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

Toxoplasmosis is a reportable disease in Brazil. The objective of this study was to investigate a toxoplasmosis outbreak at a research institution in Londrina-PR, Brazil. The outbreak was reported in October 2015; however, the first cases occurred in August 2015. Blood samples were collected from 674 persons at the institution. Samples were collected from soil, water (water tank) and food (vegetables) served in the restaurant. Each participant responded to an epidemiological questionnaire. For the blood samples, a chemiluminescent microparticle immunoassay was performed to detect IgM, IgG and specific IgG avidity antibodies; 10.8% (73/674) had evidence of acute toxoplasmosis. Statistical analysis showed a significant association (p < .001) between acute infection and eating lunch in the restaurant of the institution. Regarding the types of food offered in the restaurant during the period, there was a significant association between consuming raw salad (p < .001) and becoming ill. We conclude that the vegetables or raw vegetables served in the restaurant were probably the source of infection; however, the long period between exposure and case reporting made it difficult to identify the source of transmission.

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

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.

Investigation and environmental analysis of samples from outbreak of toxoplasmosis at research institution in Londrina, Paraná, Brazil, 2016 / Investigação e análise ambiental de amostras oriundas de surto de toxoplasmose em uma instituição de pesquisa em Londrina, Paraná, Brasil, 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.

Resumo O objetivo deste estudo foi relatar um surto de toxoplasmose humana em uma instituição de pesquisa em Londrina, Paraná, no período de dezembro de 2015 a fevereiro de 2016. Amostras de sangue de 26 indivíduos sintomáticos foram coletadas e o imunoensaio de quimioluminescência de micropartículas foi realizado para detectar IgM, IgG e teste de avidez de IgG específica em laboratório oficial. Um total de 20 pessoas com sintomas e sorologia compatíveis com toxoplasmose aguda (IgM positiva e IgG com baixa avidez) foi selecionado como casos, enquanto 45 funcionários assintomáticos que trabalhavam nas mesmas equipes e durante os mesmos turnos foram utilizados como controles. Todos os participantes da investigação responderam a um questionário epidemiológico. Foram coletadas três amostras de água e uma de lodo das cisternas de abastecimento da instituição, 10 de solo, 11 de vegetais, três amostras de fezes de gato e um cadáver de filhote felino doméstico para detecção de T. gondii pela reação em cadeia da polimerase (PCR). Após análise dos dados epidemiológicos, o consumo de hortaliças no restaurante da instituição foi a única variável associada à ocorrência da doença. Em resultados laboratoriais, todas as amostras apresentaram resultados negativos a PCR. O rápido reconhecimento do surto, notificação e investigação prematura poderia ter quebrado a cadeia de transmissão, evitando assim o surgimento de novos casos. Além disso, a adoção de boas práticas de manipulação de alimentos poderia ter impedido a ocorrência do surto.

[Gestational and congenital toxoplasmosis: a practical approach to disease notification]. / Toxoplasmose adquirida na gestação e toxoplasmose congênita: uma abordagem prática na notificação da doença.

OBJECTIVE: to demonstrate the experience of implanting toxoplasmosis notification during pregnancy and congenital toxoplasmosis in a Sentinel Unit (SU) and describe reported cases. METHODS: this was a descriptive study of the implantation of a notification protocol using a specific notification form for suspected cases of toxoplasmosis in pregnant women and congenital toxoplasmosis in a reference center in Paraná State, Brazil, from August 2013 to August 2014. RESULTS: all 64 suspected cases were notified and case investigation was completed by the SU Epidemiology Sector; 63 received prenatal care and 51 received treatment during pregnancy; 7 of the children being clinically monitored had confirmed diagnosis of congenital toxoplasmosis. CONCLUSION: implanting toxoplasmosis notification afforded epidemiological, clinical and diagnostic data on the disease that contributed to the assessment of the clinical evolution of children exposed to Toxoplasma gondii.