Case-control study of an outbreak of acute toxoplasmosis in an industrial plant in the state of São Paulo, Brazil / Estudo caso-controle de surto de toxoplasmose aguda em indústria no estado de São Paulo, Brasil
Rev. Inst. Med. Trop. Säo Paulo
; 54(5): 239-244, Sept.-Oct. 2012. ilus
Article
in English
| LILACS
| ID: lil-648557
Responsible library:
BR1.1
ABSTRACT
Foodborne diseases represent operational risks in industrial restaurants. We described an outbreak of nine clustered cases of acute illness resembling acute toxoplasmosis in an industrial plant with 2300 employees. These patients and another 36 similar asymptomatic employees were diagnosed with anti-T. gondii IgG titer and avidity by ELISA. We excluded 14 patients based on high IgG avidity and chronic toxoplasmosis 13 from controls and one from acute disease other than T. gondii infection. We also identified another three asymptomatic employees with T.gondii acute infection and also anti-T. gondii IgM positive as remaining acute cases. Case control study was conducted by interview in 11 acute infections and 20 negative controls. The ingestion of green vegetables, but not meat or water, was observed to be associated with the incidence of acute disease. These data 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. We emphasized the accurate diagnosis of indexed cases and the detection of asymptomatic infections to determine the extent of the toxoplasmosis outbreak.
RESUMO
Doenças transmitidas por alimentos representam riscos operacionais em restaurantes industriais. Descrevemos surto de nove casos agrupados de doença aguda semelhante à toxoplasmose em indústria de 2300 funcionários. Estes pacientes e outros 36 funcionários assintomáticos foram diagnosticados por ELISA para o título e avidez de IgG anti-T. gondii. Foram excluídos 14 pacientes com toxoplasmose crônica e alta avidez 13 de controles e um de doença aguda não relacionada à infecção por T. gondii. Também identificamos três empregados assintomáticos com infecção aguda por T.gondii, que como os restantes agudos apresentavam anti-T.gondii IgM ELISA positivo. Conduzimos estudo caso controle por entrevista em 11 infecções agudas e 20 controles negativos. A ingestão de vegetais, mas não de carne ou água, foi associada com a incidência da doença aguda. Esses dados reforçam a importância do controle sanitário em restaurantes industriais e também demonstram a necessidade de melhoria no controle de qualidade sobre vegetais em risco de contaminação por oocistos de T. gondii. Enfatizamos o diagnóstico preciso de casos e a detecção de infecções assintomáticas para determinar a extensão do surto de toxoplasmose.
Full text:
Available
Collection:
International databases
Health context:
Sustainable Health Agenda for the Americas
/
SDG3 - Health and Well-Being
/
Neglected Diseases
Health problem:
Goal 9: Noncommunicable diseases and mental health
/
Goal 10: Communicable diseases
/
Goal 8: Outbreaks, emergencies and disasters
/
Target 3.3: End transmission of communicable diseases
/
Target 3.9: Reduce the amount of deaths produced by dangerous chemicals and the pollution of the air, water and soil
/
Neglected Diseases
/
Zoonoses
Database:
LILACS
Main subject:
Restaurants
/
Toxoplasma
/
Immunoglobulin M
/
Antibodies, Protozoan
/
Toxoplasmosis
/
Disease Outbreaks
/
Industry
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Humans
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Rev. Inst. Med. Trop. Säo Paulo
Journal subject:
Tropical Medicine
Year:
2012
Document type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Universidade de São Paulo/BR