Visceral larva migrans: a seroepidemiological survey in five municipalities of São Paulo State, Brazil

Chieffi, Pedro Paulo; Ueda, Mirthes; Camargo, Eide Dias; Souza, Ana Maria Carvalho de; Guedes, Marilda L. da Silva; Gerbi, Laércio José; Spir, Marlene; Moreira, Argeu S.

doi:10.1590/S0036-46651990000300010

Abstracts

An enzyme-linked immunosorbent assay (ELISA), employing antigens from Toxocara canis larvae and the absortion of suspected sera with Ascaris lumbricoides extracts was used in a seroepidemiological study performed in five municipalities of São Paulo State, Brazil (São Paulo, Campinas, Santos, Marília and Presidente Prudente) in order to determine the frequency of antibodies to Toxocara. In 2,025 blood samples collected, 806 proceeded from male subjects and 1,219 from females; 483 samples were collected from subjects under 15 years of age and the remaining 1,542 from subjects aged 15 years or over. Among the 2,025 sera investigated, 3.60% had antibodies to Toxocara at significant levels. A moderate predominance of infection with Toxocara among male subjects (3.72%) was observed, although the difference was not statistically significant when this rate was compared with that for female (3.28%). Related to age, a higher frequency of positive results was detected among subjects under 15 years (6.41%) against the older group (2.53%). A trend of more elevated rates of infection was observed in municipalities with high demographic densities (São Paulo, Campinas and Santos). Nevertheless, such findings only appeared to be statistically significant in subjects younger than 15 years.

Visceral Larva Migrans; Toxocara sp.; Toxocara canis; Seroepidemiological survey

Realizou-se inquérito soroepidemiológico, para detecção de anticorpos anti-Toxocara, em 2.025 soros de indivíduos residentes em cinco municípios do Estado de São Paulo (São Paulo, Campinas, Santos, Marília e Presidente Prudente), através de técnica imunoenzimática (ELISA) e emprego de antígenos obtidos a partir de larvas de 2º - 3º estádio de Toxocara canis. Após absorção com extratos de Ascaris lumbricoides, revelou-se a presença de anticorpos anti-Toxocara, em níveis significativos, em 3,60% dos soros examinados, com predominância de indivíduos com idade inferior a 15 anos (6,41%). Observou-se, ainda, tendência a ocorrerem índices mais elevados de infecção por larvas de Toxocara entre indivíduos residentes em municípios com maior densidade demográfica (São Paulo, Campinas e Santos), especialmente no grupo com menos de 15 anos de idade.

SEROEPIDEMIOLOGY

Visceral larva migrans: a seroepidemiological survey in five municipalities of São Paulo State, Brazil

Síndrome de larva migrans visceral: inquérito soroepidemiológico em cinco municípios do estado de São Paulo, Brasil

Pedro Paulo Chieffi^I,II; Mirthes Ueda^III; Eide Dias Camargo^III; Ana Maria Carvalho de Souza^III; Marilda L. da Silva Guedes^II; Laércio José Gerbi^III; Marlene Spir^III; Argeu S. Moreira^III

^IInstituto de Medicina Tropical de São Paulo LIM 47. São Paulo, SP, Brasil

^IIFaculdade de Ciências Médicas da Santa Casa de São Paulo. São Paulo, SP, Brasil

^IIIInstituto Adolfo Lutz. São Paulo, SP, Brasil

^{Address for correspondence} Address for correspondence: Dr. Pedro Paulo Chieffi Instituto de Medicina Tropical de São Paulo Av. Dr. Enéas de Carvalho Aguiar, 470 CEP 05403, São Paulo, SP, Brasil

SUMMARY

An enzyme-linked immunosorbent assay (ELISA), employing antigens from Toxocara canis larvae and the absortion of suspected sera with Ascaris lumbricoides extracts was used in a seroepidemiological study performed in five municipalities of São Paulo State, Brazil (São Paulo, Campinas, Santos, Marília and Presidente Prudente) in order to determine the frequency of antibodies to Toxocara. In 2,025 blood samples collected, 806 proceeded from male subjects and 1,219 from females; 483 samples were collected from subjects under 15 years of age and the remaining 1,542 from subjects aged 15 years or over. Among the 2,025 sera investigated, 3.60% had antibodies to Toxocara at significant levels. A moderate predominance of infection with Toxocara among male subjects (3.72%) was observed, although the difference was not statistically significant when this rate was compared with that for female (3.28%). Related to age, a higher frequency of positive results was detected among subjects under 15 years (6.41%) against the older group (2.53%). A trend of more elevated rates of infection was observed in municipalities with high demographic densities (São Paulo, Campinas and Santos). Nevertheless, such findings only appeared to be statistically significant in subjects younger than 15 years.

Key words: Visceral Larva Migrans; Toxocara sp.; Toxocara canis; Seroepidemiological survey.

RESUMO

Realizou-se inquérito soroepidemiológico, para detecção de anticorpos anti-Toxocara, em 2.025 soros de indivíduos residentes em cinco municípios do Estado de São Paulo (São Paulo, Campinas, Santos, Marília e Presidente Prudente), através de técnica imunoenzimática (ELISA) e emprego de antígenos obtidos a partir de larvas de 2º 3º estádio de Toxocara canis. Após absorção com extratos de Ascaris lumbricoides, revelou-se a presença de anticorpos anti-Toxocara, em níveis significativos, em 3,60% dos soros examinados, com predominância de indivíduos com idade inferior a 15 anos (6,41%). Observou-se, ainda, tendência a ocorrerem índices mais elevados de infecção por larvas de Toxocara entre indivíduos residentes em municípios com maior densidade demográfica (São Paulo, Campinas e Santos), especialmente no grupo com menos de 15 anos de idade.

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1. BEAVER, P.C. Parasitological reviews. Larva migrans. Exp. Parasit, 5: 587-621, 1956.
2. BEAVER, P.C. Toxocariasis (VLM) in relationship to tropical eosinophilia. Bull. Soc. Path. exot., 55: 555-576, 1962.
3. BEAVER, P.C.; SNYDER, H.; CARRERA, G.; DENT, J. & LAFFERTY, J. Chronic eosinophilia due to visceral larva migrans. Report of three cases. Pediatrics, 9: 7-19, 1952.
4. CHIATTONE, C.S. CHIEFFI, P.P. & PAES, R.A.P. Síndrome de larva migrans visceral em adulto. Apresentaçăo de um caso. Rev. Inst. Adolfo Lutz, 43: 85-88, 1983.
5. CHIEFFI, P.P. & MULLER, E.E. Prevalęncia de parasitismo por Toxocara canis em căes e presença de ovos de Toxocara em solo de localidades públicas da zona urbana do município de Londrina, Estado do Paraná, Brasil. Rev. Saúde públ. (S. Paulo), 10: 367-372, 1976.
6. CHIEFFI, P.P. & MULLER, E.E. Estudo da variaçăo mensal na contaminaçăo do solo por ovos de Toxocara sp. (Nematoda, Ascaroidea), na zona urbana do município de Londrina, Estado do Paraná, Brasil. Rev. Inst. Adolfo Lutz, 38: 13-16, 1978.
7. CHIEFFI, P.P.; WALDMAN, E.A.; WALDMAN, C.C.S.; SAKATA, E.E.; GERBI, L.J.; ROCHA, A.B. & AGUIAR, P.R. Aspectos epidemiológicos das enteroparasitoses no Estado de Săo Paulo. Rev. paul. Med., 99: 34-36, 1982.
8. CYPESS, R.H.; KAROL, M.H.; ZIDIAN, J.L.; GLICKMAN, L.T. & GITLIN, D. Larva-specific antibodies in patients with visceral larva migrans. J. infect. Dis., 135: 623-640, 1977.
9. DE SAVIGNY, D.H.; VOLLER, A. & WOODRUFF, A.W. Toxocariasis: serological diagnosis by enzyme immunoassay. J. clin. Path., 32: 284-288, 1979.
10. EHRHARD, T. & KERNBAUM, S. Toxocara canis et toxocarose humaine. Bull. Inst. Pasteur, 77: 225-228, 1979.
11. ENGVALL, E. & PERLMANN, P. Enzyme-linked immunosorbent assay (ELISA). Quantitative assay of immunoglobulin in antigen coated tubes. J. Immunol., 109: 129-135, 1972.
12. FERREIRA, L.F.; OLIVEIRA, E.L. & CAMILLO-COURA, L. Sobre a presença de ovos de Toxocara em praças da cidade do Rio de Janeiro. Rev. Soc. bras. Med. trop., 10: 51-54, 1976.
13. FERREIRA, L.F.; SILVA, M.L. & CAMILLO-COURA, L. Toxocara e outros helmintos, em căes, na cidade do Rio de Janeiro. Rev. Soc. bras. Med. trop., 10: 361-365, 1976.
14. GLICKMAN, L.T.; MAGNAVAL, J.F.; DOMANSKI, L.M.; SHOFER, F.S.; LAURIA, S.S.; GOTTSTEIN, B. & BROCHIER, B. Visceral larva migrans in French adults: a new disease syndrome? Amer. J. Epidem., 125: 1019-1034, 1987.
15. GLICKMAN, L.T. & SCHANTZ, P.M. Epidemiology and pathogenesis of zoonotic toxocariasis. Epidem. Rev., 3: 230-250, 1981.
16. GLICKMAN, L.T.; SCHANTZ, P.M. & CYPESS, R.H. Epidemiological characteristics and clinical findings in patients with serologically proven toxocariasis. Trans. roy. Soc. trop. Med. Hyg., 73: 254-258, 1979.
17. GROSS, E.M.; ZEITAN, R. & TOROK, V. Toxocara canis infection in dogs in Beersheba, Israel. J. Helminth., 58: 139-141, 1984.
18. HUNTLEY, C.C.; COSTAS, M.C. & LYERLY, A. Visceral larva migrans syndrome: clinical characteristics and immunological studies in 51 patients. Pediatrics, 36: 523-536, 1965.
19. LYNCH, N.R.; EDDY, K.; HODGEN, A.N.; LOPEZ, R.I. & TURNER, K.J. Seroprevalence of Toxocara canis infection in tropical Venezuela. Trans. roy. Soc. trop. Med. Hyg., 82: 275-281, 1988.
20. MAGNAVAL, J.F.; MARCHESAN, P. & LARROUY, G. Les syndromes de larva migrans vescerale ascaridienne dans la region Midi-Pyrenees. Bull. Soc. Path. exot., 76: 69-75, 1983.
21. MATSUMARA, K. & ENDO, R. Seroepiodemiological study of toxocaral infection in man by enzyme-linked immunosorbent assay. J. Hyg. (Lond.), 90: 61-65, 1983.
22. MOK, C.H. Visceral larva migrans. A discussion based on a review of the literature. Clin. Pediat. (Phila.), 7: 565-573, 1968.
23. NICHOLAS, W.L.; STEWART, A.C. & WALKER, J.C. Toxocariasis: a serological survey of blood donors in the Australian Capital Territory together with observations on the risk of infection. Trans roy. Soc. trop. Med. Hyg., 80: 217-221, 1986.
24. SCHANTZ, P.M. & GLICKMAN, L.T. Ascaridos de perros y gatos: un problema de salud publica y de medicina veterinaria. Bol. Ofic. sanit. panamer., 94: 571-586, 1983.
25. SNYDER, C.H. Visceral larva migrans. Ten years experience. Pediatriacs, 28: 85-91, 1961.
26. VAN KNAPEN, F.; VAN LEUSDEN, J.; POLDERMAN, A.M. & FRANCHIMONT, J.H. Visceral larva migrans: examination by means of enzymelinked immunosorbent assay of human sera for antibodies to secretory-excretory antigen of the second stage larvae of Toxocara canis Z. Parazitenk., 69: 113-118, 1983.

Address for correspondence:

Dr. Pedro Paulo Chieffi

Instituto de Medicina Tropical de São Paulo

Av. Dr. Enéas de Carvalho Aguiar, 470

CEP 05403, São Paulo, SP, Brasil

Publication Dates

Publication in this collection
13 Sept 2006
Date of issue
June 1990

History

Received
13 Sept 1989

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. BEAVER, P.C. Parasitological reviews. Larva migrans. Exp. Parasit, 5: 587-621, 1956.

[2] 2. BEAVER, P.C. Toxocariasis (VLM) in relationship to tropical eosinophilia. Bull. Soc. Path. exot., 55: 555-576, 1962.

[3] 3. BEAVER, P.C.; SNYDER, H.; CARRERA, G.; DENT, J. & LAFFERTY, J. Chronic eosinophilia due to visceral larva migrans. Report of three cases. Pediatrics, 9: 7-19, 1952.

[4] 4. CHIATTONE, C.S. CHIEFFI, P.P. & PAES, R.A.P. Síndrome de larva migrans visceral em adulto. Apresentaçăo de um caso. Rev. Inst. Adolfo Lutz, 43: 85-88, 1983.

[5] 5. CHIEFFI, P.P. & MULLER, E.E. Prevalęncia de parasitismo por Toxocara canis em căes e presença de ovos de Toxocara em solo de localidades públicas da zona urbana do município de Londrina, Estado do Paraná, Brasil. Rev. Saúde públ. (S. Paulo), 10: 367-372, 1976.

[6] 6. CHIEFFI, P.P. & MULLER, E.E. Estudo da variaçăo mensal na contaminaçăo do solo por ovos de Toxocara sp. (Nematoda, Ascaroidea), na zona urbana do município de Londrina, Estado do Paraná, Brasil. Rev. Inst. Adolfo Lutz, 38: 13-16, 1978.

[7] 7. CHIEFFI, P.P.; WALDMAN, E.A.; WALDMAN, C.C.S.; SAKATA, E.E.; GERBI, L.J.; ROCHA, A.B. & AGUIAR, P.R. Aspectos epidemiológicos das enteroparasitoses no Estado de Săo Paulo. Rev. paul. Med., 99: 34-36, 1982.

[8] 8. CYPESS, R.H.; KAROL, M.H.; ZIDIAN, J.L.; GLICKMAN, L.T. & GITLIN, D. Larva-specific antibodies in patients with visceral larva migrans. J. infect. Dis., 135: 623-640, 1977.

[9] 9. DE SAVIGNY, D.H.; VOLLER, A. & WOODRUFF, A.W. Toxocariasis: serological diagnosis by enzyme immunoassay. J. clin. Path., 32: 284-288, 1979.

[10] 10. EHRHARD, T. & KERNBAUM, S. Toxocara canis et toxocarose humaine. Bull. Inst. Pasteur, 77: 225-228, 1979.

[11] 11. ENGVALL, E. & PERLMANN, P. Enzyme-linked immunosorbent assay (ELISA). Quantitative assay of immunoglobulin in antigen coated tubes. J. Immunol., 109: 129-135, 1972.

[12] 12. FERREIRA, L.F.; OLIVEIRA, E.L. & CAMILLO-COURA, L. Sobre a presença de ovos de Toxocara em praças da cidade do Rio de Janeiro. Rev. Soc. bras. Med. trop., 10: 51-54, 1976.

[13] 13. FERREIRA, L.F.; SILVA, M.L. & CAMILLO-COURA, L. Toxocara e outros helmintos, em căes, na cidade do Rio de Janeiro. Rev. Soc. bras. Med. trop., 10: 361-365, 1976.

[14] 14. GLICKMAN, L.T.; MAGNAVAL, J.F.; DOMANSKI, L.M.; SHOFER, F.S.; LAURIA, S.S.; GOTTSTEIN, B. & BROCHIER, B. Visceral larva migrans in French adults: a new disease syndrome? Amer. J. Epidem., 125: 1019-1034, 1987.

[15] 15. GLICKMAN, L.T. & SCHANTZ, P.M. Epidemiology and pathogenesis of zoonotic toxocariasis. Epidem. Rev., 3: 230-250, 1981.

[16] 16. GLICKMAN, L.T.; SCHANTZ, P.M. & CYPESS, R.H. Epidemiological characteristics and clinical findings in patients with serologically proven toxocariasis. Trans. roy. Soc. trop. Med. Hyg., 73: 254-258, 1979.

[17] 17. GROSS, E.M.; ZEITAN, R. & TOROK, V. Toxocara canis infection in dogs in Beersheba, Israel. J. Helminth., 58: 139-141, 1984.

[18] 18. HUNTLEY, C.C.; COSTAS, M.C. & LYERLY, A. Visceral larva migrans syndrome: clinical characteristics and immunological studies in 51 patients. Pediatrics, 36: 523-536, 1965.

[19] 19. LYNCH, N.R.; EDDY, K.; HODGEN, A.N.; LOPEZ, R.I. & TURNER, K.J. Seroprevalence of Toxocara canis infection in tropical Venezuela. Trans. roy. Soc. trop. Med. Hyg., 82: 275-281, 1988.

[20] 20. MAGNAVAL, J.F.; MARCHESAN, P. & LARROUY, G. Les syndromes de larva migrans vescerale ascaridienne dans la region Midi-Pyrenees. Bull. Soc. Path. exot., 76: 69-75, 1983.

[21] 21. MATSUMARA, K. & ENDO, R. Seroepiodemiological study of toxocaral infection in man by enzyme-linked immunosorbent assay. J. Hyg. (Lond.), 90: 61-65, 1983.

[22] 22. MOK, C.H. Visceral larva migrans. A discussion based on a review of the literature. Clin. Pediat. (Phila.), 7: 565-573, 1968.

[23] 23. NICHOLAS, W.L.; STEWART, A.C. & WALKER, J.C. Toxocariasis: a serological survey of blood donors in the Australian Capital Territory together with observations on the risk of infection. Trans roy. Soc. trop. Med. Hyg., 80: 217-221, 1986.

[24] 24. SCHANTZ, P.M. & GLICKMAN, L.T. Ascaridos de perros y gatos: un problema de salud publica y de medicina veterinaria. Bol. Ofic. sanit. panamer., 94: 571-586, 1983.

[25] 25. SNYDER, C.H. Visceral larva migrans. Ten years experience. Pediatriacs, 28: 85-91, 1961.

[26] 26. VAN KNAPEN, F.; VAN LEUSDEN, J.; POLDERMAN, A.M. & FRANCHIMONT, J.H. Visceral larva migrans: examination by means of enzymelinked immunosorbent assay of human sera for antibodies to secretory-excretory antigen of the second stage larvae of Toxocara canis Z. Parazitenk., 69: 113-118, 1983.