Identifying probable cases of neurocysticercosis at an urban community hospital in Los Angeles through active surveillance: A local application addressing the under-reporting of a WHO "major neglected disease"

Background: Neurocysticercosis (NCC) is an infection of the central nervous system caused by the presence of larval stage, Taenia solium, the pork tapeworm. It is a major cause of worldwide epilepsy and disability. This infection is endemic in the developing world, however, due to immigration, is being increasingly identified in immigration hub areas of developed countries. The World Health Organization (WHO) has recently categorized NCC as one of several “major neglected diseases.” The authors noted that no cases of NCC at an urban community hospital were reported to the local health department, despite serving a largely Hispanic/Latino immigrant population. Methods: A pilot study was conducted at a community hospital in urban Los Angeles utilizing active surveillance to identify probable cases of NCC (defined by Del Brutto, 2001) by reviewing CT Brain scan reports and the corresponding medical records from January 1, 2012 to August 18, 2012. All probable living cases were forwarded to the local county health department for follow up confirmation and contact testing. Results: 191 probable neurocysticercosis cases were identified. 172 (90.05%) of identified cases were Hispanic. 126 (65.97%) cases were born in Mexico. Only 14 (7.33%) of cases had a history of seizure activity. 7 (4.19%) cases died while hospitalized. Conclusions: Neurocysticercosis is vastly under-reported given the large number of probable cases identified by the authors within the 8 month period. Ethnicity of probable cases was comparable to existing literature. History of seizure activity was significantly lower in identified hospital cases when compared to the literature.