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. 1986 Sep 15;135(6):618–623.

Congenital toxoplasmosis: epidemiologic features and control.

A O Carter, J W Frank
PMCID: PMC1491297  PMID: 3756692

Abstract

Toxoplasmosis is caused by the parasite Toxoplasma gondii. It is acquired from undercooked meat or from food or fomites contaminated by cat feces. The disease can be transmitted to the fetus only during maternal parasitemia, which is associated with primary infection. Extrapolation from current data suggests that there are 140 to 1400 cases of congenital toxoplasmosis per year in Canada and that 70 to 280 of the infants are severely affected at birth; many of the others suffer sequelae later in life. Serologic diagnosis of primary infection in the mother is quite sensitive and specific. Diagnosis in the infant is more difficult and may take several months. Prenatal treatment of the woman and postnatal treatment of the infant are hampered by the lack of proven efficacy as well as ethical and compliance problems. Preventive serologic screening and prophylaxis have the same drawbacks. Educating young women to avoid infection is an inexpensive, low-risk intervention that would be the preferred preventive strategy if it could be shown to be effective. Immunization may prove to be the most cost-effective method of preventing congenital toxoplasmosis if a safe and effective vaccine is developed.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alford C. A., Jr, Stagno S., Reynolds D. W. Congenital toxoplasmosis: clinical, laboratory, and therapeutic considerations, with special reference to subclinical disease. Bull N Y Acad Med. 1974 Feb;50(2):160–181. [PMC free article] [PubMed] [Google Scholar]
  2. Beattie C. P. The ecology of toxoplasmosis. Ecol Dis. 1982;1(1):13–20. [PubMed] [Google Scholar]
  3. Breslow L., Somers A. R. The lifetime health-monitoring program. A practical approach to preventive medicine. N Engl J Med. 1977 Mar 17;296(11):601–608. doi: 10.1056/NEJM197703172961104. [DOI] [PubMed] [Google Scholar]
  4. Broadbent E. J., Ross R., Hurley R. Screening for toxoplasmosis in pregnancy. J Clin Pathol. 1981 Jun;34(6):659–664. doi: 10.1136/jcp.34.6.659. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Desmonts G., Couvreur J. Congenital toxoplasmosis. A prospective study of 378 pregnancies. N Engl J Med. 1974 May 16;290(20):1110–1116. doi: 10.1056/NEJM197405162902003. [DOI] [PubMed] [Google Scholar]
  6. Desmonts G., Couvreur J. Toxoplasmose congénitale. Etude prospective de l'issue de la grossesse chez 542 femmes atteintes de toxoplasmose acquise en cours de gestation. Ann Pediatr (Paris) 1984 Nov;31(10):805–809. [PubMed] [Google Scholar]
  7. Desmonts G., Daffos F., Forestier F., Capella-Pavlovsky M., Thulliez P., Chartier M. Prenatal diagnosis of congenital toxoplasmosis. Lancet. 1985 Mar 2;1(8427):500–504. doi: 10.1016/s0140-6736(85)92096-3. [DOI] [PubMed] [Google Scholar]
  8. Desmonts G. Some remarks on the immunopathology of toxoplasmic uveitis. Mod Probl Ophthalmol. 1976;16:228–232. [PubMed] [Google Scholar]
  9. Dubey J. P. Prevention of abortion and neonatal death due to toxoplasmosis by vaccination of goats with the nonpathogenic coccidium hammondia hammondi. Am J Vet Res. 1981 Dec;42(12):2155–2157. [PubMed] [Google Scholar]
  10. Eckerling B., Neri A., Eylan E. Toxoplasmosis. A cause of infertility. Fertil Steril. 1968 Nov-Dec;19(6):883–891. [PubMed] [Google Scholar]
  11. FELDMAN H. A., MILLER L. T. Serological study of toxoplasmosis prevalence. Am J Hyg. 1956 Nov;64(3):320–335. doi: 10.1093/oxfordjournals.aje.a119845. [DOI] [PubMed] [Google Scholar]
  12. FFRENCH G. E., FISH N. A. A survey of toxoplasmosis in an Ontario community. Can Med Assoc J. 1961 Apr 8;84:757–767. [PMC free article] [PubMed] [Google Scholar]
  13. Fayer R. Toxoplasmosis update and public health implications. Can Vet J. 1981 Nov;22(11):344–352. [PMC free article] [PubMed] [Google Scholar]
  14. Foulon W., Naessens A., Volckaert M., Lauwers S., Amy J. J. Congenital toxoplasmosis: a prospective survey in Brussels. Br J Obstet Gynaecol. 1984 May;91(5):419–423. doi: 10.1111/j.1471-0528.1984.tb04777.x. [DOI] [PubMed] [Google Scholar]
  15. Frenkel J. K. Breaking the transmission chain of Toxoplasma: a program for the prevention of human toxoplasmosis. Bull N Y Acad Med. 1974 Feb;50(2):228–235. [PMC free article] [PubMed] [Google Scholar]
  16. Frenkel J. K., Dubey J. P. Toxoplasmosis and its prevention in cats and man. J Infect Dis. 1972 Dec;126(6):664–673. doi: 10.1093/infdis/126.6.664. [DOI] [PubMed] [Google Scholar]
  17. Frenkel J. K. Immunity in toxoplasmosis. Bull Pan Am Health Organ. 1985;19(4):354–367. [PubMed] [Google Scholar]
  18. Kimball A. C., Kean B. H., Fuchs F. Congenital toxoplasmosis: a prospective study of 4,048 obstetric patients. Am J Obstet Gynecol. 1971 Sep 15;111(2):211–218. doi: 10.1016/0002-9378(71)90892-1. [DOI] [PubMed] [Google Scholar]
  19. Lambotte R. Toxoplasmose congénitale. Evaluation du bénéfice thérapeutique prénatal. J Gynecol Obstet Biol Reprod (Paris) 1976 Mar;5(2):265–269. [PubMed] [Google Scholar]
  20. Nussenzweig R. S. Progress in malaria vaccine development: characterization of protective antigens. Scand J Infect Dis Suppl. 1982;36:40–45. [PubMed] [Google Scholar]
  21. Remington J. S., Efron B., Cavanaugh E., Simon H. J., Trejos A. Studies on toxoplasmosis in El Salvador. Prevalence and incidence of toxoplasmosis as measured by the Sabin-Feldman dye test. Trans R Soc Trop Med Hyg. 1970;64(2):252–267. doi: 10.1016/0035-9203(70)90132-x. [DOI] [PubMed] [Google Scholar]
  22. Ruoss C. F., Bourne G. L. Toxoplasmosis in pregnancy. J Obstet Gynaecol Br Commonw. 1972 Dec;79(12):1115–1118. doi: 10.1111/j.1471-0528.1972.tb11897.x. [DOI] [PubMed] [Google Scholar]
  23. Seah S. K. Prevalence of toxoplasmosis in a Canadian city. Can J Public Health. 1973 Oct;64(Suppl):–35. [PubMed] [Google Scholar]
  24. Sharf M., Eibschitz I., Eylan E. Latent toxoplasmosis and pregnancy. Obstet Gynecol. 1973 Sep;42(3):349–354. [PubMed] [Google Scholar]
  25. Stray-Pedersen B. A prospective study of acquired toxoplasmosis among 8,043 pregnant women in the Oslo area. Am J Obstet Gynecol. 1980 Feb 1;136(3):399–406. doi: 10.1016/0002-9378(80)90870-4. [DOI] [PubMed] [Google Scholar]
  26. Tizard I. R., Fish A., Quinn J. P. Some observations on the epidemiology of toxoplasmosis in Canada. J Hyg (Lond) 1976 Aug;77(1):11–21. doi: 10.1017/s0022172400055467. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Viens P., Auger P., Villeneuve R., Stefanescu-Soare I. Serological survey for congenital toxoplasmosis among 4,136 pregnant women. Trans R Soc Trop Med Hyg. 1977;71(2):136–139. doi: 10.1016/0035-9203(77)90080-3. [DOI] [PubMed] [Google Scholar]
  28. Viens P., Morisset R., Stefanescu I., Strykowski H. La toxoplasmose en milieu québécois. I. Résultats d'une enquête séro-épidémiologique par la technique d'immunofluorescence. Union Med Can. 1973 Oct;102(10):2072–2077. [PubMed] [Google Scholar]
  29. Williams K. A., Scott J. M., Macfarlane D. E., Williamson J. M., Elias-Jones T. F., Williams H. Congenital toxoplasmosis: a prospective survey in the West of Scotland. J Infect. 1981 Sep;3(3):219–229. doi: 10.1016/s0163-4453(81)90773-8. [DOI] [PubMed] [Google Scholar]
  30. Wilson C. B., Remington J. S., Stagno S., Reynolds D. W. Development of adverse sequelae in children born with subclinical congenital Toxoplasma infection. Pediatrics. 1980 Nov;66(5):767–774. [PubMed] [Google Scholar]
  31. van Loon A. M., van der Logt J. T., Heessen F. W., van der Veen J. Enzyme-linked immunosorbent assay that uses labeled antigen for detection of immunoglobulin M and A antibodies in toxoplasmosis: comparison with indirect immunofluorescence and double-sandwich enzyme-linked immunosorbent assay. J Clin Microbiol. 1983 Jun;17(6):997–1004. doi: 10.1128/jcm.17.6.997-1004.1983. [DOI] [PMC free article] [PubMed] [Google Scholar]

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