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

Table 2 Frequency of symptoms in outbreaks of meat-borne toxoplasmosis in humans in the USA

Location	New York City	Pennsylvania	New York City	South Carolina	Tennessee	Wisconsin	Illinois
References	[53]	[54]	[55]	[56]	[57]	[9]	[8]
Year of outbreak	1968	1974	1975	1979	2017	2017	2018
No. of patients	5^a	4^b	5	3	2^c	9^d	6^e
Meat ingested	Beef	Kibbeh nayeh (Syrian dish)	Lamb	Venison	Venison	Venison	Venison
Incubation period (days)	8–13	10–30	8–13	7–10	7	7	4–14
Patients with symptoms (%)
Symptoms
Fever	100	100	100	100	100	100	100
Lymphadenopathy	60.0	75.0	66.6	NR	NR	33.3	NR
Headache	100	NR	66.6	100	NR	100	100
Chills	40.0	100	NR	100	NR	100	NR
Sweats	NR	NR	NR	100	NR	100	66.6
Decreased appetite	NR	NR	NR	100	100	88.8	NR
Fatigue	NR	100	80.0	100	NR	88.8	83.3
Myalgia	80.0	NR	66.6	NR	100	NR	NR
Anorexia	40.0	NR	NR	NR	NR	NR	NR
Sore throat	NR	NR	20.0	NR	NR	77.7	NR
Arthralgia	NR	NR	20.0	NR	NR	77.7	83.3
Rash	60.0	NR	20.0	33.3	NR	NR	NR
Confusion	40.0	NR	NR	NR	NR	11.1	NR
Nausea	40.0	NR	NR	NR	NR	NR	NR
Eye pain	NR	NR	NR	NR	NR	11.1	NR
Blurred vision	NR	NR	NR	NR	NR	33.3	NR
Ophthalmic	NR	NR	20.0	NR	NR	16.6	NR
Abdominal pain	20.0	NR	NR	NR	NR	NR	NR

NR = Not reported by patient or not recorded
^aAte undercooked hamburgers on 5 March 1968. Two patients had abnormal sensation (dysesthesia) in lower extremities; splenomegaly in three
^bAte Kibbeh nayeh (a beef dish) at a wedding party in a Syrian restaurant on 23 November 1974
^cPatient and his adult grandson ate pan-seared heart of deer; both of them developed identical symptoms 7 days later
^dAte undercooked grilled venison kabobs at a deer retreat on 29 September 2017
^eCanadian hunters ate venison at a retreat in Illinois, 22 November–4 December 2018

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