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Table 1 Frequency of symptoms in outbreaks of toxoplasmosis in humans associated with ingestion of food or water contaminated with oocysts

From: Outbreaks of clinical toxoplasmosis in humans: five decades of personal experience, perspectives and lessons learned

Location São Paulo, Brazil Georgia, USA Panama Paraná, Brazil São, Paulo, Brazil Goiás, Brazil Paraná, Brazil Paraná, Brazil French Guiana
References [15] [10, 16,17,18] [19] [20,21,22] [23] [24] [25] [26] [27]
Year of outbreak 1966 1977 1979 2001 2009 2015 2015 2016 2017
No. of patients 99 35a 31b 155c 11d 14 54e 20f 20 g
Incubation period (days)   4–21 5–16 NR NR NR NR NR NR
 Symptoms
  Fever 79.7 94.2 90.3 82.5 81.8 85.7 51.8 NR 75.0
  Lymphadenopathy 61.6 88.5 77.4 75.4 63.6 42.9 40.7 80.0 30.0
  Headache 32.3 88.5 77.4 87.0 63.6 64.3 31.5 85.0 30.0
  Myalgia 10.1 62.8 67.7 80.0 54.5 50 NR 75.0 5.0
  Stiff neck NR 57.1 54.8 NR NR NR NR NR NR
  Anorexia NR 57.1 NR 69.0 54.5 71.4 NR NR NR
  Sore throat 17.1 45.7 NR NR 27.2 NR NR NR NR
  Arthralgia 4.0 25.7 29.0 61.2 36.3 57.1 NR NR NR
  Rash NR 22.8 0 7.0 NR 14.3 NR NR 5.0
  Confusion 3.0 20.0 NR NR NR NR NR NR NR
  Earache NR 17.1 NR NR NR NR NR NR NR
  Nausea/vomiting NR 17.1 36.6 38.7 27.2 50 NR 100 NR
  Eye pain NR NR 25.8 NR NR NR 7.4 NR NR
  Blurred vision NR NR NR NR NR NR 22.2 NR NR
  Ophthalmic NR 0 NR NR 18.1 57.2 NR 15.0 5.0
  Abdominal pain NR 11.4 54.8 NR 9.0 42.9 NR NR NR
  Asthenia 52.5 NR NR NR 81.8 78.6 50.0 45.0 NR
  Night sweats NR NR NR 53.5 81.8 42.9 NR NR NR
  No. of abortions/congenital infection NR 1 NR 6 NR 1 NR 5 1
  1. NR = Not reported by the patient or not recorded
  2. aThirty-five of 37 persons were sick; they were young adults (mean age 23.8 years), 32 male, five female (three pregnant, one with congenitally infected fetus). Additional symptoms were chest pain in three, hepatitis in four, rhinitis in five of 35 patients. One person developed ocular lesions 4 years later (see text)
  3. bThirty five of 98 soldiers from one battalion were ill; three were sick enough to be hospitalized and 18 took medical leave of absence from work. Clinical toxoplasmosis was confirmed in 31. In addition to the symptoms listed above, two had hepatomegaly, one had splenomegaly, and one had chills
  4. cAdditionally, 128 persons had malaise. Ophthalmic examinations were conducted as a follow-up (see text). Ten women seroconverted during pregnancy; one of these had a spontaneous abortion. Six babies were born with congenital toxoplasmosis; one died at 9 months of age despite anti-T. gondii therapy (see text)
  5. dDysuria in two, diarrhea in two, irritability in one of 11 patients
  6. eThe subjects were 16 to 64 years old and the outbreak lasted 4 months. Ingestion of salad contaminated with oocysts was linked epidemiologically, but the direct cause could not be established
  7. fSix (30%) persons had cough, and 15 (45%) had apathy
  8. gTwenty of 54 cases had serological evidence of acute toxoplasmosis in inhabitants of an Amerindian village. Of these 20, six were adults and 14 were children, all symptomatic. A woman diagnosed at 10 weeks of pregnancy had a spontaneous abortion at 19 weeks of gestation, despite treatment with spiramycin. T. gondii was isolated from fetal tissues and from the blood of a 2-year-old boy