Investigation and environmental analysis of samples from outbreak of toxoplasmosis at research institution in Londrina, Paraná, Brazil, 2016

Abstract

The objective of this study was to report an outbreak of human toxoplasmosis at a research institution in Londrina, Paraná, from December 2015 to February 2016. Blood samples from 26 symptomatic individuals were collected and the microparticle chemiluminescence immunoassay was performed to detect IgM, IgG and specific IgG avidity test in the official laboratory. A total of 20 people with symptoms and serology compatible with acute toxoplasmosis (IgM positive and IgG with low avidity) were selected as cases, while 45 asymptomatic employees working in the same teams and during the same shifts were selected as controls. All the participants of the investigation answered an epidemiological questionnaire. Three samples of water and one sludge from the institution's supply cisterns, 10 soil samples, 11 plant samples, three cat fecal samples and one domestic feline cadaver were collected for analysis of the polymerase chain reaction (PCR) for T. gondii. After analyzing the epidemiological data, the consumption of vegetables in the restaurant of the institution was the only variable associated with the occurrence of the disease. In laboratory results, all the samples showed negative results to PCR. The rapid recognition of the outbreak, early notification and investigation could have broken the chain of transmission early, thus preventing the emergence of new cases. In addition, the adoption of good food handling practices could have prevented the occurrence of the outbreak.

Contamination of Soil, Water, Fresh Produce, and Bivalve Mollusks with Toxoplasma gondii Oocysts: A Systematic Review

“…LAMP: loop-mediated isothermal amplification. Articles with results only or also based on microscopy assay or other methods that were not specified: [ 49 , 57 , 60 , 80 , 84 , 85 , 86 ].…”

“…Indeed, only 13 of the selected articles studied the association between oocyst detection in environmental matrices with human T. gondii infection and toxoplasmosis (outbreaks, endemic, or sporadic cases), most of them from North and South America. Five of these studies focused on soil [ 56 , 60 , 70 , 77 , 80 ], with three of them reporting positive samples; 10 were in water [ 51 , 60 , 70 , 87 , 88 , 89 , 91 , 92 , 104 , 105 ], with eight reporting positive samples; and three were on fresh produce [ 60 , 88 , 92 ], with one reporting positive samples and the other reporting negative samples, but suggesting that the occurrence of toxoplasmosis was connected with vegetable consumption in a restaurant [ 60 ] ( Table 1 , Table 2 , Table 3 and Table 4 ).…”

“…The number of samples collected was extremely variable: from three irrigation, municipal, and/or cistern water samples [ 60 , 88 , 111 ] to 1427 public water supply samples [ 109 ]. In addition, the sample volume ranged from 0.01 L [ 61 ] to up to 2500 L [ 100 ].…”

A Review of Toxoplasmosis and Neosporosis in Water Buffalo (Bubalus bubalis)

“…Moreover, vertical transmission is an important form of parasitic infection in humans and domestic animals, such as pigs and sheep ( 9 – 11 ). The infection in immunocompetent humans is usually asymptomatic; however, recent studies have reported clinical cases associated with outbreaks ( 12 , 13 ). In livestock, especially in goats and sheep, toxoplasmosis is responsible for economic losses, mainly due to reproductive disorders, which include abortion, stillbirth, and birth of weak animals ( 4 ).…”

Epidemiology of a toxoplasmosis outbreak in a research institution in northern Paraná, Brazil

“…In Brazil, outbreak notification and epidemiological investigation is a compulsory activity of health surveillance (Reingold, 1998). Since 1967, when the first outbreak of toxoplasmosis was registered in Bragança Paulista, São Paulo, Brazil, more than 35 reports have been published worldwide, with most of them in Brazil (da Costa et al, 2020; Pinto‐Ferreira, Caldart, et al, 2019; Pinto‐Ferreira, Mitsuka‐Breganó, et al, 2019). The main transmission routes were water (Moura et al, 2006), vegetables (Brasil, 2012), fruits (Dutra et al, 2011), undercooked meats (Masur, Jones, Lempert, & Cherubini, 1978), raw meats (Pomares, 2011) and unpasteurized goat's milk (Chiari & Neves, 1984).…”