Should Oklahoma be concerned about parasitic zoonoses?

Objective: To assess the presence of cysticercosis, toxocariasis, and toxoplasmosis in Oklahoma.

Methods: Hospitalizations and deaths with a diagnosis of cysticercosis, toxocariasis, or toxoplasmosis were identified from the Oklahoma State Department of Health (OSDH) hospital discharge database and from the OSDH death certificate database, respectively, from years 1999 to 2004. Diagnoses were determined with ICD-9 and ICD-10 codes. Multiple hospitalizations from the same individual were merged.

Results: A total of 37 hospitalizations (65% male, median age group 25-29, 27% white and 68% other race) with cysticercosis, nine hospitalizations with taeniasis (56% male, median age group 55-59 and 78% white), four with toxocariasis (75% female and 75% white), and 35 with toxoplasmosis (66% male, median age group 35-39 and 51% white) were identified. No deaths associated with cysticercosis or toxocariasis were found. Eleven deaths with toxoplasmosis as one of the multiple causes of death were identified (82% male, mean age 40 years, 64% white and 27% Native American). All eleven individuals were infected with HIV.

Conclusion: These findings indicate that cysticercosis, toxocariasis and toxoplasmosis are present in Oklahoma. These numbers most likely under-estimate the current situation in Oklahoma since only individuals with symptoms severe enough to seek medical attention and be hospitalized for at least 14 hours are captured. Moreover, the OSDH hospital discharge database is not inclusive of all medical institutions in the state. Hence, Oklahoma should be concerned about parasitic zoonoses. Further investigation to determine risk factors should be performed to inform future state policies.