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Tytuł:
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Toxoplasmosis Outbreak Associated With Toxoplasma gondii-Contaminated Venison-High Attack Rate, Unusual Clinical Presentation, and Atypical Genotype.
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Autorzy:
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Schumacher AC; Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.; Bureau of Communicable Diseases, Division of Public Health, Wisconsin Department of Health Services, Madison, Wisconsin, USA.
Elbadawi LI; Bureau of Communicable Diseases, Division of Public Health, Wisconsin Department of Health Services, Madison, Wisconsin, USA.; Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
DeSalvo T; Bureau of Communicable Diseases, Division of Public Health, Wisconsin Department of Health Services, Madison, Wisconsin, USA.
Straily A; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Ajzenberg D; INSERM, Université de Limoges, UMR_S 1094, Tropical Neuroepidemiology, Limoges, France.; University Hospital, French National Reference Center for Toxoplasmosis and Biological Resource Center for Toxoplasma, Limoges, France.
Letzer D; Infectious Disease Specialists of Southeast Wisconsin, Brookfield, Wisconsin, USA.
Moldenhauer E; Jackson County Health and Human Services, Black River Falls, Wisconsin, USA.
Handly TL; Jackson County Health and Human Services, Black River Falls, Wisconsin, USA.
Hill D; United States Department of Agriculture, Agricultural Research Service, Animal Parasitic Diseases Lab, Beltsville, Maryland, USA.
Dardé ML; INSERM, Université de Limoges, UMR_S 1094, Tropical Neuroepidemiology, Limoges, France.; University Hospital, French National Reference Center for Toxoplasmosis and Biological Resource Center for Toxoplasma, Limoges, France.
Pomares C; Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de Nice, INSERM, U1065, Centre Méditerranéen de Médecine Moléculaire, Faculté de Médecine, Virulence microbienne et signalisation inflammatoire - Université de la Côte d'Azur, Nice, France.
Passebosc-Faure K; University Hospital, French National Reference Center for Toxoplasmosis and Biological Resource Center for Toxoplasma, Limoges, France.
Bisgard K; Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Gomez CA; The Jack S. Remington Laboratory for Specialty Diagnostics, National Reference Center for the Study and Diagnosis of Toxoplasmosis, Palo Alto, California, USA.; Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Press C; The Jack S. Remington Laboratory for Specialty Diagnostics, National Reference Center for the Study and Diagnosis of Toxoplasmosis, Palo Alto, California, USA.
Smiley S; Bureau of Communicable Diseases, Division of Public Health, Wisconsin Department of Health Services, Madison, Wisconsin, USA.
Montoya JG; The Jack S. Remington Laboratory for Specialty Diagnostics, National Reference Center for the Study and Diagnosis of Toxoplasmosis, Palo Alto, California, USA.
Kazmierczak JJ; Bureau of Communicable Diseases, Division of Public Health, Wisconsin Department of Health Services, Madison, Wisconsin, USA.
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Źródło:
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Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2021 May 04; Vol. 72 (9), pp. 1557-1565.
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Typ publikacji:
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Journal Article; Research Support, U.S. Gov't, P.H.S.
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Język:
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English
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Imprint Name(s):
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Publication: Jan. 2011- : Oxford : Oxford University Press
Original Publication: Chicago, IL : The University of Chicago Press, c1992-
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MeSH Terms:
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Toxoplasma*/genetics
Toxoplasmosis, Animal*/epidemiology
Animals ; Disease Outbreaks ; Female ; Genotype ; Humans ; Incidence ; Male ; Meat ; Middle Aged ; North America ; Polymorphism, Restriction Fragment Length ; Wisconsin
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References:
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Grant Information:
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CC999999 United States ImCDC Intramural CDC HHS; U50 CK000421 United States CK NCEZID CDC HHS
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Contributed Indexing:
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Keywords: Toxoplasma gondii; genetic characterization; outbreak; toxoplasmosis
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Entry Date(s):
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Date Created: 20200516 Date Completed: 20210520 Latest Revision: 20220716
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Update Code:
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20240105
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PubMed Central ID:
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PMC9248295
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DOI:
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10.1093/cid/ciaa285
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PMID:
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32412062
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Background: During 2017, in response to a physician's report, the Wisconsin Department of Health Services, Division of Public Health, began investigating an outbreak of febrile illness among attendees of a retreat where never frozen, intentionally undercooked, locally harvested venison was served. Preliminary testing tentatively identified the illness as toxoplasmosis.
Methods: Confirmatory human serology panels and testing of the venison to confirm and categorize the presence and type of Toxoplasma gondii were completed by French and American national reference laboratories. All 12 retreat attendees were interviewed; medical records were reviewed.
Results: All attendees were male; median age was 51 years (range: 22-75). After a median incubation period of 7 days, 9 (82%) of 11 exposed persons experienced illness lasting a median of 12 days. All 9 sought outpatient healthcare for symptoms including fever, chills, sweats, and headache (100%) and ocular disturbances (33%). Testing confirmed the illness as toxoplasmosis and venison as the infection source. Multiple laboratory results were atypical for toxoplasmosis, including transaminitis (86%), lymphocytopenia (88%), thrombocytopenia (38%), and leukopenia (63%). One exposed but asymptomatic person was seronegative; the other had immunity from prior infection. The T. gondii strain was identified as closely related to an atypical genotype (haplogroup 12, polymerase chain reaction restriction fragment length polymorphism genotype 5) common in North American wildlife but with previously uncharacterized human clinical manifestations.
Conclusions: The T. gondii strain contaminating the venison might explain the unusual clinical presentations. In North America, clinicians and venison consumers should be aware of risk for severe or unusual presentations of acute toxoplasmosis after consuming undercooked game meat.
(Published by Oxford University Press for the Infectious Diseases Society of America 2020.)
Comment in: Clin Infect Dis. 2021 May 4;72(9):1566-1567. (PMID: 32412061)
Erratum in: Clin Infect Dis. 2022 Mar 23;74(6):1126. (PMID: 35169828)
