Would-be blood donors are politely reject

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mg22029473.200-2_300WHEN the letter arrives, it must come as a shock. Would-be blood donors are politely rejected because they’ve tested positive for a deadly tropical infection – and their doctors aren’t much help. Kristy Murray at Baylor College of Medicine in Houston, Texas, recalls one doctor telling a patient: “The test is wrong. That disease doesn’t exist in the US!”

But an estimated 330,000 US citizens, and possibly as many as a million, carry the parasite that causes Chagas disease. It is a chronic, silent infection that leads to lethal heart or gut damage in 40 per cent of cases. It is the most common parasitic disease in the Americas, and it can be treated – if the doctor is aware of it. Most US doctors aren’t.

Then there are intestinal worms, a chronic infestation that spreads in faeces and drains energy and nutrients from children across Africa. Cases aren’t supposed to occur in rich countries. Yet Toxocara canis, an intestinal worm that can cause asthma and epilepsy, is carried by 21 per cent of black people in the US – compared with 31 per cent of people in central Nigeria.

“It’s so sad,” says Peter Hotez of Baylor College of Medicine, who founded the US’s first dedicated school of tropical medicine in 2011. He estimates that Chagas, worms and other diseases typically associated with the developing world could afflict some 14 million impoverished people in the US (see “Under the radar“, below).

“They are called neglected tropical diseases,” says Hotez. “But in reality, this is about poverty, not climate.” Worryingly, both situations are getting worse (see “A climate of disease“).

In recent years the world has begun to take notice. In 2000, the United Nations Millennium Development Goals highlighted the impact of neglected tropical diseases (NTDs) on economic development, and last year member countries of the World Health Organization pledged to eliminate or control 17 of the worst of them.





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