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Surveillance for Soil Transmitted Helminths, Strongyloidiasis, Toxocariasis, Cryptosporidiosis and Other Parasitic Diseases in Mississippi

31 Pages Posted: 9 Oct 2020

See all articles by Richard S. Bradbury

Richard S. Bradbury

Government of the United States of America - CDC Division of Parasitic Diseases and Malaria, Parasitic Diseases Branch

Meredith Lane

Government of the United States of America - CDC Division of Parasitic Diseases and Malaria, Parasitic Diseases Branch

Irene Arguello

University of Mississippi - Division of Infectious Disease

Sukwan Handali

Government of the United States of America - CDC Division of Parasitic Diseases and Malaria, Parasitic Diseases Branch

Gretchen Cooley

Government of the United States of America - CDC Division of Parasitic Diseases and Malaria, Parasitic Diseases Branch

Nils Pilotte

Smith College - Department of Biological Sciences

John M. Williams

University of Mississippi - Division of Infectious Disease

Sam Jameson

University of Mississippi - Division of Infectious Disease

Susan P. Montgomery

Government of the United States of America - CDC Division of Parasitic Diseases and Malaria, Parasitic Diseases Branch

Kathryn Hellman

University of Mississippi - Division of Infectious Disease

Michelle Tharp

University of Mississippi - Division of Genetics

Lisa Haynie

University of Mississippi Medical Center - School of Nursing, The Delta Mercy Project

Regina Galloway

University of Mississippi Medical Center - Department of Microbiology

Bruce Brackin

Mississippi State Department of Health

Brian M. Kirmse

University of Mississippi - Division of Genetics

Lisa Stempak

University of Mississippi Medical Center - Department of Pathology

Paul Byers

Mississippi State Department of Health

Steven Williams

Smith College - Department of Biological Sciences

Fazlay Faruque

University of Mississippi - School of Public Health

Charlotte Victoria Hobbs

University of Mississippi - Division of Infectious Disease

More...

Abstract

Background: Recently reports of foci of hookworm and strongyloidiasis in rural Alabama has highlighted the possibility of continued soil transmitted helminth (STH) transmission in the American South. However, very little active parasitic disease surveillance has been undertaken in this region since the second decade of the last century. 

Methods: Convenience sampling was used for pilot surveillance of soil STH infection and strongyloidiasis in Mississippi. Microscopy and real-time PCR were performed on stool samples. Seroprevalence of other parasitic disease exposure, namely toxocariasis, cryptosporidiosis and giardiasis, was determined multiplex serology. 

Findings: Real-time PCR testing of 594 fecal samples from Mississippi residents for Necator americanus and Strongyloides stercoralis identified one confirmed S. stercoralis positive. A subset of 224 samples were also tested by real-time PCR for Ancylostoma spp., Ascaris lumbricoides and Trichuris trichiura, yielding negative results. Saturated salt flotation microscopy on 507 of the fecal samples was negative. 

Multiplex serology testing of 1,960 serum samples from Mississippi residents yielded a seroprevalence of Toxocara spp. antibodies (8.8%) notably higher than national averages. The seroprevalence of Cryptosporidium spp. antibodies was 27.4%, while 5.7% had antibodies to Giardia duodenalis. Four (0.3%) sera contained antibodies to S. stercoralis

Interpretation: These data suggest that  STH infection is not common and strongyloidiasis may still occur in Mississippi residents. Exposure to Toxocara appears to be common. These results are from testing of convenience samples and do not eliminate the possibility that isolated foci of hookworm and other STH transmission remain in Mississippi. 

Funding Statement: This work was funded by the University of Mississippi Medical Center and the Centers for Disease Control and Prevention.

Declaration of Interests: None of the authors have commercial or other association that might pose a conflict of interest.

Ethics Approval Statement: This study was approved by the UMMC Institutional Review Board; on ethical review, CDC was determined to be non-engaged and therefore did not require a separate IRB review. All samples sent to CDC were de-identified.

Keywords: Soil-transmitted helminths, Toxocara, Cryptosporidium, pediatric, United States

Suggested Citation

Bradbury, Richard S. and Lane, Meredith and Arguello, Irene and Handali, Sukwan and Cooley, Gretchen and Pilotte, Nils and Williams, John M. and Jameson, Sam and Montgomery, Susan P. and Hellman, Kathryn and Tharp, Michelle and Haynie, Lisa and Galloway, Regina and Brackin, Bruce and Kirmse, Brian M. and Stempak, Lisa and Byers, Paul and Williams, Steven and Faruque, Fazlay and Hobbs, Charlotte Victoria, Surveillance for Soil Transmitted Helminths, Strongyloidiasis, Toxocariasis, Cryptosporidiosis and Other Parasitic Diseases in Mississippi. Available at SSRN: https://ssrn.com/abstract=3706062 or http://dx.doi.org/10.2139/ssrn.3706062

Richard S. Bradbury

Government of the United States of America - CDC Division of Parasitic Diseases and Malaria, Parasitic Diseases Branch ( email )

United States

Meredith Lane

Government of the United States of America - CDC Division of Parasitic Diseases and Malaria, Parasitic Diseases Branch ( email )

United States

Irene Arguello

University of Mississippi - Division of Infectious Disease ( email )

Jackson, MS 39202
United States

Sukwan Handali

Government of the United States of America - CDC Division of Parasitic Diseases and Malaria, Parasitic Diseases Branch ( email )

Gretchen Cooley

Government of the United States of America - CDC Division of Parasitic Diseases and Malaria, Parasitic Diseases Branch ( email )

United States

Nils Pilotte

Smith College - Department of Biological Sciences ( email )

Northampton, MA 01060
United States

John M. Williams

University of Mississippi - Division of Infectious Disease ( email )

Jackson, MS 39202
United States

Sam Jameson

University of Mississippi - Division of Infectious Disease ( email )

Jackson, MS 39202
United States

Susan P. Montgomery

Government of the United States of America - CDC Division of Parasitic Diseases and Malaria, Parasitic Diseases Branch ( email )

United States

Kathryn Hellman

University of Mississippi - Division of Infectious Disease ( email )

Jackson, MS 39202
United States

Michelle Tharp

University of Mississippi - Division of Genetics ( email )

Jackson, MS 39202
United States

Lisa Haynie

University of Mississippi Medical Center - School of Nursing, The Delta Mercy Project ( email )

Jackson, MS 39216-4505
United States

Regina Galloway

University of Mississippi Medical Center - Department of Microbiology ( email )

Jackson, MS 39216-4505
United States

Bruce Brackin

Mississippi State Department of Health ( email )

Brian M. Kirmse

University of Mississippi - Division of Genetics ( email )

Jackson, MS 39202
United States

Lisa Stempak

University of Mississippi Medical Center - Department of Pathology ( email )

Jackson, MS 39216-4505
United States

Paul Byers

Mississippi State Department of Health ( email )

Jackson, MS
United States

Steven Williams

Smith College - Department of Biological Sciences ( email )

Northampton, MA 01060
United States

Fazlay Faruque

University of Mississippi - School of Public Health ( email )

Oxford, MS 38677
United States

Charlotte Victoria Hobbs (Contact Author)

University of Mississippi - Division of Infectious Disease ( email )

Jackson, MS 39202
United States