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Journal Jya 4

This document discusses human toxoplasmosis caused by the parasite Toxoplasma gondii. It can cause behavioral changes and many cases of reactivation are associated with AIDS. Major cases are asymptomatic but acute phase symptoms can include lymphadenopathy. Congenital infection can cause complications in fetuses and infants. Prevention requires not consuming undercooked meat or untreated water and educating pregnant women.

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0% found this document useful (0 votes)
53 views

Journal Jya 4

This document discusses human toxoplasmosis caused by the parasite Toxoplasma gondii. It can cause behavioral changes and many cases of reactivation are associated with AIDS. Major cases are asymptomatic but acute phase symptoms can include lymphadenopathy. Congenital infection can cause complications in fetuses and infants. Prevention requires not consuming undercooked meat or untreated water and educating pregnant women.

Uploaded by

gythrie
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Research Journal of Infectious Diseases

ISSN 2052-5958

Review

Open Access

Relevant aspects of human toxoplasmosis


Katia Denise S Bresciani1*, Andr Luiz B Galvo2, Amanda L de Vasconcellos2, Jos Antonio Soares3, Lucas Vinicius Shigaki de
Matos2, Julia Cestari Pierucci2, Luiz da Silveira Neto2, Tercilia Oliveira Rodrigues1, Italmar Teodorico Navarro4, Jancarlo Ferreira
Gomes5 and Alvimar J da Costa2
*Correspondence: bresciani@fmva.unesp.br

These authors contributed equally to this work.


1
UNESP, Universidade Estadual Paulista Julio de Mesquita Filho, Faculdade de Medicina Veterinria de Araatuba, Araatuba, So
Paulo, Brazil.
2
UNESP, Universidade Estadual Paulista Julio de Mesquita Filho, Faculdade de Cincias Agrrias e Veterinrias, UNESP, Jaboticabal,
So Paulo, Brazil.
3
FKB, Fundao Karnig Bazarian, Faculdades Integradas de Itapetininga, Itapetininga, So Paulo, Brazil.
4
UEL, Universidade Estadual de Londrina, Centro de Cincias Biolgicas, Londrina, Paran, Brazil.
5
UNICAMP, Universidade Estadual de Campinas, Institutos de Biologia e Computao, Campinas, So Paulo, Brazil.

Abstract

Considering the great importance that the infection by Toxoplasma gondii has in public health, the aim of this article was
to demonstrate some aspects about this disease in human being. This parasite can cause several behavioral changes and
many cases of reactivation of this disease are associated with Acquired Immunodeficiency Syndrome AIDS. Major
cases of human infections by T. gondii are assymptomatic and the main clinical manifestation in the acute phase of this
zoonosis is lymphadenopathy, usually in the cervical area. There may also be fever, night sweats, myalgia, maculopapular
rash lymphocytic atypia and chorioretinitis. The congenital and/or acquired chronic latent cerebral toxoplasmosis play an
important role in the development of some types of neurodegeneration, like Alzheimer disease and Down Syndrome. Humans
and animals should not consume raw or undercooked meat, unpasteurized or not boiled dairy products, water without
being treated and poorly washed fruits and vegetables. Educational programs focused on reducing T. gondii environmental
contamination are essential for the congenital infection control. Due to the severity of this kind of infection and its sequel,
it is critical that those responsible for the communitys health establish prevention programs to avoid such a situation,
obtaining results in the medium and long term, and particularly preserving the involved populations welfare. A lack or
incomplete prenatal treatment was identified as an important risk factor for congenital toxoplasmosis, reinforcing the need
of improvement of prenatal care. In this study was demonstrated the importance of implementing prevention programs to
guide pregnant women to prevent the infection. Preventive measures like information and health education; screening of
pregnant women and infants; limiting harm from risk behaviour; treatment of risk cases and vaccination are recommended.
Serum monitoring throughout pregnancy, so as detect cases of maternal seroconversion allowing for early maternal treatment
is also basic. Some countries have adopted control programs of human toxoplasmosis, however, this issue should be of world
attention, considering its relevant aspects of public health, requiring the establishment of community education campaigns
and monitoring of pregnant women in the pre and neonatal, especially in a preventive action to reduce the pathogenic effects
of this disease.
Keywords: Toxoplasma gondii, public health, parasitic control, congenital infection

Introduction

Toxoplasma gondii has great importance in public health.


Women in initial stages of gestation may undergo miscarriage,
premature birth, neonatal death and even the classical Sabins
Triad, characterized by retinochoroiditis, cerebral calcifications,
hydrocephaly or microcephaly [1,2].
This parasite can cause behavioral changes [3] and during
pregnancy cases of antenatal depression and anxiety have
been related [4-7].
Many cases of reactivation of this disease are associated
with Acquired Immunodeficiency Syndrome - AIDS, including
pregnant women [8], especially with brain abscess manifestation
[9-11].
Educational programs focused on reducing T. gondii environ-

mental contamination are essential for the congenital infection


control [7,12,13].

Human toxoplasmosis

Major cases of human infections by T. gondii are assymptomatic


and the main clinical manifestation in the acute phase of this
zoonosis is lymphadenopathy, usually in the cervical area. There
may also be fever, night sweats, myalgia, maculopapular rash
lymphocytic atypia [14] and also chorioretinitis [11].
In primary infection of immunocompetent patients,
microgranulomas with no necrosis of giant cells, in cases of
cervical lymphadenopathy, can be observed.
In hosts with immune deficiency, neonates and the ones
infected by the protozoan during intrauterine life, the findings

2013 Bresciani et al; licensee Herbert Publications Ltd. This is an Open Access article distributed under the terms of Creative Commons Attribution License
(http://creativecommons.org/licenses/by/3.0). This permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Bresciani et al. Research Journal of Infectious Diseases 2013,


http://www.hoajonline.com/journals/pdf/2052-5958-1-7.pdf

may include necrotizing meningoencephalitis and systemic


aggravation. Lymphadenopathy-type Piringer Kuchinka and
encephalitis were particularly evident [15].
The continued T. gondii tachyzoites proliferation and
tissue destruction can occur in fetal brain even when there
is a marked maternal immune response including maternal
IgG [16].
Patients with autism spectrum disorders (ASD) and with
chronic toxoplasmosis have persistent neuroinflammation,
hypercytokinemia with hypermetabolism associated with
enhanced lipid peroxidation, and extreme changes in the
weight resulting in obesity [17].
The congenital and/or acquired chronic latent cerebral
toxoplasmosis play an important role in the development
of some types of neurodegeneration, like Alzheimer disease
and Down Syndrome [18].
The intermediate hosts, humans and animals, can acquire
the disease by eating raw or undercooked meat, infected with
tissue cysts, as well by the consumption of raw vegetables
and water contaminated with oocysts [19]. Tachyzoites of T.
gondii can be acquired by consuming unpasteurized milk, eggs,
blood transfusion, semen, organ transplantation, laboratory
accidents with biological material and by transplacental via
[14,19-24].
In its cycle, the protozoan shows two evolutionary forms
in the intermediate host: tachyzoites, structures of rapid
multiplication present in organic fluids in the acute phase, and
bradyzoites, confined in tissue cysts, especially in the central
nervous system and muscles, in the chronic infection. Oocysts,
the final product of sexual reproduction, are formed only in
the digestive tract of felids, definitive hosts that shed the
oocysts with their feces, where by means of sporogony they
become infective and extremely resistant to environmental
conditions [19,25-27].
The cats are probably the main sources of environmental
contamination, because, when infected, they release large
quantities of oocysts, allowing the continuity of the parasite
biological cycle [23]. Our research group noticed that T. gondii
oocysts are widely distributed on the soil of elementary
public schools in our region, likely constituting the main
contamination source for these children [12]. It was observed
that cat owners in a cohort of middle-aged UK women do
not have an increased risk of brain cancer, when compared
with non-cat owners [28].
Cases of enhanced maternal-fetal transmission of T.
gondii infection of HIV-infected women chronically infected
were described, which may have important public health
consequences, considering the increasing frequency of HIVinfection observed among human being around the world [8].
The prevalence of 3599 samples of the National Health
Survey 2000 (NHS-2000) and 2916 of the National Health and
Nutrition Survey 2006 (NHNS-2006) serum banks, obtained
from 198 year old subjects of both genders and all states
of Mexico was studied. Anti-T. gondii IgG antibodies were

doi: 10.7243/2052-5958-1-7

determined by ELISA and confirmed by western blot. National


crude prevalence was 60.1% and 62.6% for NHS-2000 and
NHNS-2006, respectively [29].
All soldiers before being deployed in jungle operations
should be tested for T. gondii antibodies and to receive
adequate health information about the routine use of
personnel filters to purify their water for consumption [13].
The tachyzoite, reaches the fetus by transplacental via,
causing different levels of damage severity, depending on
the virulence and/or lineage, on the strain of the mothers
immune response capacity and on the gestational period that
the woman presents, that can result, even, in fetal death or
severe clinical manifestations. Toxoplasmosis may manifest
months or even years later in children born with this parasitosis
and in these cases the most common manifestations are
retinocorioidite, cerebral calcifications, neuropathies and
microcephaly [4].
Studies demonstrated that chorioretinitis affected 18.9%
of children suffering from congenital toxoplasmosis despite
antenatal and neonatal screening associated with early
treatment. Long-standing follow-up is needed because the
first lesion can occur as late as 12 years after birth. Late lesions
were less often macular but nevertheless caused sometimes
visual impairment [6].
The demonstration of the occurrence of human
toxoplasmosis associated to the milk ingestion from proven
infected goats, is particularly important in rural and periurban areas where these animals are raised for the purpose
of production of milk for domestic consumption [30].
Contamination of municipal water reservoirs with a
significant amount of T. gondii oocysts can lead to epidemics,
as recorded in Canada, in 1995, or trigger outbreaks like the
one reported in 2001, in Santa Isabel do Iva, Paran State,
Brazil [31,32,33].

Control of human toxoplasmosis

Humans and animals should not consume raw or undercooked


meat, unpasteurized or not boiled dairy products, water
without being treated and poorly washed fruits and
vegetables [34]. Meat products from ovine and swine are
more contaminated with this parasite cysts, and these are
rarely found in bovine [9,14].
Monitoring of Toxoplasma infection in animals destined
for human consumption is a great challenge for human
toxoplasmosis prevention. In Spain, some people eat
horse meat and it was observed that many horses from
various regions of the country are serologically positive for
toxoplasmosis [35]. It was showed the impossibility of any
serological test asserting the absence of T. gondii in meat
and guarantee that undercooked lamb can be consumed
without risk for people [36,37].
As daily routine, the cleaning of catteries, with fecal
material removal is indicated, since, in dependence on the
environmental conditions, the T. gondii oocysts eliminated

Bresciani et al. Research Journal of Infectious Diseases 2013,


http://www.hoajonline.com/journals/pdf/2052-5958-1-7.pdf

by cats require at least 24 hours to sporulate and become


infectious. It is also important to cover or encircle sand tanks
for children recreation, especially when they are not in use,
to prevent the cats access [12,33].
Dishes and utensils should be washed with hot water after
contact with unwashed fruits, vegetables, unpasteurized
milk and seafood. Pregnant women and immunosuppressed
individuals need to wear gloves to get contact with the soil
or dumps, avoiding possible touches in cat feces [34].
A lack or incomplete prenatal treatment was identified
as an important risk factor for congenital toxoplasmosis,
reinforcing the need of improvement of prenatal care in Brazil
[5]. A 2009 survey in the United States showed that 87.7%
counsel patients about how to prevent toxoplasmosis [38].
In our studies, were interviewed 85 teachers about
toxoplasmosis and 67.06% (57/85) did not know about this
issue. Interviews were made with 30 teachers of 18 educators
from local elementary schools in Brazil and 28.33% did not
know anything about the topic [32]. One hundred and thirty
four elderly people, from the institutions, were interviewed
and 86.57% (116/134) were ignorant of the dissemination
ways [39]. There is a need of implanting programs of control
against human toxoplasmosis[39-43].
Its important to reinforce the importance of sanitation
control in industrial restaurants and also demonstrate the
need for improvement in quality control regarding vegetables
at risk for T. gondii oocyst contamination [44].
Strategies to work on muscle fluids offers a great potential
for toxoplasmosis studies on farm animals, especially for large
scale control studies. We cannot yet offer any serological test
asserting the absence of Toxoplasma in meat and offering the
guarantee that undercooked lamb can be consumed without
posing an unacceptable risk for people at risk and freezing
the meat remains necessary [36,37].
Prenatal screening is performed in Austria, France and
Slovenia and neonatal screening in the New England states of
the USA, parts of Brazil, Denmark and Ireland, but on-demand
examination for T. gondii antibodies are widely practiced in
many European countries [45].
Since 1975, in Austria, serological monitoring of pregnant
negative women until the third month of pregnancy
it is mandatory , and for suspected cases, treatment is
performed until four months of pregnancy with spiramycin
and piimetamina associated with sulfadiazine after three
months and three weeks [45,46].
In France, since 1978, T. gondii tests were established in
seronegative women. However, control measures are not
standardized in this country, and so there are divergence
between treatment protocols and diagnostic interpretation
of infection [47].
In some American states, only serological monitoring of
newborns for Toxoplasma IgM has been preconized, without
prenatal intervention [48]. The Guidelines for Prevention and
Treatment of Opportunistic Infections in HIV-Infected Adults

doi: 10.7243/2052-5958-1-7

and Adolescents, produced by Centers for Disease Control and


Prevention, National Institutes of Health, and HIV Medicine
Association of the Infectious Diseases Society of America,
contains detailed recommendation [49,50].
Considering the high prevalence of HIV infection in
the Kyrgyz Republic, personalized medical orientation as
well as treatment and prevention of T. gondii infection are
recommended, with special attention to health education for
those with lower economic and social status and less access
to information [51].
In Spain, due to the low incidence of toxoplasmosis
in pregnant women, there is no proper disease control
recommendation from health authorities, however, detailed
control program has been preconized by the Spanish Society
of Pediatric Infectious Diseases for the diagnosis and treatment
of congenital toxoplasmosis [52].
Early detection with repeated sorological examination
and the treatment of pregnant women can reduce the risk
of infection by T. gondii as observed in India [53].
Pregnant women in Al Hasas, Saudi Arabia, are substantially
vulnerable to toxoplasmosis infection because have no
sufficient knowledge for primary prevention of congenital
toxoplasmosis [54].
The most commonly therapy is the combination of
pyrimethamine and sulfadiazine and folinic acid [55]. In
Germany, spiramycin is given until the 16th week of pregnancy,
followed by at least 4 weeks of combination therapy with
pyrimethamine, sulfadiazine, and folinic acid independent of
the infection stage of the fetus and this treatment program was
efficient in mimimize transplacentary parasitic transmission
[56].
As future perspectives, vaccines development studies
against T. gondii have demonstrated that heterologous DNA
priming and recombinant adenovirus boost strategy may
provide protective immunity against T. gondii infection [57]
and multiantigenic DNA antigen pGRA7-ROP1 was more
effective in stimulating host protective immune responses
than separately injected single antigens, and that IL-12 serves
as a good DNA adjuvant [58].
It was possible to show the importance of implementing
prevention programs to guide pregnant women to prevent
the infection. Preventive measures like information and
health education; screening of pregnant women and infants;
limiting harm from risk behaviour; treatment of risk cases
and vaccination are recommended [38]. Serum monitoring
throughout pregnancy, so as detect cases of maternal
seroconversion allowing for early maternal treatment is also
basic [7,10].

Conclusions

Some countries have adopted control programs of human


toxoplasmosis, however, this issue should be of world attention,
considering its relevant aspects of public health, requiring
the establishment of community education campaigns and

Bresciani et al. Research Journal of Infectious Diseases 2013,


http://www.hoajonline.com/journals/pdf/2052-5958-1-7.pdf

doi: 10.7243/2052-5958-1-7

monitoring of pregnant women in the pre and neonatal,


especially in a preventive action to reduce the pathogenic
effects of this disease.
List of abbreviations

AIDS: Acquired Immunodeficiency Syndrome


T. gondii: Toxoplama gondii
HIV: Human Immunodeficiency virus

Competing interests

The authors declare that they have no competing interests.

Authors contributions
Authors
contributions

KDSB

ALBG

ALV

LVSM

JCP

JAS

JFG

AJC

Research concept and design

--

--

--

--

--

Collection and/
or assembly of
data

Data analysis and


interpretation

Writing the
article

Critical revision
of the article

--

--

--

--

--

Final approval of
article

--

--

--

--

--

--

--

--

Statistical
analysis

--

--

--

--

--

--

--

--

Acknowledgement and funding

To FAPESP for the financial support for this publication.

Publication history

EIC: Ishtiaq Qadri, King Abdul Aziz, University, Jeddah, Saudi Arabia.
Editor: Claudio A. Pereira, University of Buenos Aires, Argentina.
Received: 12-Jun-2013 Revised: 20-Aug-2013
Accepted: 02-Sep-2013 Published: 19-Sep-2013

Reference
1. Jones JL, Kruszon-Moran D, Wilson M, McQuillan G, Navin T and McAuley
JB. Toxoplasma gondii infection in the United States: seroprevalence
and risk factors. Am J Epidemiol. 2001; 154:357-65. | Article | PubMed
2. Soares JAS, Nsser LS, Carvalho, SFG, Caldeira, AP. Achados oculares em
crianas com toxoplasmose congnita. Arq Bras Oftalmol. 2011; 74:2557. | Article
3. Lafferty KD. Look what the cat dragged in: do parasites contribute to
human cultural diversity? Behav Processes. 2005; 68:279-82. | Article |
PubMed
4. Groer MW, Yolken RH, Xiao JC, Beckstead JW, Fuchs D, Mohapatra
SS, Seyfang A and Postolache TT. Prenatal depression and anxiety in
Toxoplasma gondii-positive women. Am J Obstet Gynecol. 2011; 204:433
e1-7. | Article | PubMed Abstract | PubMed FullText
5. Campello Porto L and Duarte EC. Association between the risk of
congenital toxoplasmosis and the classification of toxoplasmosis in
pregnant women and prenatal treatment in Brazil, 1994-2009. Int J
Infect Dis. 2012; 16:e480-6. | Article | PubMed
6. Faucher B, Garcia-Meric P, Franck J, Minodier P, Francois P, Gonnet S,
LOllivier C and Piarroux R. Long-term ocular outcome in congenital
toxoplasmosis: a prospective cohort of treated children. J Infect. 2012;
64:104-9. | Article | PubMed
7. Lopes-Mori FM, Mitsuka-Bregano R, Bittencourt LH, Dias RC, Goncalves
DD, Capobiango JD, Reiche EM, Morimoto HK, Freire RL and Navarro IT.
Gestational toxoplasmosis in Parana State, Brazil: prevalence of IgG

antibodies and associated risk factors. Braz J Infect Dis. 2013; 17:405-9.
| Article | PubMed
8. Fernandes MA, Batista GI, Carlos Jda C, Gomes IM, Azevedo KM, Setubal
S, Oliveira SA, Velarde LG and Cardoso CA. Toxoplasma gondii antibody
profile in HIV-1-infected and uninfected pregnant women and the
impact on congenital toxoplasmosis diagnosis in Rio de Janeiro, Brazil.
Braz J Infect Dis. 2012; 16:170-1174. | Article | PubMed
9. Dubey JP, Lago EG, Gennari SM, Su C and Jones JL. Toxoplasmosis in
humans and animals in Brazil: high prevalence, high burden of disease,
and epidemiology. Parasitology. 2012; 139:1375-424. | Article |
PubMed
10. Fernandes MA, Batista GI, Carlos Jda C, Gomes IM, Azevedo KM, Setubal
S, Oliveira SA, Velarde LG and Cardoso CA. Toxoplasma gondii antibody
profile in HIV-1-infected and uninfected pregnant women and the
impact on congenital toxoplasmosis diagnosis in Rio de Janeiro, Brazil.
Braz J Infect Dis. 2012; 16:170-1174. | Article | PubMed
11. Hermida Perez JA, Hernandez AB and Gutierrez RS. Manifestaciones
oftalmolgicas de la infeccin por toxoplasma en paciente portador
del virus de la inmunodeficiencia humana. Descripcin de un caso.
Medicina de Famlia SEMERGEN. 2013; (in press). | Article
12. dos Santos TR, Nunes CM, Luvizotto MC, de Moura AB, Lopes WD, da
Costa AJ and Bresciani KD. Detection of Toxoplasma gondii oocysts
in environmental samples from public schools. Vet Parasitol. 2010;
171:53-7. | Article | PubMed
13. Gomez-Marin JE, de-la-Torre A, Barrios P, Cardona N, Alvarez C and
Herrera C. Toxoplasmosis in military personnel involved in jungle
operations. Acta Trop. 2012; 122:46-51. | Article | PubMed
14. Bonametti AM, Passos JN, Silva EMK and Bortoliero AL. Surto de
Toxoplasmose aguda transmitida atravs da ingesto de carne crua de
gado ovino. Rev Soc Bras Med Trop. 1997; 30:21-5. | Article |
15. Perna C, Rodrigues-Figueira Y, Morales C, Rodrguez J I, Hardisson D and
Viguer JM. Revisin de casos con diagnstico de toxoplasmosis en el
Hospital La Paz de Madrid (1967-2010). Rev Esp Patol. 2012; 45:5-13. |
Article
16. Ferguson DJ, Bowker C, Jeffery KJ, Chamberlain P and Squier W.
Congenital toxoplasmosis: continued parasite proliferation in the fetal
brain despite maternal immunological control in other tissues. Clin
Infect Dis. 2013; 56:204-8. | Article | PubMed
17. Prandota J. Autism spectrum disorders may be due to cerebral
toxoplasmosis associated with chronic neuroinflammation causing
persistent hypercytokinemia that resulted in an increased lipid
peroxidation, oxidative stress, and depressed metabolism of
endogenous and exogenous substances. Res. Autismo Spectrum
Disorders. 2010; 5:119-155. | Article
18. Prandota J. Metabolic immune, epigenetic, endocrine and phenotypic
abnormalities found in individuals with autism spectrum disorders,
Down Syndrome and Alzheimer Disease may be caused by congenital
and/or acquired chronic cerebral toxoplasmosis. Res. Autismo Spectrum
Disorders. 2011; 5:14-59. | Article
19. Garcia LC. Toxoplasma gondii. In A.S.M. Press, Diagnosis Medical
Parasitology. 2007; 562-63. | Book
20. Dubey JP. Toxoplasmosis. J Am Vet Med Assoc. 1986; 189:166-70. |
PubMed
21. Dubey JP, Greene CE, Lappin MR. Toxoplasmosis and Neosporosis. In
Greene CE, Infectious diseases of the dog and cat. 1990; 818-34. | Book
22. Dubey JP. Toxoplasmosis. JAAMA. 1994; 205:1593-98. | Website
23. Tenter AM, Heckeroth AR and Weiss LM. Toxoplasma gondii: from
animals to humans. Int J Parasitol. 2000; 30:1217-58. | Article |
PubMed Abstract | PubMed FullText
24. Powell CC, Brewer M and Lappin MR. Detection of Toxoplasma gondii in
the milk of experimentally infected lactating cats. Vet Parasitol. 2001;
102:29-33. | Article | PubMed
25. Kawazoe U. Toxoplasma gondii. In Neves DP, Parasitologia Humana.
2002; 147-56.
26. Miller NL, Frenkel JK and Dubey JP. Oral infections with Toxoplasma
cysts and oocysts in felines, other mammals, and in birds. J Parasitol.
1972; 58:928-37. | Article | PubMed

Bresciani et al. Research Journal of Infectious Diseases 2013,


http://www.hoajonline.com/journals/pdf/2052-5958-1-7.pdf
27. Dubey JP. Toxoplasmosis and neosporosis. In Greene CE, Infectious
diseases of the dog and cat. 1998; 493-03.
28. Benson VS, Green J and Beral V. The relationship between owning a cat
and the risk of developing a brain cancer in a prospective study of UK
women: comment on Thomas et al. Biol Lett. 2012; 8:1040-1; author
reply 1042. | Article | PubMed
29. Caballero-Ortega H, Uribe-Salas FJ, Conde-Glez CJ, Cedillo-Pelaez C,
Vargas-Villavicencio JA, Luna-Pasten H, Canedo-Solares I, Ortiz-Alegria
LB and Correa D. Seroprevalence and national distribution of human
toxoplasmosis in Mexico: analysis of the 2000 and 2006 National Health
Surveys. Trans R Soc Trop Med Hyg. 2012; 106:653-9. | Article | PubMed
30. Chiari CA and Neves DP. Toxoplasmose humana adquirida atravs da
ingesto de leite de cabra. Mem Inst Oswaldo Cruz 1984; (79) 337-40.
31. Bowie WR, King AS, Werker DH, Isaac-Renton JL, Bell A, Eng SB and
Marion SA. Outbreak of toxoplasmosis associated with municipal
drinking water. The BC Toxoplasma Investigation Team. Lancet. 1997;
350:173-7. | Article | PubMed
32. Fundao Nacional de Sade-FUNASA. Boletim Eletrnico
Epidemiolgico 2003. | Website
33. Almeida MJ, Oliveira, LHH, Freire, RL and Navarro, RT. Aspectos
sociopolticos da epidemiologia de toxoplasmose em Santa Isabel do
Iva (PR). Cinc Sade Coletiva. 2011; 16:1363-73. | Pdf
34. Monteiro SG. In Editora Roca, Parasitologia na Medicina Veterinria
2010; 370p.
35. Garcia-Bocanegra I, Cabezon O, Arenas-Montes A, Carbonero A, Dubey
JP, Perea A and Almeria S. Seroprevalence of Toxoplasma gondii in
equids from Southern Spain. Parasitol Int. 2012; 61:421-4. | Article |
PubMed
36. Villena I, Durand B, Aubert D, Blaga R, Geers R, Thomas M, Perret C,
Alliot A, Escotte-Binet S, Thebault A, Boireau P and Halos L. New strategy
for the survey of Toxoplasma gondii in meat for human consumption.
Vet Parasitol. 2012; 183:203-8. | Article | PubMed
37. Jones JL and Dubey JP. Foodborne toxoplasmosis. Clin Infect Dis. 2012;
55:845-51. | Article | PubMed
38. Ross DS, Rasmussen SA, Cannon MJ, Anderson B, Kilker K, Tumpey
A, Schulkin J and Jones JL. Obstetrician/gynecologists knowledge,
attitudes, and practices regarding prevention of infections in
pregnancy. J Womens Health (Larchmt). 2009; 18:1187-93. | Article |
PubMed.
39. Crdia DFF, Amarante AFT and Bresciani KDS. Ponto de vista de
professoras de escolas municipais do ensino fundamental de Araatuba
(SP) sobre as parasitoses. Rev Cin Exten. 2007; 3:43-55. | Article
40. Lima FF, Koivisto MB, Perri SHV and Bresciani KDS. O conhecimento
de idosos sobre parasitoses em instituies no governamentais do
Municpio de Araatuba- SP. Rev Cin Exten. 2008; 4:77-85. | Article
41. Tom RO, Serrano ACM, Nunes CM, Perri SHV and Bresciani KDS.
Inqurito epidemiolgico sobre conceitos de zoonoses parasitrias para
professores de escolas municipais do ensino infantil de Araatuba-SP.
Rev Cin Exten. 2005; 2:1-11. | Article
42. Bresciani KDS, Galvo ALB, Vasconcellos AL, Silveira Neto L, Incio SV,
Soares JA, Gomes JF, Santos TR, Santos, RR. In Nova Publishers, New
York. Toxoplasmosis in public health. Toxoplasma gondii: Prevalence
in Humans and Animals, Genetic Structure and Role in Disease
Distribution 2013a (in press).
43. Bresciani KDS, Cardia DFF, Camossi LG, Galvo ALB, Vasconcellos AL,
Santos RR, Santos TR and Soares, JA. Need for a continuing education
program for toxoplasmosis control. Educ J. 2013; 2:114-118. | Pdf
44. Ekman CC, Chiossi MF, Meireles LR, Andrade Junior HF, Figueiredo WM,
Marciano MA and Luna EJ. Case-control study of an outbreak of acute
toxoplasmosis in an industrial plant in the state of Sao Paulo, Brazil. Rev
Inst Med Trop Sao Paulo. 2012; 54:239-44. | Article | PubMed
45. Eskild Petersen. Toxoplasmosis. Seminars in Fetal & Neonatal Medicine.
2007; 12:214-223. | Article
46. Aspock H. Prevention of congenital toxoplasmosis in Austria. Arch
Pediatr. 2003; 10 Suppl 1:16-7. | PubMed
47. Rilling V, Dietz K, Krczal D, Knotek F and Enders G. Evaluation of a

doi: 10.7243/2052-5958-1-7
commercial IgG/IgM Western blot assay for early postnatal diagnosis of
congenital toxoplasmosis. Eur J Clin Microbiol Infect Dis. 2003; 22:17480. | PubMed
48. Centers for Disease Control and Prevention. Preventing congenital
toxoplasmosis. MMWR Recomm Rep. 2000; 49:5775. | Website
49. Guidelines for Prevention and Treatment of Opportunistic Infections in
HIV-Infected Adults and Adolescents. Recommendations from CDC, the
National Institutes of Health, and the HIV Medicine Association of the
Infectious Diseases Society of America. 2009; 58(RR04)1-198. | Website
50. Jones JL and Roberts JM. Toxoplasmosis hospitalizations in the United
States, 2008, and trends, 1993-2008. Clin Infect Dis. 2012; 54:e58-61. |
Article | PubMed
51. Minbaeva G, Schweiger A, Bodosheva A, Kuttubaev O, Hehl AB, Tanner
I, Ziadinov I, Torgerson PR and Deplazes P. Toxoplasma gondii infection
in Kyrgyzstan: seroprevalence, risk factor analysis, and estimate of
congenital and AIDS-related toxoplasmosis. PLoS Negl Trop Dis. 2013;
7:e2043. | Article | PubMed Abstract | PubMed FullText
52. Baquero-Artigao F, Martn FC, Fuentes Corripio I, Gonc Mellgren A,
Fortuny Guasch C, Fernndez-Miranda MC, Gonzlez-Tom MI, Gianzo
JAC, Neth O and Ramos Amador, JT. Gua de la Sociedad Espanola
de Infectologa Peditrica para el diagnstico y tratamiento de la
toxoplasmosis congnita. An Pediatr, 2013. | Article | Website
53. Chintapalli S and Padmaja IJ. Seroprevalence of toxoplasmosis in
antenatal women with bad obstetric history. Trop Parasitol. 2013; 3:626. | Article | PubMed Abstract | PubMed FullText
54. Amin TT, Al Ali MN, Alrashid AA, Al-Agnam AA and Al Sultan AA.
Toxoplasmosis Preventive Behavior and Related Knowledge among
Saudi Pregnant Women: An Exploratory Study. Glob J Health Sci. 2013;
5:131-43. | Article | PubMed
55. Mittal V and Ichhpujani RL. Toxoplasmosis - An update. Trop Parasitol.
2011; 1:9-14. | PubMed Abstract | PubMed FullText
56. Hotop A, Hlobil H and Gross U. Efficacy of rapid treatment initiation
following primary Toxoplasma gondii infection during pregnancy. Clin
Infect Dis. 2012; 54:1545-52. | Article | PubMed
57. Yu L, Yamagishi J, Zhang S, Jin C, Aboge GO, Zhang H, Zhang G, Tanaka T,
Fujisaki K, Nishikawa Y and Xuan X. Protective effect of a prime-boost
strategy with plasmid DNA followed by recombinant adenovirus
expressing TgAMA1 as vaccines against Toxoplasma gondii infection in
mice. Parasitol Int. 2012; 61:481-6. | Article | PubMed
58. Quan JH, Chu JQ, Ismail HA, Zhou W, Jo EK, Cha GH and Lee YH.
Induction of protective immune responses by a multiantigenic DNA
vaccine encoding GRA7 and ROP1 of Toxoplasma gondii. Clin Vaccine
Immunol. 2012; 19:666-74. | Article | PubMed Abstract | PubMed
FullText

Citation:
Bresciani KDS, Galvo ALB, Vasconcellos ALd, Soares
JA, Matos LVSd, Pierucci JC, Neto LdS, Rodrigues TO,
Navarro IT, Gomes JF and Costa AJd. Relevant aspects
of human toxoplasmosis. Res J Infect Dis. 2013; 1:7.
http://dx.doi.org/10.7243/2052-5958-1-7

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