This week the Centers for Disease Control and Prevention (CDC) announced a new initiative that targets parasitic diseases in the United States. Coinciding with the publication of a series of articles in the American Journal of Tropical Medicine and Hygiene (AJTMH), the new CDC initiative will prioritize five major parasitic diseases — Chagas disease, cysticercosis, toxocariasis, toxoplasmosis and trichomoniasis — which are considered neglected because they mainly impact Americans who live in extreme poverty, especially in the southern United States and in degraded urban areas of major U.S. cities. CDC’s renewed commitment to these diseases is extremely welcome, and I especially want to congratulate the dynamic leadership of their Division of Parasitic Diseases and Malaria including Drs. Monica Parise and Larry Slutsker, who lead these activities.
In the United States, there is a largely hidden burden of diseases caused by a group of chronic and debilitating parasitic, bacterial, and congenital infections known as the neglected infections of poverty. Like their neglected tropical disease counterparts in developing countries, the neglected infections of poverty in the US disproportionately affect impoverished and under-represented minority populations. The major neglected infections include the helminth infections, toxocariasis, strongyloidiasis, ascariasis, and cysticercosis; the intestinal protozoan infection trichomoniasis; some zoonotic bacterial infections, including leptospirosis; the vector-borne infections Chagas disease, leishmaniasis, trench fever, and dengue fever; and the congenital infections cytomegalovirus (CMV), toxoplasmosis, and syphilis.
In 1962, an estimated 40 million Americans lived in poverty, almost one-quarter of the US population. Today, the poverty rate in the US is roughly half of what it was when The Other America was first published, however, the total number of people living in poverty remains about the same. We now recognize that this group of 36.5 million impoverished Americans is at higher risk for heart disease, cancer, and other chronic diseases compared to the rest of the US population. However, it is not well known that just as the poorest people in the low-income countries of Africa, Asia, and Central and South America have the highest rates of the neglected tropical diseases (NTDs), there is evidence to suggest that large numbers of the poorest Americans living in the US also suffer from some of these unique infections.