The Companion Animal Parasite Council— the nation’s leading source on parasitic diseases that threaten the health of pets and people — today issued the Top Ten Heartworm cities with Cincinnati, Ohio, topping the list.

These 10 U.S. cities had the highest percentage increase in positive heartworm tests:

1)    Cincinnati, Ohio
2)    Stockton, California
3)    Amarillo, Texas
4)    San Diego, California
5)    Lexington-Fayette, Kentucky
6)    Springfield, Massachusetts
7)    Fort Collins, Colorado
8)    Newark, New Jersey
9)    Spokane, Washington
10)    Seattle, Washingto

Nationally, prevalence rates for heartworm have risen each of the last five years and are now up 20% from 2013 levels, according to CAPC.

You can check your state’s risk for heartworm disease and tick borne disease here