Digging into Toxoplasma gondii infections via soil: A quantitative microbial risk assessment approach.

Soil has been identified as an important source of exposure to a variety of chemical and biological contaminants. Toxoplasma gondii is one of those potential biological contaminants associated with serious health effects in pregnant women and immunocompromised patients. Gardening or consumption of homegrown vegetables may present an important route of T. gondii infection via accidental ingestion of soil. In the Netherlands, there is quantitative information on the risk of T. gondii infection via meat products, but not on the risk of infection through soil. The objective of this study was to develop a quantitative microbial risk assessment (QMRA) model for estimating the risk associated with T. gondii exposure via accidental soil ingestion in the Netherlands. In order to obtain the needed information, a magnetic capture method for detection of T. gondii oocysts in soil samples was developed, and T. gondii DNA was detected using qPCR targeting the 529 bp repeat element. The method was shown to provide 95% probability of detection (95% CI: 88-100%) when at least 34 oocysts are present in 25 g of soil. T. gondii DNA was detected in 5 of 148 soil samples with interpretable results (3%, 95% CI: 1.5-7.7%). Results for 18 samples were not interpretable due to PCR inhibition. The estimated amount of oocysts presented in qPCR positive samples was quantified by a linear model, and the amount varied from 8 to 478 in 25 g of soil. The estimated incidence rate of T. gondii infection from the QMRA model via soil varied from 0.3 to 1.8 per 1000 individuals per day. Several data gaps (e.g., soil contamination/ingestion and oocysts viability) have been identified in this study, the structure of the model can be applied to obtain more accurate estimates of the risk of T. gondii infection via soil when data become available.