BACKGROUND: Congenital toxoplasmosis presents as severe, life-altering disease in North America. If mothers of infants with congenital toxoplasmosis could be identified by risks, it would provide strong support for educating pregnant women about risks, to eliminate this disease. Conversely, if not all risks are identifiable, undetectable risks are suggested. A new test detecting antibodies to sporozoites demonstrated that oocysts were the predominant source of Toxoplasma gondii infection in 4 North American epidemics and in mothers of children in the National Collaborative Chicago-based Congenital Toxoplasmosis Study (NCCCTS). This novel test offered the opportunity to determine whether risk factors or demographic characteristics could identify mothers infected with oocysts. METHODS: Acutely infected mothers and their congenitally infected infants were evaluated, including in-person interviews concerning risks and evaluation of perinatal maternal serum samples. RESULTS: Fifty-nine (78%) of 76 mothers of congenitally infected infants in NCCCTS had primary infection with oocysts. Only 49% of these mothers identified significant risk factors for sporozoite acquisition. Socioeconomic status, hometown size, maternal clinical presentations, and ethnicity were not reliable predictors. CONCLUSIONS: Undetected contamination of food and water by oocysts frequently causes human infections in North America. Risks are often unrecognized by those infected. Demographic characteristics did not identify oocyst infections. Thus, although education programs describing hygienic measures may be beneficial, they will not suffice to prevent the suffering and economic consequences associated with congenital toxoplasmosis. Only a vaccine or implementation of systematic serologic testing of pregnant women and newborns, followed by treatment, will prevent most congenital toxoplasmosis in North America.
BACKGROUND:Congenital toxoplasmosis presents as severe, life-altering disease in North America. If mothers of infants with congenital toxoplasmosis could be identified by risks, it would provide strong support for educating pregnant women about risks, to eliminate this disease. Conversely, if not all risks are identifiable, undetectable risks are suggested. A new test detecting antibodies to sporozoites demonstrated that oocysts were the predominant source of Toxoplasma gondii infection in 4 North American epidemics and in mothers of children in the National Collaborative Chicago-based Congenital Toxoplasmosis Study (NCCCTS). This novel test offered the opportunity to determine whether risk factors or demographic characteristics could identify mothers infected with oocysts. METHODS: Acutely infected mothers and their congenitally infectedinfants were evaluated, including in-person interviews concerning risks and evaluation of perinatal maternal serum samples. RESULTS: Fifty-nine (78%) of 76 mothers of congenitally infectedinfants in NCCCTS had primary infection with oocysts. Only 49% of these mothers identified significant risk factors for sporozoite acquisition. Socioeconomic status, hometown size, maternal clinical presentations, and ethnicity were not reliable predictors. CONCLUSIONS: Undetected contamination of food and water by oocysts frequently causes humaninfections in North America. Risks are often unrecognized by those infected. Demographic characteristics did not identify oocyst infections. Thus, although education programs describing hygienic measures may be beneficial, they will not suffice to prevent the suffering and economic consequences associated with congenital toxoplasmosis. Only a vaccine or implementation of systematic serologic testing of pregnant women and newborns, followed by treatment, will prevent most congenital toxoplasmosis in North America.
Authors: D V Patel; E M Holfels; N P Vogel; K M Boyer; M B Mets; C N Swisher; N J Roizen; L K Stein; M A Stein; J Hopkins; S E Withers; D G Mack; R A Luciano; P Meier; J S Remington; R L McLeod Journal: Radiology Date: 1996-05 Impact factor: 11.105
Authors: Rima McLeod; Kenneth Boyer; Theodore Karrison; Kristen Kasza; Charles Swisher; Nancy Roizen; Jessica Jalbrzikowski; Jack Remington; Peter Heydemann; A Gwendolyn Noble; Marilyn Mets; Ellen Holfels; Shawn Withers; Paul Latkany; Paul Meier Journal: Clin Infect Dis Date: 2006-04-11 Impact factor: 9.079
Authors: Hua Cong; Ernest J Mui; William H Witola; John Sidney; Jeff Alexander; Alessandro Sette; Ajesh Maewal; Rima McLeod Journal: Immunome Res Date: 2010-12-03
Authors: Joseph D Benevento; Rama D Jager; A Gwendolyn Noble; Paul Latkany; William F Mieler; Mari Sautter; Sanford Meyers; Marilyn Mets; Michael A Grassi; Peter Rabiah; Kenneth Boyer; Charles Swisher; Rima McLeod Journal: Arch Ophthalmol Date: 2008-08
Authors: J McAuley; K M Boyer; D Patel; M Mets; C Swisher; N Roizen; C Wolters; L Stein; M Stein; W Schey Journal: Clin Infect Dis Date: 1994-01 Impact factor: 9.079
Authors: N Roizen; C N Swisher; M A Stein; J Hopkins; K M Boyer; E Holfels; M B Mets; L Stein; D Patel; P Meier Journal: Pediatrics Date: 1995-01 Impact factor: 7.124
Authors: Gang Cheng; Stephen P Muench; Ying Zhou; Gustavo A Afanador; Ernest J Mui; Alina Fomovska; Bo Shiun Lai; Sean T Prigge; Stuart Woods; Craig W Roberts; Mark R Hickman; Patty J Lee; Susan E Leed; Jennifer M Auschwitz; David W Rice; Rima McLeod Journal: Bioorg Med Chem Lett Date: 2013-02-13 Impact factor: 2.823
Authors: Gustavo A Afanador; Stephen P Muench; Martin McPhillie; Alina Fomovska; Arne Schön; Ying Zhou; Gang Cheng; Jozef Stec; Joel S Freundlich; Hong-Ming Shieh; John W Anderson; David P Jacobus; David A Fidock; Alan P Kozikowski; Colin W Fishwick; David W Rice; Ernesto Freire; Rima McLeod; Sean T Prigge Journal: Biochemistry Date: 2013-12-13 Impact factor: 3.162