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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
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