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Biological Health Hazard – Toxoplasmosis Outbreak: Warta District, Brazil

2016/03/07

TOXOPLASMOSIS – BRAZIL: (PARANA)
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Published Date: 2016-03-07 11:25:33
Subject: PRO/AH/EDR> Toxoplasmosis – Brazil: (PR)
Archive Number: 20160307.4074495

Date: Fri 4 Mar 2016
Source: Folha de Londrina [in Portuguese, trans. Mod.JW, edited]

According to epidemiological surveillance, 20 cases of toxoplasmosis were confirmed in the Londrina unit of the Brazilian Agricultural Research Corporation (Embrapa).

Five months after identifying an outbreak of toxoplasmosis on the premises of the Agronomic Institute of Parana (Iapar), in the south of Londrina, the Department of Epidemiological Surveillance of the Municipal Health Department, yesterday [3 Mar 2016] confirmed another outbreak, this time in the unit of the Brazilian Agricultural Research Corporation (Embrapa), located in the district of Warta [Londrina], in the north.

According to the manager of Epidemiological Surveillance Londrina, Rosangela Libaroni, 73 people showed symptoms of the disease transmitted by the feces of cats between the end of last year [2015] and the end of January [2016]. The tests confirmed 20 cases of acute toxoplasmosis and dismissed another 10. The rest of the cases still under investigation await official reports; 3 patients presented symptoms, but were not infected.

The task force set up to try to identify the source of contamination has a partnership with the State University of Londrina (UEL). The head of the Department of Preventive Veterinary Medicine UEL, Italmar Navarro, said the research is in the analysis phase, but said that contamination through water was discarded. He also recalled that there was no conclusion, after a series of laboratory tests, about the focus of contamination that caused the outbreak in Iapar late last year [2015].

Yesterday afternoon [3 Mar 2016], the drinking fountains of Embrapa, which had been sealed were reactivated, but the cafeteria remains closed. Rosangela Libaroni reported that all the people who have been infected will be questioned to see if they had eaten at the local cafeteria. “If it is not the water, suspicion falls on the food. We have to know the origin of this food, because of the risk of an outbreak elsewhere in the city,” she said.

The press office reported that since the beginning of the outbreak, when dengue was suspected, Embrapa is collaborating with the epidemiological surveillance investigations, following all protocols and observing precautionary measures. According to Embrapa, all [affected] people are doing well, and with the release of water [from suspicion], the unit resumed normal routine.

In October last year [2015], 93 people were infected by the disease in Iapar headquarters. At the time, more than 800 people were subjected to tests. Even after the health authorities discarded water as the cause of the outbreak in Iapar, a spout that supplied water to the population was closed.

[Byline: Celso Felizardo]

Communicated by:
ProMED-mail
<promed@promedmail.org>

[It is probably not a coincidence that 2 veterinary institutions experience outbreaks of toxoplasmosis among their employees, and both discard water transmission. Water transmission of toxoplasmosis has been reported previously several times from Brazil (see ProMED-mail postings listed below).

However, if the premises are contaminated with _Toxoplasma_ oocysts from roaming cats, the staff can be contaminated by either eating in the facilities and the food being contaminated by oocysts containing dust, or by inhaling and swallowing dust contaminated with oocysts.

These 2 possibilities were the only possible explanations for an outbreak reported in a horse stable in Georgia, USA in 1979 (Teutsch SM, Juranek DD, Sulzer A, et al: Epidemic toxoplasmosis associated with infected cats. N Engl J Med. 1979; 300(13): 695-9; abstract available at http://www.ncbi.nlm.nih.gov/pubmed/763300.

It would be interesting to know if cats are roaming freely in the Embrapa and Iapar facilities and analyze environmental samples for _Toxoplasma_ oocysts. – Mod.EP

Maps of Brazil can be seen at http://s13.postimg.org/jumnalk87/map_of_Brazil.gif and http://healthmap.org/promed/p/9511. – Sr.Tech.Ed.MJ]

See Also

2015
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Toxoplasmosis – Brazil: (PR) waterborne susp 20151107.3773850
2013
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Toxoplasmosis – Brazil (03): (PA) 20130714.1823961
Toxoplasmosis – Brazil (02): (PA) comment 20130701.1801078
Toxoplasmosis – Brazil: (PA) 20130629.1799160
2011
—-
Toxoplasmosis – Brazil (02): (MT) background 20111007.3017
Toxoplasmosis – Brazil: (MT) 20111006.3006
2002
—-
Toxoplasmosis – Brazil (Parana) (02) 20020115.3264
Toxoplasmosis – Brazil (Parana) 20020112.3237
………………………………………….jw/ep/mj/ml

Source:
A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases


Related Information

Parasites — Toxoplasmosis (toxoplasma infection). Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/toxoplasmosis/.

Centers for Disease Control and Prevention, et al. Diagnosis and management of foodborne illnesses: A primer for physicians and other health care professionals. MMWR Recommendations and Reports. 2004;53:1. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5304a1.htm.

Guerina NG, et al. Congenital toxoplasmosis: Clinical features and diagnosis. http://www.uptodate.com/home.

Guerina NG, et al. Congenital toxoplasmosis: Treatment, outcome and prevention. http://www.uptodate.com/home.

Park Y-H, et al. Clinical features and treatment of ocular toxoplasmosis. Korean Journal of Parasitology. 2013;51:393.

Gilbert R, et al. Toxoplasmosis and pregnancy. http://www.uptodate.com/home.

Toxoplasmosis: Pregnant women. Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/toxoplasmosis/gen_info/pregnant.html.

Heller HM. Toxoplasmosis in HIV infected patients. http://www.cdc.gov/parasites/toxoplasmosis/gen_info/pregnant.html.

 

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