After hearing Catherine Flowers speak last semester, I was struck by the lack of environmental justice in today’s USA. She covered a few deeply disturbing developments, including the reemergence of hookworm in impoverished areas such as Lowndes County, Alabama.
Hookworm, a parasite connotated with developing countries, enters the body through the skin and finds its way to the small intestine where it consumes blood from the host. Symptoms range from abdominal pain, nausea, and fever, to developing anemia. The disease was claimed to be gone in 1980 in the United States. However, it may have never been completely eradicated. In fact, a staggering 34 % of people in Lowndes County tested positive for genetic traces of hookworm.
It is clear that the lack of environmental justice is one of the main drivers behind this disease. As Catherine Flowers illustrated, the lack of infrastructure, particularly septic systems, in areas such as Lowndes County combined rainfalls and occasional floods have created a suitable environment for hookworm.
However, listening to her speak again made me feel a sense of hope in solving these issues. She underlined that we have the power to make change, referring to national and worldwide movements started by high school and college students, and the power of social media.
It is crucial that we recognize the injustice occurring in our society and make an effort to change it for the better. As Catherine Flowers stated, it all starts locally, from the ground up. And we have to keep that in mind as we are working on our group projects in this class, spreading awareness about divestment and reducing the use of plastics here at Duke.
Environmental study in Lowndes County, Alabama, fails to prove hookworm infection
A recent published study of hookworm disease in rural Alabama did not achieve statistical significance. The Alabama Department of Public Health (ADPH) has reviewed the study, “Human Intestinal Parasite Burden and Poor Sanitation in Rural Alabama,” published in the November 2017 issue of American Journal of Tropical Medicine and Hygiene.1 This study used an experimental technology that was not FDA-approved in order to determine whether hookworm genetic material could be identified in stool specimens of residents who resided in Lowndes County, Alabama. ADPH was actively involved in the development of the study, which was approved by the Baylor University and ADPH Institutional Review Boards. The authors concluded that the study did not obtain statistical significance.
In an attempt to validate the results of the study, 9 of 20 individuals identified as positive in the study submitted specimens for additional testing via microscopy for ova and parasites (O & P), which is the benchmark confirmatory testing procedure. This confirmatory testing was performed by the Centers for Disease Control and Prevention (CDC). All specimens tested were negative for O & P, and thus no evidence of hookworm infection was found in any of the residents of Lowndes County who were tested.
While ADPH continues to monitor the counties in the West Central and Southwestern districts of Alabama for evidence of gastrointestinal (GI) outbreaks, there is currently no evidence of an increased incidence of GI outbreaks in these ADPH Districts (which include, among others, the counties of Lowndes, Dallas, Hale, Perry, Wilcox, Marengo, Choctaw, and Sumter) than in other parts of Alabama.
Montgomery, Alabama, April 9, 2018
Contact: Dr. Mary G. McIntyre, (334) 206-5200
1. Am J Trop Med Hyg. 2017 Nov;97(5):1623-1628. doi: 10.4269/ajtmh.17-0396.
Purely as a devil’s advocate. The Federal government once said they absolutely did not conduct tests on Black Tuskegee airmen involving syphilis – then they corrected themselves to say they did. At this point, we should be highly skeptical of any government studies conducted and/or reported on in Trump’s Federal government. Untreated raw sewage WILL lead to disease – history tells us this consistently. Have the same test conducted independently by a Canadian or European lab.
Thanks for this post. I live “in the middle of Hale”, and have studied zoonotic parasites for 4 1/2 years.
This info. is very interesting.
MzHazel