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.
Highlights
Toxocara canis and Toxocara cati are ascarid nematodes that ubiquitously infect dogs and cats and can result in environmental contamination if the feces of infected animals contaminate community spaces
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
[1] Human ingestion of embryonated eggs through contaminated soil, poor hygiene practices, or uncleaned vegetables, can result in paratenic zoonotic toxocariasis. [2,3,4] As Toxocara eggs develop in the soil, it is possible to detect the developmental progression of the helminth from germinal cells to the presence of viable infective larvae via microscopy
Summary
Toxocara canis and Toxocara cati are ascarid nematodes that ubiquitously infect dogs and cats and can result in environmental contamination if the feces of infected animals contaminate community spaces. [1] Human ingestion of embryonated eggs through contaminated soil, poor hygiene practices, or uncleaned vegetables, can result in paratenic zoonotic toxocariasis. Following the ingestion of an embryonated egg, the third stage larva enters the bloodstream. It burrows through body tissues, where the worms can accumulate in the eye, brain, liver, or skin, leading to visceral or ocular larva migrans, blindness, subclinical cerebral infection, or covert infection which can diminish neurological cognition or result in developmental delays. Toxocariasis is an underreported and understudied disease in the United States Both the parasite and human toxocariasis have been described as ‘enigmatic’ due to numerous deficiencies in the understanding of the organism, including the role of cerebral toxocariasis and the possible link to neurocognitive deficits and blindness in children. Both the parasite and human toxocariasis have been described as ‘enigmatic’ due to numerous deficiencies in the understanding of the organism, including the role of cerebral toxocariasis and the possible link to neurocognitive deficits and blindness in children. [2, 5] The US Centers for Disease Control and Prevention (CDC) identifies human toxocariasis as one of five neglected parasitic infections in the U.S, and it is possibly the most common helminthiasis in the United States after pinworm (Enterobius vermicularis). [8, 10] Toxocariasis is a neglected disease of poverty due to its disproportionately high seroprevalence in areas of community poverty, especially among underrepresented minority populations living in poor areas. [10,11,12]
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