Toxocara species environmental contamination of public spaces in New York City

Abstract

Human toxocariasis has been identified as an under-diagnosed parasitic zoonosis and health disparity of significant public health importance in the United States due to its high seropositivity among socioeconomically disadvantaged groups, and possible links to cognitive and developmental delays. Through microscopy and quantitative PCR, we detected that Toxocara eggs are widespread in New York City public spaces, with evidence of significant levels of contamination in all five boroughs. The Bronx had the highest contamination rate (66.7%), while Manhattan had the lowest contamination rate (29.6%). Moreover, infective eggs were only found in the Bronx playgrounds, with over 70% of eggs recovered in embryonic form and the highest egg burden (p = 0.0365). All other boroughs had eggs in the pre-infectious, unembronyated form. Toxocara cati, the cat roundworm, was the predominant species. These results suggest that feral or untreated cats in New York City represent a significant source of environmental contamination. These findings indicate that human toxocariasis has emerged as an important health disparity in New York City, with ongoing risk of acquiring Toxocara infection in public spaces, especially in poorer neighborhoods. There is a need for reducing environmental Toxocara contamination. Additional rigorous public health interventions should explore further approaches to interrupt transmission to humans.

An Integrated Study of Toxocara Infection in Honduran Children: Human Seroepidemiology and Environmental Contamination in a Coastal Community

“…Such high seroprevalence warrants a clinical investigation as covert toxocariasis would be a serious concern among the studied children [ 3 ]. Further, evidence indicates strong links between seropositivity and cognitive and developmental delays [ 1 , 4 , 5 , 27 , 28 ]. To reinforce the plausible link between seropositivity and health effects, we found that after controlling for STH infections, the presence of anti- Toxocara antibodies was associated with high levels of eosinophilia.…”

“…Recent research suggests that this infection may partially account for cognitive deficits and other neurological complications seen among socioeconomically disadvantaged children [ 1 , 4 ]. There is a strong body of research from Europe and South America and a recent interest resurgence in the United States [ 5 , 6 ].…”

Soil-Transmitted Helminths in the USA: a Review of Five Common Parasites and Future Directions for Avenues of Enhanced Epidemiologic Inquiry

“…[ 37 ] 2016: 14-month-old canine with hookworm invasion of the brainstem, TX ( Ancylostoma spp. ) [ 38 ] Trichuris trichiura (whipworm) unavailable Highest: 55.2% in 366 Native born School children ages 6–12, KY Lowest:: 0.5% in 3729 Caucasian school children ages 5–15, GA unavailable Strongyloides stercoralis 68,000 – 100,000[ 26 ] Highest: 3.8% in 366 Native born School children ages 6–12, KY Lowest: 0% in 439 School children ages 10–14, KY 2020: 68-year -old man with COVID-19 infection immigrating 20 years prior from Ecuador, CT 2020: 16.5% positive serology in 97 individuals from a community with failing sanitation/poverty, central TX (75% with no travel history) [ 13 ••] 2017: 61-year old US-born man with HIV coinfection, no significant travel history, CT [ 11 ] 2017: 7.3% stool samples from 55 individuals in area of failing sanitation and poverty, Lowndes County, AL [ 24 ] 2013: 1.9% in 378 positive serology from persons presenting to Remote Area Medical Clinics, KY (only 1 positive participant had significant travel history) [ 28 ] Toxocara canis , T. cati 1.3–2.8 million [ 26 ] unavailable 2019: 3-year-old girl with OLM, previously healthy presenting with blurry vision and headache, AK [ 33 ] 2017: 5.2% positive serology from 11 individuals testing positive for any GI parasites in area of failing sanitation and poverty, Lowndes County, AL [ 24 ] 2015–2016: 66.7% contamination with eggs & larvae in 10/15 soil samples from the Bronx, 38.9% in 7/18 soil samples from Staten Island, 33.3% in 6/18 soil samples from Queens, 30.8% 4/13 soil samples from Brooklyn, 29.6% in 8/27 soil samples from Manhattan, NY [ 39 ] 2014: 4.6% egg positive fecal samples from 523,934 cats and 1.8% egg positive fecal samples from 2,750,718 dogs, national [ 40 ] 2014: 75-year-old female with pulmonary toxocariasis (only travel history 15 years prior to Caribbean), NJ [ 41 ] 2011–2014: 5.1% overall seroprevalence from 13,509 individuals from NHANES 2011–2014, national [ 42 ] 2009–2010: 68 case reports of OLM in individuals aged 1–60, national [ 43 ] …”

“…2015–2016: 66.7% contamination with eggs & larvae in 10/15 soil samples from the Bronx, 38.9% in 7/18 soil samples from Staten Island, 33.3% in 6/18 soil samples from Queens, 30.8% 4/13 soil samples from Brooklyn, 29.6% in 8/27 soil samples from Manhattan, NY [ 39 ]…”

Global COVID-19 Efforts as the Platform to Achieving the Sustainable Development Goals

“…There is increasing evidence that tropical diseases are also causative for propagating poverty in those infected [ 24 ]. In the USA, an urban study in New York City reported a direct correlation with more Toxocara parasite in city parks from poor neighborhoods compared with rich boroughs [ 25 ]. Another study in a clinic that serves low-income patients located in Washington D.C. was found to have endemic levels of a potentially dangerous parasite called Strongyloides stercoralis in this low-income population [ 26 ].…”