Brain Worms

Brain Infections from Parasitic Worms: A Neglected Global Health Crisis
The recent revelation that independent presidential candidate Robert F. Kennedy, Jr. once had a parasitic worm in his brain has shone a spotlight on a significant yet often overlooked global health issue – infections caused by parasitic worms that can invade and damage the brain and central nervous system. While relatively rare in the United States, these infections represent a major public health challenge in many low- and middle-income regions of the world.
The World Health Organization estimates a staggering 2.56 million to 8.3 million people are living with neurocysticercosis, a potentially life-threatening brain infection caused by the pork tapeworm Taenia solium. This parasitic disease is particularly prevalent in Latin America, sub-Saharan Africa, India, and other parts of Asia, where it is a leading cause of acquired seizures and a significant contributor to disability and premature death.
To better understand the nature of these brain infections and their global impact, we consulted with leading experts in the field – Shira Shafir, an epidemiologist and associate adjunct professor at the University of California, Los Angeles, and Clinton White, a parasitologist and infectious diseases professor at the University of Texas Medical Branch at Galveston. Their insights, originally published in an interview with Scientific American, shed light on this neglected tropical disease burden.
According to Shafir, it is not adult worms that typically invade the brain, but rather their earlier developmental stages, such as eggs or larvae. "We generally don't have adult worms that end up in the brain," she explained. "What does end up in the brain are parasites in their earlier developmental stages, such as eggs or larvae—or, for lack of a better word, baby worms."
One of the most common culprits is Taenia solium, the pork tapeworm, which has a complex life cycle involving both humans and pigs as hosts. Shafir described this cycle: "Definitively, pigs are the natural hosts. So pigs get infected with a tapeworm. When it is in the pig, it penetrates the intestinal wall and goes to the musculature – the part of pigs that people consume. Humans can then get infected with the intestinal form of the tapeworm by consuming undercooked infected pork."
However, the real danger arises when a human infected with the intestinal tapeworm spreads the eggs through fecal contamination. If another person accidentally ingests these eggs, they can hatch and migrate to various organs, including the brain, causing the condition known as neurocysticercosis.
White elaborated on the potentially severe consequences of this brain infection: "The cysts, these little round, balloonlike structures, are about a centimeter in diameter and are clear, fluid-filled sacs. Sometimes the cysts can become big enough that if they get into the fluid around the brain, called the cerebrospinal fluid (CSF), they can get stuck at little openings in the brain and block the flow [of CSF]. That leads to hydrocephalus [swelling of the brain], and that's often fatal unless the patient undergoes emergency surgery."
Even when the cysts themselves do not cause such life-threatening blockages, the body's inflammatory response as the larvae die can trigger serious neurological problems. "Usually the cysts don't cause a lot of problems—it's the inflammatory response that you get when [the larvae] are starting to die and dying that can cause problems—particularly seizures," White noted.
Regarding Kennedy's claim that the worm "ate a portion" of his brain, Shafir firmly refuted such sensationalist language. "Discussions of eating brains are better left in zombie movies than in legitimate scientific discourse," she stated. "The parasitic infections that impact the brain do not eat the brain. Now, that doesn't mean that they cannot damage brain tissue. But that kind of inflammatory language indicates a lack of scientific literacy and is pretty concerning."
While neurocysticercosis and other parasitic brain infections are relatively uncommon in the United States, with only about 1,000 hospitalizations per year, they represent a significant and often neglected health burden in many resource-poor regions of the world. Shafir expressed frustration that these diseases, which disproportionately impact marginalized communities, only receive attention when high-profile individuals are affected.
"It is unfortunate that these parasitic infections, which disproportionately impact individuals in low- and middle-income countries, only get the attention and discussion when a high-profile individual gets infected," she remarked. "There are thousands of people throughout the world who are dealing wi

Episode Transcript

(00:00):
Here's the article doubled in length,with credit given to Scientific American for the
interview portion. Brain infections from parasiticworms a neglected global health crisis. The
recent revelation that Independent presidential candidate RobertF. Kennedy Junior once had a parasitic
worm in his brain has shown aspotlight on a significant yet often overlooked global
health issue, infections caused by parasiticworms that can invade and damage the brain

(00:26):
and central nervous system. While relativelyrare in the United States, these infections
represent a major public health challenge inmany low and middle income regions of the
world. The World Health Organization estimatesa staggering two point five six million to
eight point three million people are livingwith neurocystic or kosis, a potentially life

(00:48):
threatening brain infection caused by the porktapeworm taneous solium. This parasitic disease is
particularly prevalent in Latin America, SubSaharan Africa, India, and other parts
of Asia, where it is aleading cause of acquired seizures and a significant
contributor to disability and premature death.To better understand the nature of these brain
infections and their global impact. Weconsulted with leading experts in the field,

(01:12):
Shira Schaffir, an epidemiologist and associateadjunct professor at the University of California,
Los Angeles, and Clinton White,a parasitologist and infectious diseases professor at the
University of Texas Medical Branch at Galveston. Their insights, originally published in an
interview with Scientific American, shed lighton this neglected tropical disease burden. According

(01:34):
to Shaffir, it is not adultworms that typically invade the brain, but
rather their earlier developmental stages such aseggs or larvae. We generally don't have
adult worms that end up in thebrain, she explained. What does end
up in the brain are parasites intheir earlier developmental stages such as eggs or
larvae, or, for lack ofa better word, baby worms. One

(01:57):
of the most common culprits is tineoussolium, the pork tapeworm, which has
a complex life cycle involving both humansand pigs as hosts. Shaffir described this
cycle definitively. Pigs are the naturalhosts, so pigs get infected with a
tapeworm when it is in the pig. It penetrates the intestinal wall and goes

(02:19):
to the musculature, the part ofpigs that people consume. Humans can then
get infected with the intestinal form ofthe tapeworm by consuming undercooked infected pork.
However, the real danger arises whena human infected with the intestinal tapeworm spreads
the eggs through fecal contamination. Ifanother person accidentally ingests these eggs, they
can hatch and migrate to various organs, including the brain, causing the condition

(02:42):
known as neurocystics or kosis. Whiteelaborated on the potentially severe consequences of this
brain infection. The cysts, theselittle round, balloon like structures, are
about a centimeter in diameter and areclear, fluid filled sacks. Sometimes the
cysts can become big enough that ifthey get into the fluid around the brain,
called the cerebrospinal fluid CSF, theycan get stuck at little openings in

(03:05):
the brain and block the flow ofCSF. That leads to hydrocephalous swelling of
the brain, and that's often fatalunless the patient undergoes emergency surgery. Even
when the cysts themselves do not causesuch life threatening blockages. The body's inflammatory
response as the larvae dye can triggerserious neurological problems. Usually, the cysts

(03:27):
don't cause a lot of problems.It's the inflammatory response that you get when
the larvae are starting to die anddyeing that can cause problems, particularly seizures.
White noted regarding Kennedy's claim that theworm ate a portion of his brain,
Shaffir firmly refuted such sensationalist language.Discussions of eating brains are better left

(03:47):
in zombie movies than in legitimate scientificdiscourse. She stated, the parasitic infections
that impact the brain do not eatthe brain. Now that doesn't mean that
they cannot damn brain tissue, butthat kind of inflammatory language indicates a lack
of scientific literacy and is pretty concerning. While neurocystic orcosis and other parasitic brain

(04:11):
infections are relatively uncommon in the UnitedStates, with only about one thousand hospitalizations
per year, they represent a significantand often neglected health burden in many resource
poor regions of the world. Shaffirexpressed frustration that these diseases, which disproportionately
impact marginalized communities, only receive attentionwhen high profile individuals are affected. It

(04:32):
is unfortunate that these parasitic infections,which disproportionately impact individuals in low and middle
income countries, only get the attentionand discussion when a high profile individual gets
infected. She remarked, there arethousands of people throughout the world who are
dealing with legitimate problems from these parasiticinfections. We underfund research, We underfund

(04:56):
the development of new treatments which arenot prioritized until they become front page worthy
news because they're impacting someone who isnotable. Addressing this global health crisis will
require increased investment in research, improvediagnostic tools and treatments, and robust public
health measures to prevent transmission, particularlyin regions where lack of sanitation, poor

(05:20):
food safety practices, and limited accessto healthcare perpetuate the cycle of infection.
By shining a light on these neglectedtropical diseases, experts hope to mobilize the
resources and attention needed to protect vulnerablepopulations from the devastating impacts of parasitic brain
infections. Credit The quotes and insightsfrom Shiri Shaffir and Clinton White are from

(05:44):
their interview with Scientific American. Thanksfor listening, remember to like and share
wherever you get your podcasts.