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      Severe Acquired Toxoplasmosis Caused by Wild Cycle of Toxoplasma gondii, French Guiana

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          Abstract

          From 1998 through 2006, 44 cases of severe primary toxoplasmosis were observed in French Guiana in immunocompetent adults. Toxoplasma gondii isolates exhibited an atypical multilocus genotype. Severe disease in humans may result from poor host adaptation to neotropical zoonotic strains of T. gondii circulating in a forest-based cycle.

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          Toxoplasma gondii comprises three clonal lineages: correlation of parasite genotype with human disease.

          D K Howe, L D Sibley (1995)
          The population genetic structure of Toxoplasma gondii was determined by multilocus restriction fragment length polymorphism analysis at 6 loci in 106 independent isolates from humans and animals. Phylogenetic and statistical analyses indicated a highly unusual population structure consisting of 3 widespread clonal lineages. Extensively mixed genotypes were only apparent in 4 strains, which indicated that, while not separate species, sexual recombination between the 3 lineages is exceedingly rare in natural populations. T. gondii is a major cause of subclinical human infection and an important opportunistic pathogen that causes severe disease in immunocompromised patients. While strains from all 3 lineages were isolated from humans, the majority of human toxoplasmosis cases were associated with strains of a type II genotype. The correlation of specific clonal lineages with human toxoplasmosis has important implications for development of vaccines, drug treatments, and diagnostic protocols.
          Article 0 comments Cited 193 times – based on 0 reviews     Review now
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            Fatal outbreak of human toxoplasmosis along the Maroni River: epidemiological, clinical, and parasitological aspects.

            Dayanand Panchoe, Marie-Laure Dardé, Danielle Maubon … (2007)
            Well-documented outbreaks of human toxoplasmosis infection are infrequently reported. Here, we describe a community outbreak of multivisceral toxoplasmosis that occurred in Patam, a Surinamese village near the French Guianan border. From the end of December 2003 through the middle of January 2004, 5 adult patients in Patam, including 2 pregnant women, were initially hospitalized for multivisceral toxoplasmosis. A French-Surinamese epidemiological investigation was conducted in the village; inquiries and clinical examinations were performed, and blood and environmental samples were obtained. For all serologically confirmed cases of toxoplasmosis, molecular analysis and mouse inoculations were performed for diagnosis and genetic characterization of Toxoplasma gondii. The hospitalized patients, who did not have any immunodeficiencies, presented with an infectious disease with multivisceral involvement. Serological examination confirmed acute toxoplasmosis. One adult died, and a neonate and a fetus with congenital toxoplasmosis also died. During the investigation, 4 additional acute cases of toxoplasmosis were diagnosed among the 33 villagers. Only 3 inhabitants had serological evidence of previous T. gondii infection. In total, we reported 11 cases of toxoplasmosis: 8 multivisceral cases in immunocompetent adults, resulting in 1 death; 2 cases of lethal congenital toxoplasmosis in a neonate and a fetus; and 1 symptomatic case in a child. Molecular analysis demonstrated that identical isolates of only 1 atypical strain were responsible for at least 5 of the 11 cases of toxoplasmosis in the outbreak. No epidemiological sources could be linked to this severe community-wide outbreak of toxoplasmosis. This report is in agreement with the particular features of toxoplasmosis involving atypical strains that were recently described in French Guiana.
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              Severe acquired toxoplasmosis in immunocompetent adult patients in French Guiana.

              C Aznar, R Bouyne, M Bourbigot … (2002)
              The most common presentation of symptomatic postnatally acquired toxoplasmosis in immunocompetent patients is painless cervical adenopathy. Acute visceral manifestations are associated in rare cases. We report 16 cases of severe primary toxoplasmosis diagnosed in French Guiana during a 6.5-year period. All of the subjects were immunocompetent adults hospitalized with clinical presentations consisting of a marked, nonspecific infectious syndrome accompanied by an altered general status with at least one visceral localization, mainly pulmonary involvement (14 cases). Acute toxoplasmosis was diagnosed according to the results of serological tests suggestive of recent primary infection and the absence of an alternative etiology. Recovery was rapid following specific antitoxoplasmosis treatment. Thirteen of the 16 patients had consumed game in the 2 weeks before the onset of the symptoms, and in eight cases the game was considered to have been undercooked. Toxoplasma strains, which were virulent in mice, were isolated from three patients. Microsatellite analysis showed that all of these isolates exhibited an atypical multilocus genotype, with one allele found only for isolates of this region.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Infect Dis
                Journal ID (publisher-id): EID
                Title: Emerging Infectious Diseases
                Publisher: Centers for Disease Control and Prevention
                ISSN (Print): 1080-6040
                ISSN (Electronic): 1080-6059
                Publication date (Print): April 2009
                Volume: 15
                Issue: 4
                Pages: 656-658
                Affiliations
                [1]Université des Antilles et de la Guyane, Cayenne, French Guiana (B. Carme)
                [2]Centre Hospitalier de Cayenne, Cayenne (B. Carme, M. Demar)
                [3]Faculté de Médecine de Limoges, Limoges, France (D. Ajzenberg, M.L. Dardé)
                Author notes
                Address for correspondence: Bernard Carme, Faculté de Médecine et Centre Hospitalier, Parasitologie et Mycologie, Rue des Flamboyants, Cayenne F-97306, French Guiana; email: carme.bernard@ 123456wanadoo.fr
                Article
                Publisher ID: 08-1306
                DOI: 10.3201/eid1504.081306
                PMC ID: 2671434
                PubMed ID: 19331765
                SO-VID: 75e4c9a3-6676-4947-8034-dcf49fdf9b10
                History
                Categories
                Subject: Dispatch

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: wild cycle french guiana,amazonia,epidemiology,dispatch,toxoplasma gondii,severe toxoplasmosis,atypical strains
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: wild cycle french guiana, amazonia, epidemiology, dispatch, toxoplasma gondii, severe toxoplasmosis, atypical strains

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