In a world first, leading animal health products provider Afrivet has rolled out a pilot vaccination campaign in Upper Gxulu, a village near Keiskammahoek in the Eastern Cape.
Members of the Afrivet One Health team spent a week in the village to tackle neurocysticercosis, a preventable parasitic infection caused by larval cysts of the pork tapeworm.
The infection has previously infested the rural pig population in the village.
Afrivet explains that neurocysticercosis, commonly referred to as NCC, is a top cause of serious neurological disorders such as seizures in people living in certain rural settings around the world.
The One Health team has been working on the project for longer than two years. Despite several challenges and delays caused by the Covid-19 pandemic as well as an earlier outbreak of African swine fever, they were able to ear-tag and vaccinate 115 pigs against the tapeworm that causes NCC in humans.
“Many rural parts of the Eastern Cape have a high prevalence of this disease,” says Afrivet director Vuyokazi Makapela.
Pigs, people and epilepsy
Speaking to Food For Mzansi, she says over the years several studies have been conducted with one study clearly showing that over 60% of the epilepsy cases diagnosed in humans in the Eastern Cape were caused by NCC.
She adds, “This area [Upper Gxulu] poses a unique challenge in the fight against this disease.
“Many rural households have pigs living in close contact with their owners, and many communities are still making use of pit toilets which are accessible to the pigs.”
This might come as a surprise to many who do not know that there is a clear link between pigs, people and epilepsy, says Makapela.
She goes on to explain that NCC is considered one of the world’s most majorly neglected (or “orphan”) zoonotic diseases. In fact, it poses a global challenge, most often in resource-poor communities that live in close contact with their livestock. NCC is thus caused by a tapeworm that cycles between humans and pigs.
50 million people with epilepsy
Caryn Shacklock, laboratory manager at Afrivet, says, “It is most often a problem in conditions where pigs are free-ranging and living in close contact with humans, and where human waste hygiene and sanitation is a challenge.”
Of the estimated 50 million people with epilepsy in the world today, 80% live in areas infested with Taenia solium, the scientific name for the pork tapeworm.
In about 30% of these people, the worm is the cause of their epilepsy.
“If a person accidentally ingests tapeworm eggs that are shed in human faeces, the larvae can migrate to the brain, forming a cyst that may result in epilepsy,” adds Shacklock.
The life cycle of the tapeworm is complex and the link between the disease and the consumption of undercooked pork is not easily or commonly understood. It is estimated that the time lapse between infection with the worm egg and the symptoms of epilepsy can easily be between five to ten years.
So, it is quite difficult to assess the prevalence of this disease in a community of people because current infections will only show symptoms of disease years later.
Vaccines to the rescue
The adult tapeworm lives in the human small intestine. Tapeworm eggs are shed in the faeces and if ingested by a pig, the larvae migrate to the muscles and form cysts (called cysticerci).
Fortunately, a vaccine has been developed for use in pigs that will render the pig immune to the tapeworm infection and thus break the cycle of transmission from human to pig.
“When used in conjunction with a specific dewormer that will kill the larvae that are encysted in the pig’s muscles, we are able to eliminate NCC from a community in a short period of time.
“This solution is monumental in a time when our country’s health care system and facilities are already under immense strain due to Covid-19,” explains Shacklock.
The Upper Gxulu vaccinations were preceded by a number of community engagements and education sessions facilitated by the Afrivet team, the Keiskammahoek state veterinarian and animal health technicians.
Together, they visited each household in the area and administered the vaccine to all healthy pigs older than eight weeks. The process will be repeated in four weeks’ time when the second vaccination and an oral dose of the dewormer will be given to each of the pigs.
Shacklock says, “After we inspected each pig as we injected it, we found an alarmingly high number of pigs infected with tapeworm cysts.”
Afrivet hopes that when they inspect the pigs at the end of the project, after ten months, they will see this number greatly reduced.
Pour on dips for mange that is prevalent and weight-bands, which are used for accurately estimating the weight of the animals for safe dosing of medication, were also distributed to all pig owners.
Afrivet chief executive Dr Peter Oberem describes the Upper Gxulu project as a personal highlight. The Afrivet One Health team felt both humbled and proud to be involved in such a ground-breaking intervention, the results of which, Oberem believes, will lead to an improved quality of life for the community.
ALSO READ: E. Cape MEC applauds Afrivet’s Ngcobo dip tank project
