Risk Factors for Toxoplasma gondii Infection in the United States

• Published in: Clinical infectious diseases 2009-09, Vol.49 (6), p.878-884
• Main Authors: Jones, Jeffrey L., Dargelas, Valerie, Roberts, Jacquelin, Press, Cindy, Remington, Jack S., Montoya, Jose G.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Animals; Antibodies, Protozoan - blood; ARTICLES AND COMMENTARIES; Biological and medical sciences; Case-Control Studies; Cat Diseases - diagnosis; Cat Diseases - epidemiology; Cat Diseases - parasitology; Cat Diseases - transmission; Cats; Congenital toxoplasmosis; Cost of Illness; Eye diseases; Female; Food Parasitology; Goat milk; Human protozoal diseases; Humans; Hygiene; Infections; Infectious diseases; Meat; Meat - parasitology; Meats; Medical sciences; Middle Aged; Milk - parasitology; Multivariate Analysis; Parasites; Parasitic diseases; Predisposing factors; Pregnancy; Pregnancy Complications, Parasitic - diagnosis; Pregnancy Complications, Parasitic - epidemiology; Pregnancy Complications, Parasitic - etiology; Preventive medicine; Protozoal diseases; Questionnaires; Risk Factors; Seroepidemiologic Studies; Sex Factors; Shellfish - parasitology; Toxoplasma - immunology; Toxoplasma gondii; Toxoplasmosis; Toxoplasmosis - diagnosis; Toxoplasmosis - epidemiology; Toxoplasmosis - etiology; Toxoplasmosis - transmission; Toxoplasmosis, Animal - diagnosis; Toxoplasmosis, Animal - epidemiology; Toxoplasmosis, Animal - transmission; Toxoplasmosis, Congenital - diagnosis; Toxoplasmosis, Congenital - epidemiology; Toxoplasmosis, Congenital - etiology; United States - epidemiology; Young Adult
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/605433

Background. Toxoplasmosis can cause severe ocular and neurological disease. We sought to determine risk factors for Toxoplasma gondii infection in the United States. Methods. We conducted a case-control study of adults recently infected with T. gondii . Case patients were selected from the Palo Alto Medical Foundation Toxoplasma Serology Laboratory from August 2002 through May 2007; control patients were randomly selected from among T. gondii -seronegative persons. Data were obtained from serological testing and patient questionnaires. Results. We evaluated 148 case patients with recent T. gondii infection and 413 control patients. In multivariate analysis, an elevated risk of recent T. gondii infection was associated with the following factors: eating raw ground beef (adjusted odds ratio [aOR], 6.67; 95% confidence limits [CLs], 2.09, 21.24; attributable risk [AR], 7%); eating rare lamb (aOR, 8.39; 95% CLs, 3.68, 19.16; AR, 20%); eating locally produced cured, dried, or smoked meat (aOR, 1.97; 95% CLs, 1.18, 3.28; AR, 22%); working with meat (aOR, 3.15; 95% CLs, 1.09, 9.10; AR, 5%); drinking unpasteurized goat's milk (aOR, 5.09; 95% CLs, 1.45, 17.80; AR, 4%); and having 3 or more kittens (aOR, 27.89; 95% CLs, 5.72, 135.86; AR, 10%). Eating raw oysters, clams, or mussels (aOR, 2.22; 95% CLs, 1.07, 4.61; AR, 16%) was significant in a separate model among persons asked this question. Subgroup results are also provided for women and for pregnant women. Conclusions. In the United States, exposure to certain raw or undercooked foods and exposure to kittens are risk factors for T. gondii infection. Knowledge of these risk factors will help to target prevention efforts.