title: HUMAN TOXOPLASMOSIS OUTBREAKS AND THE AGENT INFECTING FORM. FINDINGS FROM A SYSTEMATIC REVIEW.
abstract: Toxoplasmosis, a worldwide highly prevalent zoonotic infection, is transmitted either by the oocysts, from water and soil, or the tissue cysts, in raw or undercooked infected meat, of Toxoplasma gondii. An ongoing debate is whether there are differences between the clinical and epidemiological characteristics of the outbreaks due to one or the other infective form of the agent. We performed a systematic review, recovering 437 reported outbreaks of which 38 were selected. They were complete reports containing ascribed Toxoplasma infecting form, and clinical and demographic data. There was no gender or age group selection in the outbreaks, which were described more often in the Americas. A large number of individuals were affected when oocysts, associated with soil and water contaminated with cat feces, were considered the transmission source. Onset of symptoms occurred early when the infection was ascribed to meat tissue cysts (11.4 ± 6.7 days) with sharpened temporal distribution of cases, while a broader and prolonged appearance of new cases was observed when oocysts in water were the source of the infection (20 ± 7 days, p < 0.001). Such information may be useful in the design and implementation of control strategies.
authors.affiliation: Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Luciana Regina
authors.initials: LR
authors.lastname: Meireles
authors.affiliation: Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Claudio Cesar Jaguaribe
authors.initials: CC
authors.lastname: Ekman
authors.affiliation: Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Heitor Franco de
authors.initials: HF
authors.lastname: Andrade
authors.affiliation: Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Expedito José de Albuquerque
authors.initials: EJ
authors.lastname: Luna
mesh_terms: D000818:Animals; D002415:Cats; D004196:Disease Outbreaks; D005243:Feces / Q000469:parasitology; D005260:Female; D016266:Food Parasitology; D006801:Humans; D008297:Male; D008460:Meat / Q000469:parasitology; D033661:Oocysts; D014122:Toxoplasma; D014123:Toxoplasmosis / Q000453:epidemiology* / Q000635:transmission*; D014867:Water / Q000469:parasitology
chemical_list: D014867:Water