To the Editor.—
The editorial by William R. Barclay, MD, on an apparent increase in diphyllobothriasis (fish tapeworm disease) in the United States (1981;246:2448) is based on a report from the National Centers for Disease Control (CDC) (MMWR, July 27, 1981), which is difficult to construe without consulting the literature. Two points deserve amplification.First, no current data document persistent transmission of diphyllobothriasis in the Midwest. VonBonsdorf's1 recent, authoritative monograph quotes work by T. B. Magath and others that represents the position of 50 years ago.At that time evidence for Diphyllobothrium plerocercoids in fish caught in midwestern waters indicated two areas of activity. The first involved a few lakes in northeastern Minnesota that drained into the Arctic Ocean via tributaries of the Nelson River. Resurvey of one waterway in this area by Weinstein and Appelget2 in 1952 disclosed continued contamination of fish in Lake Shawga near Ely,
Dooley JR. Diphyllobothriasis in Americans and Asians. JAMA. 1982;247(16):2230–2231. doi:10.1001/jama.1982.03320410016008
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