of reso urces in eradication campaigns.