{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:18:35Z","timestamp":1792811915616,"version":"4.5.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"9","funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006088","name":"National Center for Emerging and Zoonotic Infectious Diseases","doi-asserted-by":"publisher","award":["NU50CK000421"],"award-info":[{"award-number":["NU50CK000421"]}],"id":[{"id":"10.13039\/100006088","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>During 2017, in response to a physician\u2019s report, the Wisconsin Department of Health Services, Division of Public Health, began investigating an outbreak of febrile illness among attendees of a retreat where never frozen, intentionally undercooked, locally harvested venison was served. Preliminary testing tentatively identified the illness as toxoplasmosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Confirmatory human serology panels and testing of the venison to confirm and categorize the presence and type of Toxoplasma gondii were completed by French and American national reference laboratories. All 12 retreat attendees were interviewed; medical records were reviewed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>All attendees were male; median age was 51 years (range: 22\u201375). After a median incubation period of 7 days, 9 (82%) of 11 exposed persons experienced illness lasting a median of 12 days. All 9 sought outpatient healthcare for symptoms including fever, chills, sweats, and headache (100%) and ocular disturbances (33%). Testing confirmed the illness as toxoplasmosis and venison as the infection source. Multiple laboratory results were atypical for toxoplasmosis, including transaminitis (86%), lymphocytopenia (88%), thrombocytopenia (38%), and leukopenia (63%). One exposed but asymptomatic person was seronegative; the other had immunity from prior infection. The T. gondii strain was identified as closely related to an atypical genotype (haplogroup 12, polymerase chain reaction restriction fragment length polymorphism genotype 5) common in North American wildlife but with previously uncharacterized human clinical manifestations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The T. gondii strain contaminating the venison might explain the unusual clinical presentations. In North America, clinicians and venison consumers should be aware of risk for severe or unusual presentations of acute toxoplasmosis after consuming undercooked game meat.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa285","type":"journal-article","created":{"date-parts":[[2020,3,29]],"date-time":"2020-03-29T11:06:59Z","timestamp":1585480019000},"page":"1557-1565","source":"Crossref","is-referenced-by-count":58,"title":["Toxoplasmosis Outbreak Associated With <i>Toxoplasma gondii-<\/i>Contaminated Venison\u2014High Attack Rate, Unusual Clinical Presentation, and Atypical Genotype"],"prefix":"10.1093","volume":"72","author":[{"given":"Amy C","family":"Schumacher","sequence":"first","affiliation":[{"name":"Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"Bureau of Communicable Diseases, Division of Public Health, Wisconsin Department of Health Services, Madison, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina I","family":"Elbadawi","sequence":"additional","affiliation":[{"name":"Bureau of Communicable Diseases, Division of Public Health, Wisconsin Department of Health Services, Madison, Wisconsin, USA"},{"name":"Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Traci","family":"DeSalvo","sequence":"additional","affiliation":[{"name":"Bureau of Communicable Diseases, Division of Public Health, Wisconsin Department of Health Services, Madison, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Straily","sequence":"additional","affiliation":[{"name":"Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Ajzenberg","sequence":"additional","affiliation":[{"name":"INSERM, Universit\u00e9 de Limoges, UMR_S 1094, Tropical Neuroepidemiology, Limoges, France"},{"name":"University Hospital, French National Reference Center for Toxoplasmosis and Biological Resource Center for Toxoplasma, Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Letzer","sequence":"additional","affiliation":[{"name":"Infectious Disease Specialists of Southeast Wisconsin, Brookfield, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Moldenhauer","sequence":"additional","affiliation":[{"name":"Jackson County Health and Human Services, Black River Falls, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammy L","family":"Handly","sequence":"additional","affiliation":[{"name":"Jackson County Health and Human Services, Black River Falls, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dolores","family":"Hill","sequence":"additional","affiliation":[{"name":"United States Department of Agriculture, Agricultural Research Service, Animal Parasitic Diseases Lab, Beltsville, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Laure","family":"Dard\u00e9","sequence":"additional","affiliation":[{"name":"INSERM, Universit\u00e9 de Limoges, UMR_S 1094, Tropical Neuroepidemiology, Limoges, France"},{"name":"University Hospital, French National Reference Center for Toxoplasmosis and Biological Resource Center for Toxoplasma, Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christelle","family":"Pomares","sequence":"additional","affiliation":[{"name":"Service de Parasitologie Mycologie, Centre Hospitalier Universitaire de Nice, INSERM, U1065, Centre M\u00e9diterran\u00e9en de M\u00e9decine Mol\u00e9culaire, Facult\u00e9 de M\u00e9decine, Virulence microbienne et signalisation inflammatoire \u2013 Universit\u00e9 de la C\u00f4te d\u2019Azur, Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karine","family":"Passebosc-Faure","sequence":"additional","affiliation":[{"name":"University Hospital, French National Reference Center for Toxoplasmosis and Biological Resource Center for Toxoplasma, Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Bisgard","sequence":"additional","affiliation":[{"name":"Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos A","family":"Gomez","sequence":"additional","affiliation":[{"name":"The Jack S. 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