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Sapp SGH, Murray B, Hoover ER, Green GT, Yabsley MJ. Raccoon roundworm (Baylisascaris procyonis) as an occupational hazard: 2. Use of personal protective equipment and infection control practices among raccoon rehabilitators. Zoonoses Public Health 2018; 65:490-500. [PMID: 29603886 DOI: 10.1111/zph.12454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Indexed: 12/25/2022]
Abstract
Baylisascaris procyonis, the raccoon roundworm, is a zoonotic ascarid of importance to human and animal health. Wildlife rehabilitators who care for raccoons may be at an increased risk for exposure to the parasite, especially if proper precautions are not taken. In a wider effort to evaluate awareness regarding B. procyonis in the wildlife rehabilitation community, an online survey (38-39 questions) including questions about B. procyonis knowledge and attitudes was developed and administered to wildlife rehabilitators. To assess precautions taken among raccoon rehabilitators, participants who rehabilitated raccoons (n = 447) answered additional questions about use of personal protective equipment (PPE) and infection control practices (ICPs). Reported use of gloves was variable, but hand hygiene was generally consistent. Masks and gowns were seldom used. Part-time or infrequent volunteers and rehabilitators located in the Central, Midwest and Southeast were significantly less likely to report consistent use of PPE. A total knowledge score from the survey was used to predict the likelihood of reporting the use of particular ICPs/PPE. Knowledge score had a highly significant but small effect on the likelihood of prophylactic use of anthelmintics, anthelmintics use for B. procyonis specifically, cleaning appropriately, and using species-dedicated housing. Risk factor analysis was performed on data from a prior serologic survey to evaluate factors associated with exposure to B. procyonis and inconsistent handwashing after contact with live raccoons and their faeces; practising rehabilitation in B. procyonis hyperendemic regions and practising rehabilitation in the western region were significant risk factors for being seropositive. These data further demonstrate that correct PPE/ICPs are critical in mitigating the risk of B. procyonis exposure among raccoon rehabilitators and among other captive species.
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Affiliation(s)
- S G H Sapp
- Southeastern Cooperative Wildlife Disease Study, Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.,Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - B Murray
- Warnell School of Forestry and Natural Resources, University of Georgia, Athens, GA, USA
| | - E R Hoover
- National Environmental Health Association, Denver, CO, USA
| | - G T Green
- Warnell School of Forestry and Natural Resources, University of Georgia, Athens, GA, USA
| | - M J Yabsley
- Southeastern Cooperative Wildlife Disease Study, Department of Population Health, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.,Warnell School of Forestry and Natural Resources, University of Georgia, Athens, GA, USA
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Li L, Gao W, Yang X, Wu D, Bi H, Zhang S, Huang M, Yao X. Asthma and toxocariasis. Ann Allergy Asthma Immunol 2014; 113:187-92. [PMID: 24934109 DOI: 10.1016/j.anai.2014.05.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 05/14/2014] [Accepted: 05/18/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Asthma is the most common chronic disease in children and a major public health problem in adults. A relation between asthma and toxocariasis has been hypothesized. OBJECTIVE To evaluate the strength of association between asthma and Toxocara species seropositivity by conducting a systematic review and a meta-analysis of available data. METHODS PubMed, EMBASE, Web of Science, and the reference lists of all relevant articles and books were screened until October 2013. Two authors independently assessed eligibility and study quality and extracted data. A common odds ratio was estimated using a random-effects meta-analysis model of aggregated published data. RESULTS Ten studies met the inclusion criteria, for a total of 1,530 participants (723 cases and 807 controls). This meta-analysis found a significantly higher prevalence of Toxocara canis infection in patients with asthma than in controls (odds ratio 3.36, 95% confidence interval 1.76-6.42, P < .001). Similar results were found when meta-analysis was restricted to the studies considering only children or adults. CONCLUSION The results support the existence of a positive association between asthma and Toxocara species seropositivity.
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Affiliation(s)
- Lingling Li
- Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wei Gao
- Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao Yang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Dandan Wu
- Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hui Bi
- Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Sini Zhang
- Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Mao Huang
- Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xin Yao
- Department of Respiratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Cassenote AJF, de Abreu Lima AR, Pinto Neto JM, Rubinsky-Elefant G. Seroprevalence and modifiable risk factors for Toxocara spp. in Brazilian schoolchildren. PLoS Negl Trop Dis 2014; 8:e2830. [PMID: 24874504 PMCID: PMC4038482 DOI: 10.1371/journal.pntd.0002830] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Accepted: 03/10/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Toxocariasis is a worldwide helminthic zoonosis caused by infection with the larvae of the ascarid worms that comprise the Toxocara spp. Children are particularly prone to infection because they are exposed to the eggs in sandboxes and playgrounds contaminated with dog and cat feces. Certain behaviors, such as a geophagy habit, poor personal hygiene, a lack of parental supervision, close contact with young dogs, and ingestion of raw meat, as well as gender, age, and socioeconomic status, affect the prevalence of the disease. However, previous studies of the risk factors for toxocariasis have generally produced inconsistent results. An epidemiological cross-sectional study was conducted to evaluate the seroprevalence of IgG anti-Toxocara spp. antibodies and associated factors in schoolchildren from a region in the southeast of Brazil. METHODOLOGY/PRINCIPAL FINDINGS A total of 252 schoolchildren aged 1 to 12 years (120 males and 132 females) were assessed. An enzyme-linked immunosorbent assay based on Toxocara canis larval excretory-secretory antigens was used to determine outcomes. A questionnaire was used to collect information on children, family, and home characteristics. Clinical and laboratory data completed the dataset investigated in this study. Seroprevalence was 15.5% (95%CI 11.5-19.8). Geophagy (aPR 2.38 [95%CI 1.36-4.18], p-value 0.029) and the habit of hand washing before meals (aPR 0.04 [95%CI 0.01-0.11], p-value ≤ 0.001) were factors associated with increased and decreased seroprevalence, respectively. The income factor and its related variables lost statistical significance after adjustment with a multiple Poisson regression model. CONCLUSIONS/SIGNIFICANCE The current study confirms that toxocariasis is a public health problem in the evaluated area; modifiable factors such as soil contact and personal hygiene appear to have a greater influence on the acquisition of infection than sociodemographic attributes, thus representing direct targets for disease prevention and control.
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Affiliation(s)
- Alex J. F. Cassenote
- Postgraduate Program in Infectious and Parasitic Diseases, Faculty of Medicine, University of São Paulo, Cerqueira César, São Paulo, Brazil
| | - Alba R. de Abreu Lima
- Faculty of Medicine of São José do Rio Preto, Department of Molecular Biology, Vila São José, São José do Rio Preto, Brazil
| | - José M. Pinto Neto
- Faculty of Health Sciences, University Camilo Castelo Branco, São Paulo, Brazil
| | - Guita Rubinsky-Elefant
- Institute of Tropical Medicine of São Paulo, University of São Paulo, Cerqueira César, São Paulo, Brazil
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Bolivar-Mejia A, Alarcón-Olave C, Calvo-Betancourt LS, Paniz-Mondolfi A, Delgado O, Rodriguez-Morales AJ. Toxocariasis in the Americas: Burden and Disease Control. CURRENT TROPICAL MEDICINE REPORTS 2014. [DOI: 10.1007/s40475-013-0010-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Walsh MG. Toxocara infection and diminished lung function in a nationally representative sample from the United States population. Int J Parasitol 2010; 41:243-7. [PMID: 20937281 DOI: 10.1016/j.ijpara.2010.09.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 09/07/2010] [Accepted: 09/09/2010] [Indexed: 10/19/2022]
Abstract
The relevance of parasitic infection for the increasing incidence of asthma is a topic of considerable debate. Large population-based studies examining the association between helminth infection and specific measures of lung function in humans are lacking. This report sought to examine this association by exploring the differences in forced expiratory volume in 1s (FEV(1)) among participants with and without infection with Toxocara spp. using data from the Third National Health and Nutrition Examination Survey, undertaken by the United States Department of Health and Human Services, during 1988-1994. The results showed a significant association between diminished lung function and previous infection with Toxocara spp. Those with antibody evidence of Toxocara infection displayed FEV(1) that was 105.3mL less than those without previous infection. This relationship persisted while controlling for age, sex, education level, BMI, smoking status, ethnicity, immigration, rural residence and dog ownership (fully-adjusted difference=73mL). These findings suggest diminished lung function in the presence of Toxocara infection and illustrate the urgent need for longitudinal data to more clearly define the immunological relationship with helminth infection and its potential influence on lung function.
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Affiliation(s)
- Michael G Walsh
- Epidemiology and Biostatistics, School of Public Health, State University of New York, Downstate 450 Clarkson Avenue, Box 43, Brooklyn, NY 11203, USA.
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Hotez PJ, Wilkins PP. Toxocariasis: America's most common neglected infection of poverty and a helminthiasis of global importance? PLoS Negl Trop Dis 2009; 3:e400. [PMID: 19333373 PMCID: PMC2658740 DOI: 10.1371/journal.pntd.0000400] [Citation(s) in RCA: 189] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Peter J. Hotez
- Department of Microbiology, Immunology, and Tropical Medicine, The George Washington University, Washington, D.C., United States of America
- Sabin Vaccine Institute, Washington, D.C., United States of America
- * E-mail: or (PJH); (PPW)
| | - Patricia P. Wilkins
- Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail: or (PJH); (PPW)
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Abstract
In the United States, there is a largely hidden burden of diseases caused by a group of chronic and debilitating parasitic, bacterial, and congenital infections known as the neglected infections of poverty. Like their neglected tropical disease counterparts in developing countries, the neglected infections of poverty in the US disproportionately affect impoverished and under-represented minority populations. The major neglected infections include the helminth infections, toxocariasis, strongyloidiasis, ascariasis, and cysticercosis; the intestinal protozoan infection trichomoniasis; some zoonotic bacterial infections, including leptospirosis; the vector-borne infections Chagas disease, leishmaniasis, trench fever, and dengue fever; and the congenital infections cytomegalovirus (CMV), toxoplasmosis, and syphilis. These diseases occur predominantly in people of color living in the Mississippi Delta and elsewhere in the American South, in disadvantaged urban areas, and in the US-Mexico borderlands, as well as in certain immigrant populations and disadvantaged white populations living in Appalachia. Preliminary disease burden estimates of the neglected infections of poverty indicate that tens of thousands, or in some cases, hundreds of thousands of poor Americans harbor these chronic infections, which represent some of the greatest health disparities in the United States. Specific policy recommendations include active surveillance (including newborn screening) to ascertain accurate population-based estimates of disease burden; epidemiological studies to determine the extent of autochthonous transmission of Chagas disease and other infections; mass or targeted treatments; vector control; and research and development for new control tools including improved diagnostics and accelerated development of a vaccine to prevent congenital CMV infection and congenital toxoplasmosis.
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Affiliation(s)
- Peter J Hotez
- Department of Microbiology, Immunology, and Tropical Medicine, The George Washington University and Sabin Vaccine Institute, Washington, D.C., USA.
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Hotez PJ. Neglected diseases and poverty in "The Other America": the greatest health disparity in the United States? PLoS Negl Trop Dis 2007; 1:e149. [PMID: 18160982 PMCID: PMC2154393 DOI: 10.1371/journal.pntd.0000149] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Peter J. Hotez
- Sabin Vaccine Institute and Department of Microbiology, Immunology, and Tropical Medicine, George Washington University Medical Center, Washington, D. C., United States of America
- * E-mail: or
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