We believe there is strong justification for routine public health response to a case of cysticercosis. Such a response should include establishing surveillance for the disease and required reporting of cases. When cases are identified, follow-up and testing of household members and other close contacts should be initiated in an attempt to find tapeworm carriers. Such carriers can then be treated and removed as sources of continuing transmission. Investigation of locally acquired cysticercosis cases should be standard public health practice. Although data are limited, tapeworm carriers can also be found among contacts to foreign-born patients (≈5% of the time), and therefore investigation should be considered for all cysticercosis cases; however, imported cases with inactive infection (calcified lesions, indicating probable remote infection) should be a low priority for such follow-up (16). Decisions of prioritizing surveillance and control activities must be made on the basis of existing resources and competing needs. Given that a substantial (>20%) proportion of persons with cysticercosis may also be infected with the adult tapeworm, it is also advisable to screen cysticercosis patients if the diagnosing physician has not performed this screening (26). Public health authorities should also be aware that a single tapeworm carrier may be a source of infection for multiple cases of cysticercosis; therefore, the possibility of a common exposure among cases should be evaluated. As part of the public health control efforts for cysticercosis, any Taenia spp. tapeworm carriers who work as food handlers should be removed from work until successfully treated or confirmation is obtained that the infection is not T. solium tapeworm. Screening of domestic workers from areas where the disease is endemic has also been recommended (3).
We believe there is strong justification for routine public health response to a case of cysticercosis. Such a response should include establishing surveillance for the disease and required reporting of cases. When cases are identified, follow-up and testing of household members and other close contacts should be initiated in an attempt to find tapeworm carriers. Such carriers can then be treated and removed as sources of continuing transmission. Investigation of locally acquired cysticercosis cases should be standard public health practice. Although data are limited, tapeworm carriers can also be found among contacts to foreign-born patients (≈5% of the time), and therefore investigation should be considered for all cysticercosis cases; however, imported cases with inactive infection (calcified lesions, indicating probable remote infection) should be a low priority for such follow-up (16). Decisions of prioritizing surveillance and control activities must be made on the basis of existing resources and competing needs. Given that a substantial (>20%) proportion of persons with cysticercosis may also be infected with the adult tapeworm, it is also advisable to screen cysticercosis patients if the diagnosing physician has not performed this screening (26). Public health authorities should also be aware that a single tapeworm carrier may be a source of infection for multiple cases of cysticercosis; therefore, the possibility of a common exposure among cases should be evaluated. As part of the public health control efforts for cysticercosis, any Taenia spp. tapeworm carriers who work as food handlers should be removed from work until successfully treated or confirmation is obtained that the infection is not T. solium tapeworm. Screening of domestic workers from areas where the disease is endemic has also been recommended (3).
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