High Prevalence of Parasitic Infections Among Recent Immigrants in Chicago

Abstract

In 2013, approximately 41.3 million persons living in the US were immigrants, many of whom migrated from countries where parasitic infections are endemic and highly prevalent. Although extensive testing for infectious diseases is typically performed on refugees, these tests are not provided to immigrant populations, many of whom share similar risk factors and exposure histories as those in the refugee population. In order to assess the prevalence of parasitic infections among the immigrant population in Chicago, we recruited asymptomatic subjects who had moved to the United States within the last five years. Subjects were asked a symptom questionnaire and provided blood and stool samples. Samples were tested for: serum IgE level, complete blood count with differential (CBCD), and ova and parasite exam, with plans to perform polymerase chain reaction (PCR) testing on stool samples for enteric parasites and serologic testing for Chagas disease, neurocysticercosis, toxocara, schistosomiasis, and strongyloides. To date, 40 subjects have been recruited. Enrolled subjects had a mean age of 31 years; 18 of the 40 subjects were female (45%, 22/40 were male, 55%). Subjects had immigrated from Central and South America (13/40, 32.5%), Asia (12/40, 30%), India (10/40, 25%), the Middle East (3/40, 7.5%), and Africa (2/40, 5%). 10/40 (25%) patients were found to have elevated IgE (GM value of those with elevated IgE: 571 IU/mL), while 4/40 (10%) had an elevated absolute eosinophil count (AEC) (GM value of those with elevated AEC: 616 cell/mcL). To-date, one subject (1/40, 2.5%) has been found to have a parasitic infection. The positive subject was a 24 year-old asymptomatic female from Brazil discovered to have Giardia lamblia cysts and trophozoites on stool O&P; this subject had an elevated IgE level (567 IU/mL), but a normal AEC (100 cell/mcL). Based on our preliminary data, we believe that parasitic infections likely represent a large and as-yetunidentified burden of disease in the immigrant population. The planned PCR and serologic testing will add additional information about these important health problems affecting our immigrant populations.