Seroprevalence of Antibodies to Toxocara Species in the United States and Associated Risk Factors, 2011-2014

Background. Toxocariasis results from infection with larval stages of a dog and cat intestinal nematode and causes human morbidity. The current United States estimate of Toxocara exposure is 13.9% (National Health and Nutrition Examination Survey [NHANES] III [1988-1994]). Methods. We used a multiplex bead-based assay (Tc-CTL-1MBA) with purified Toxocara canis antigen to estimate Toxocara antibody seroprevalence in serum of 13 509 persons aged >= 6 years from NHANES 2011-2014 and identified seropositivity risk factors. We tested a subset of 500 samples with the T. canis enzyme immunoassay used in NHANES III to estimate prior seroprevalence had samples from NHANES III been tested by Tc-CTL-1MBA. Results. The age-standardized estimate of Toxocara seroprevalence was 5.0% (95% confidence interval [CI], 4.2%-5.8%), lower than previously reported even after adjusting for increased Tc-CTL-1MBA specificity. Risk factors for seropositivity from multiple logistic regression were older age, non-Hispanic black/Hispanic origin, male sex, living below poverty level, households with >= 0.5 persons per room, less than college education, and birth outside of the United States. Conclusions. Toxocara seroprevalence estimates in 2011-2014 were lower than in a study from NHANES III (1988-1994), but seropositivity risk factors remained the same and should continue to be the focus of prevention efforts.