Neurocysticercosis: In’s and out’s
Author(s): David Karunyakaran H
Abstract: Neurocysticercosis (NCC) is a major zoonotic parasitic disease of veterinary and public health importance, caused by the larval stages of Taenia solium, with pigs acting as the principal intermediate hosts and humans as both definitive and accidental intermediate hosts. In endemic regions with traditional pig production, NCC is the leading cause of acquired epilepsy in humans and is tightly linked to free-roaming pig husbandry, inadequate sanitation, and access of pigs to human feces. NCC arises when T. solium eggs shed in the feces of human tapeworm carriers are ingested by pigs or humans, leading to systemic cysticercosis, including neurocysticercosis when cysts localize in the central nervous system. In India and other endemic areas of Asia, Latin America, and sub-Saharan Africa, porcine cysticercosis is highly prevalent and sustains transmission in poor, rural pig-farming communities. The disease burden in people is considerable, with NCC recognized as a neglected tropical disease and a major cause of epilepsy and disability in low-resource settings.
From a veterinary perspective, control in pigs is pivotal and includes confinement, preventing access to human feces, strategic anthelmintic treatment with oxfendazole, meat inspection, and vaccination with the recombinant TSOL18 (Cysvax) vaccine, which has shown high efficacy in field trials. Integration of pig-focused interventions with human-focused measures—sanitation, treatment of human tapeworm carriers, and food safety—under a One Health framework is central to the WHO neglected tropical disease road map 2021-2030 targeting taeniasis-cysticercosis for intensified control.
