{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T12:15:10Z","timestamp":1793967310684,"version":"4.8.0"},"reference-count":68,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T00:00:00Z","timestamp":1621382400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T00:00:00Z","timestamp":1621382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Parasites Vectors"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The protozoan parasite <jats:italic>Toxoplasma gondii<\/jats:italic> has a worldwide distribution and a very wide host range, infecting most warm-blooded hosts. Approximately 30% of humanity is infected with <jats:italic>T. gondii<\/jats:italic>, but clinical toxoplasmosis is relatively infrequent. Toxoplasmosis has a wide range of clinical symptoms involving almost all organ systems. In most persons that acquire infection postnatally, symptoms (when present) are mild and mimic other diseases such as flu, Lyme disease, Q fever, hematological alterations, or mumps. It is likely that clinical disease is more common than reported. The ingestion of infected meat or food and water contaminated with oocysts are the two main modes of postnatal transmission of <jats:italic>Toxoplasma gondii<\/jats:italic>. The infective dose and the incubation period of <jats:italic>T. gondii<\/jats:italic> infection are unknown because there are no human volunteer experiments.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Here, I have critically reviewed outbreaks of clinical toxoplasmosis in humans for the past 55\u00a0years, 1966\u20132020. Information from oocyst-acquired versus meat-acquired infections was assessed separately.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Most outbreaks were from Brazil. There were no apparent differences in types or severity of symptoms in meat- versus oocyst-acquired infections. Fever, cervical lymphadenopathy, myalgia, and fatigue were the most important symptoms, and these symptoms were not age-dependent. The incubation period was 7\u201330\u00a0days. A genetic predisposition to cause eye disease is suspected in the parasites responsible for three outbreaks (in Brazil, Canada, and India). Only a few <jats:italic>T. gondii<\/jats:italic> tissue cysts might suffice to cause infection, as indicated by outbreaks affecting some (but not all) individuals sharing a meal of infected meat.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Whether the high frequency of outbreaks of toxoplasmosis in humans in Brazil is related to environmental contamination, poor hygiene, socioeconomic conditions, or to genotypes of <jats:italic>T. gondii<\/jats:italic> needs investigation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1186\/s13071-021-04769-4","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T13:09:40Z","timestamp":1621429780000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":166,"title":["Outbreaks of clinical toxoplasmosis in humans: five decades of personal experience, perspectives and lessons learned"],"prefix":"10.1186","volume":"14","author":[{"given":"Jitender P.","family":"Dubey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,19]]},"reference":[{"key":"4769_CR1","volume-title":"Toxoplasmosis of animals and man","author":"JP Dubey","year":"1988","unstructured":"Dubey JP, Beattie CP. Toxoplasmosis of animals and man. Boca Raton: CRC Press; 1988."},{"key":"4769_CR2","volume-title":"Toxoplasmosis of animals and humans","author":"JP Dubey","year":"2010","unstructured":"Dubey JP. Toxoplasmosis of animals and humans. 2nd ed. Boca Raton: CRC Press; 2010.","edition":"2"},{"key":"4769_CR3","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/B978-0-12-815041-2.00003-7","volume-title":"Toxoplasma gondii: The model apicomplexan\u2014perspectives and methods","author":"ML Dard\u00e9","year":"2020","unstructured":"Dard\u00e9 ML, Mercier A, Su C, Khan A, Grigg ME. Molecular epidemiology and population structure of Toxoplasma gondii. In: Weiss LM, Kim K, editors. Toxoplasma gondii: The model apicomplexan\u2014perspectives and methods. London: Academic Press; 2020. p. 63\u2013116."},{"key":"4769_CR4","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/B978-0-12-815041-2.00004-9","volume-title":"Toxoplasma gondii: The model apicomplexan\u2014perspectives and methods","author":"R McLeod","year":"2020","unstructured":"McLeod R, Cohen W, Dovgin S, Finkelstein L, Boyer KM. Human Toxoplasma infection. In: Weiss LM, Kim K, editors. Toxoplasma gondii: The model apicomplexan\u2014perspectives and methods. London: Academic Press; 2020. p. 117\u2013227."},{"key":"4769_CR5","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1016\/S0020-7519(00)00124-7","volume":"30","author":"AM Tenter","year":"2000","unstructured":"Tenter AM, Heckeroth AR, Weiss LM. Toxoplasma gondii: from animals to humans. Int J Parasitol. 2000;30:1217\u201358.","journal-title":"Int J Parasitol"},{"key":"4769_CR6","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1128\/CMR.05013-11","volume":"25","author":"F Robert-Gangneux","year":"2012","unstructured":"Robert-Gangneux F, Dard\u00e9 ML. Epidemiology of and diagnostic strategies for toxoplasmosis. Clin Microbiol Rev. 2012;25:264\u201396.","journal-title":"Clin Microbiol Rev"},{"key":"4769_CR7","first-page":"949","volume-title":"Infectious diseases of the fetus and the newborn infant","author":"F Peyron","year":"2016","unstructured":"Peyron F, Wallon M, Kieffer F, Garweg J. Toxoplasmosis. In: Wilson CB, Nizet V, Maldonado YA, Remington JS, Klein JO, editors. Infectious diseases of the fetus and the newborn infant. 8th ed. Philadelphia: Elsevier; 2016. p. 949\u20131042.","edition":"8"},{"key":"4769_CR8","doi-asserted-by":"crossref","first-page":"199","DOI":"10.3201\/eid2602.191218","volume":"26","author":"C Gaulin","year":"2020","unstructured":"Gaulin C, Ramsay D, Thivierge K, Tataryn J, Courville A, Martin C, et al. Acute toxoplasmosis among Canadian deer hunters associated with consumption of undercooked deer meat hunted in the United States. Emerg Infect Dis. 2020;26:199\u2013205.","journal-title":"Emerg Infect Dis"},{"key":"4769_CR9","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa285","author":"AC Schumacher","year":"2020","unstructured":"Schumacher AC, Elbadawi LI, DeSalvo T, Straily A, Ajzenberg D, Letzer D, et al. Toxoplasmosis outbreak associated with Toxoplasma gondii-contaminated venison\u2014high attack rate, unusual clinical presentation, and atypical genotype. Clin Infect Dis. 2020. https:\/\/doi.org\/10.1093\/cid\/ciaa285.","journal-title":"Clin Infect Dis"},{"key":"4769_CR10","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1056\/NEJM197903293001302","volume":"300","author":"SM Teutsch","year":"1979","unstructured":"Teutsch SM, Juranek DD, Sulzer A, Dubey JP, Sikes RK. Epidemic toxoplasmosis associated with infected cats. N Engl J Med. 1979;300:695\u20139.","journal-title":"N Engl J Med"},{"key":"4769_CR11","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1128\/CMR.14.3.659-688.2001","volume":"14","author":"BL Herwaldt","year":"2001","unstructured":"Herwaldt BL. Laboratory-acquired parasitic infections from accidental exposures. Clin Microbiol Rev. 2001;14:659\u201388.","journal-title":"Clin Microbiol Rev"},{"key":"4769_CR12","doi-asserted-by":"crossref","first-page":"630","DOI":"10.4315\/0362-028X-56.7.630","volume":"56","author":"JL Smith","year":"1993","unstructured":"Smith JL. Documented outbreaks of toxoplasmosis: transmission of Toxoplasma gondii to humans. J Food Prot. 1993;56:630\u20139.","journal-title":"J Food Prot"},{"key":"4769_CR13","doi-asserted-by":"crossref","unstructured":"Meireles LR, Ekman CCJ, de Andrade HF, Luna EJA. Human toxoplasmosis outbreaks and the agent infecting form. Findings from a systematic review. Rev Inst Med Trop S\u00e3o Paulo. 2015;57:369\u201376.","DOI":"10.1590\/S0036-46652015000500001"},{"key":"4769_CR14","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.3201\/eid2512.181565","volume":"25","author":"F Pinto-Ferreira","year":"2019","unstructured":"Pinto-Ferreira F, Caldart ET, Pasquali AKS, Mitsuka-Bregan\u00f3 R, Freire RL, Navarro IT. Patterns of transmission and sources of infection in outbreaks of human toxoplasmosis. Emerg Infect Dis. 2019;25:2177\u201382.","journal-title":"Emerg Infect Dis"},{"key":"4769_CR15","unstructured":"Magaldi C, Elkis H, Pattoli D, Coscina AL. Epidemic of toxoplasmosis at a university in S\u00e3o-Jos\u00e9-dos-Campos, S.P., Brazil. 1. Clinical and serologic data. Rev Lat-amer Microbiol Parasitol. 1969; 11:5\u201313."},{"key":"4769_CR16","doi-asserted-by":"crossref","first-page":"2S","DOI":"10.1097\/00006250-198003001-00001","volume":"55","author":"SM Teutsch","year":"1980","unstructured":"Teutsch SM, Sulzer AJ, Ramsey JE, Murray WA, Juranek DD. Toxoplasma gondii isolated from amniotic fluid. Obstet Gynecol. 1980;55:2S-4S.","journal-title":"Obstet Gynecol"},{"key":"4769_CR17","first-page":"1007","volume":"42","author":"JP Dubey","year":"1981","unstructured":"Dubey JP, Sharma SP, Juranek DD, Sulzer AJ, Teutsch SM. Characterization of Toxoplasma gondii isolates from an outbreak of toxoplasmosis in Atlanta. Georgia Am J Vet Res. 1981;42:1007\u201310.","journal-title":"Georgia Am J Vet Res"},{"key":"4769_CR18","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1016\/S0161-6420(82)34629-1","volume":"89","author":"RB Akstein","year":"1982","unstructured":"Akstein RB, Wilson LA, Teutsch SM. Acquired toxoplasmosis. Ophthalmology. 1982;89:1299\u2013302.","journal-title":"Ophthalmology"},{"key":"4769_CR19","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1056\/NEJM198209093071107","volume":"307","author":"MW Benenson","year":"1982","unstructured":"Benenson MW, Takafuji ET, Lemon SM, Greenup RL, Sulzer AJ. Oocyst-transmitted toxoplasmosis associated with ingestion of contaminated water. N Engl J Med. 1982;307:666\u20139.","journal-title":"N Engl J Med"},{"key":"4769_CR20","doi-asserted-by":"crossref","first-page":"326","DOI":"10.3201\/eid1202.041115","volume":"12","author":"L de Moura","year":"2006","unstructured":"de Moura L, Bahia-Oliveira LMG, Wada MY, Jones JL, Tuboi SH, Carmo EH, et al. Waterborne toxoplasmosis, Brazil, from field to gene. Emerg Infect Dis. 2006;12:326\u20139.","journal-title":"Emerg Infect Dis"},{"key":"4769_CR21","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/j.ajo.2015.02.017","volume":"159","author":"C Silveira","year":"2015","unstructured":"Silveira C, Muccioli C, Holland GN, Jones JL, Yu F, de Paulo A, et al. Ocular involvement following an epidemic of Toxoplasma gondii infection in Santa Isabel do Iva\u00ed. Brazil Am J Ophthalmol. 2015;159:1013\u201321.","journal-title":"Brazil Am J Ophthalmol"},{"key":"4769_CR22","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1097\/INF.0000000000001614","volume":"36","author":"AP Sanders","year":"2017","unstructured":"Sanders AP, dos Santos T, Felipe CKK, Estev\u00e3o ML, C\u00edcero C, Evangelista F, et al. Ocular lesions in congenital toxoplasmosis in Santa Isabel do Iva\u00ed, Paran\u00e1. Brazil Pediatr Infect Dis J. 2017;36:817\u201320.","journal-title":"Brazil Pediatr Infect Dis J"},{"key":"4769_CR23","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1590\/S0036-46652012000500001","volume":"54","author":"CCJ Ekman","year":"2012","unstructured":"Ekman CCJ, Chiossi MFV, Meireles LR, de Andrade J\u00fanior HF, Figueiredo WM, Marciano MAM, et al. Case-control study of an outbreak of acute toxoplasmosis in an industrial plant in the state of S\u00e3o Paulo, Brazil. Rev Inst Med Trop S\u00e3o Paulo. 2012;54:239\u201344.","journal-title":"Rev Inst Med Trop S\u00e3o Paulo"},{"key":"4769_CR24","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1111\/zph.12660","volume":"67","author":"MA da Costa","year":"2020","unstructured":"da Costa MA, Pinto-Ferreira F, de Almeida RPA, Martins FDC, Pires AL, Mareze M, et al. Artisan fresh cheese from raw cow\u2019s milk as a possible route of transmission in a toxoplasmosis outbreak, in Brazil. Zoonoses Public Health. 2020;67:122\u20139.","journal-title":"Zoonoses Public Health"},{"key":"4769_CR25","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1111\/zph.12705","volume":"67","author":"TC Monica","year":"2020","unstructured":"Monica TC, Pinto-Ferreira F, Martins FDC, de Matos RLN, de Matos AMRN, Santos AC, et al. Epidemiology of a toxoplasmosis outbreak in a research institution in northern Paran\u00e1. Brazil Zoonoses Public Health. 2020;67:760\u20134.","journal-title":"Brazil Zoonoses Public Health"},{"key":"4769_CR26","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1590\/s1984-29612019044","volume":"28","author":"F Pinto-Ferreira","year":"2019","unstructured":"Pinto-Ferreira F, Mitsuka-Bregan\u00f3 R, Monica TC, Martins FDC, de Matos RLN, Mareze M, et al. Investigation and environmental analysis of samples from outbreak of toxoplasmosis at research institution in Londrina, Paran\u00e1, Brazil, 2016. Rev Bras Parasitol Vet. 2019;28:518\u201321.","journal-title":"Rev Bras Parasitol Vet"},{"key":"4769_CR27","doi-asserted-by":"crossref","unstructured":"Blaizot R, Nabet C, Laghoe L, Faivre B, Escotte-Binet S, Djossou F, et al. Outbreak of Amazonian toxoplasmosis: A One Health investigation in a remote Amerindian community. Front Cell Infect Microbiol. 2020;10:e401.","DOI":"10.3389\/fcimb.2020.00401"},{"key":"4769_CR28","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/S0140-6736(96)11105-3","volume":"350","author":"WR Bowie","year":"1997","unstructured":"Bowie WR, King AS, Werker DH, Isaac-Renton JL, Bell A, Eng SB, et al. Outbreak of toxoplasmosis associated with municipal drinking water. Lancet. 1997;350:173\u20137.","journal-title":"Lancet"},{"key":"4769_CR29","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1016\/S0161-6420(98)96004-3","volume":"105","author":"AJ Burnett","year":"1998","unstructured":"Burnett AJ, Shortt SG, Isaac-Renton J, King A, Werker D, Bowie WR. Multiple cases of acquired toxoplasmosis retinitis presenting in an outbreak. Ophthalmology. 1998;105:1032\u20137.","journal-title":"Ophthalmology"},{"key":"4769_CR30","doi-asserted-by":"crossref","first-page":"2278","DOI":"10.1128\/AEM.64.6.2278-2280.1998","volume":"64","author":"J Isaac-Renton","year":"1998","unstructured":"Isaac-Renton J, Bowie WR, King A, Irwin GS, Ong CS, Fung CP, et al. Detection of Toxoplasma gondii oocysts in drinking water. Appl Environ Microbiol. 1998;64:2278\u201380.","journal-title":"Appl Environ Microbiol"},{"key":"4769_CR31","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1093\/cid\/cis258","volume":"54","author":"R McLeod","year":"2012","unstructured":"McLeod R, Boyer KM, Lee D, Mui E, Wroblewski K, Karrison T, et al. Prematurity and severity are associated with Toxoplasma gondii alleles (NCCCTS, 1981\u20132009). Clin Infect Dis. 2012;54:1595\u2013605.","journal-title":"Clin Infect Dis"},{"key":"4769_CR32","doi-asserted-by":"crossref","first-page":"438","DOI":"10.2307\/3284508","volume":"84","author":"JJ Aramini","year":"1998","unstructured":"Aramini JJ, Stephen C, Dubey JP. Toxoplasma gondii in Vancouver Island cougars (Felis concolor vancouverensis): serology and oocyst shedding. J Parasitol. 1998;84:438\u201340.","journal-title":"J Parasitol"},{"key":"4769_CR33","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1017\/S0950268899002113","volume":"122","author":"JJ Aramini","year":"1999","unstructured":"Aramini JJ, Stephen C, Dubey JP, Engelstoft C, Schwantje H, Ribble CS. Potential contamination of drinking water with Toxoplasma gondii oocysts. Epidemiol Infect. 1999;122:305\u201315.","journal-title":"Epidemiol Infect"},{"key":"4769_CR34","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1645\/GE-1349.1","volume":"94","author":"JP Dubey","year":"2008","unstructured":"Dubey JP, Quirk T, Pitt JA, Sundar N, Velmurugan GV, Kwok OCH, et al. Isolation and genetic characterization of Toxoplasma gondii from raccoons (Procyon lotor), cats (Felis domesticus), striped skunk (Mephitis mephitis), black bear (Ursus americanus), and cougar (Puma concolor) from Canada. J Parasitol. 2008;94:42\u20135.","journal-title":"J Parasitol"},{"key":"4769_CR35","doi-asserted-by":"crossref","first-page":"10147","DOI":"10.1038\/ncomms10147","volume":"7","author":"H Lorenzi","year":"2016","unstructured":"Lorenzi H, Khan A, Behnke MS, Namasivayam S, Swapna LS, Hadjithomas M, et al. Local admixture of amplified and diversified secreted pathogenesis determinants shapes mosaic Toxoplasma gondii genomes. Nat Commun. 2016;7:10147.","journal-title":"Nat Commun"},{"key":"4769_CR36","doi-asserted-by":"crossref","first-page":"129","DOI":"10.4103\/0301-4738.25839","volume":"54","author":"M Palanisamy","year":"2006","unstructured":"Palanisamy M, Madhavan B, Balasundaram MB, Andavar R, Venkatapathy N. Outbreak of ocular toxoplasmosis in Coimbatore. India Indian J Ophthalmol. 2006;54:129\u201331.","journal-title":"India Indian J Ophthalmol"},{"key":"4769_CR37","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1001\/archophthalmol.2009.354","volume":"128","author":"MB Balasundaram","year":"2010","unstructured":"Balasundaram MB, Andavar R, Palaniswamy M, Venkatapathy N. Outbreak of acquired ocular toxoplasmosis involving 248 patients. Arch Ophthalmol. 2010;128:28\u201332.","journal-title":"Arch Ophthalmol"},{"key":"4769_CR38","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1111\/j.1469-0691.2006.01449.x","volume":"12","author":"L Doganci","year":"2006","unstructured":"Doganci L, Tanyuksel M, Araz ER, Besirbellioglu BA, Erdem U, Ozoguz CA, et al. A probable outbreak of toxoplasmosis among boarding school students in Turkey. Clin Microbiol Infect. 2006;12:672\u20134.","journal-title":"Clin Microbiol Infect"},{"key":"4769_CR39","unstructured":"Silveira CAM. Toxoplasmose: d\u00favidas e controv\u00e9rsias. Erechim: Edifapes; 2002."},{"key":"4769_CR40","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1645\/GE-382R","volume":"90","author":"JP Dubey","year":"2004","unstructured":"Dubey JP, Navarro IT, Sreekumar C, Dahl E, Freire RL, Kawabata HH, et al. Toxoplasma gondii infections in cats from Paran\u00e1, Brazil: seroprevalence, tissue distribution, and biologic and genetic characterization of isolates. J Parasitol. 2004;90:721\u20136.","journal-title":"J Parasitol"},{"key":"4769_CR41","doi-asserted-by":"crossref","first-page":"438","DOI":"10.2307\/3284082","volume":"82","author":"JP Dubey","year":"1996","unstructured":"Dubey JP, Lunney JK, Shen SK, Kwok OCH, Ashford DA, Thulliez P. Infectivity of low numbers of Toxoplasma gondii oocysts to pigs. J Parasitol. 1996;82:438\u201343.","journal-title":"J Parasitol"},{"key":"4769_CR42","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1086\/656397","volume":"202","author":"JD Vaudaux","year":"2010","unstructured":"Vaudaux JD, Muccioli C, James ER, Silveira C, Magargal SL, Jung C, et al. Identification of an atypical strain of Toxoplasma gondii as the cause of a waterborne outbreak of toxoplasmosis in Santa Isabel do Ivai. Brazil J Infect Dis. 2010;202:1226\u201333.","journal-title":"Brazil J Infect Dis"},{"key":"4769_CR43","doi-asserted-by":"crossref","unstructured":"Wendte JM, Miller MA, Lambourn DM, Magargal SL, Jessup DA, Grigg ME. Self-mating in the definitive host potentiates clonal outbreaks of the apicomplexan parasites Sarcocystis neurona and Toxoplasma gondii. PLoS Genet. 2010;6:e1001261.","DOI":"10.1371\/journal.pgen.1001261"},{"key":"4769_CR44","unstructured":"Centro Estadual de Vigil\u00e2ncia em Sa\u00fade do Rio Grande do Sul. Prefeitura e Governo do Estado atualizam dados referentes aos casos de Toxoplasmose na cidade. 2018. https:\/\/www.cevs.rs.gov.br\/prefeitura-e-governo-do-estado-atualizam-dados-referentes-aos-casos-de-toxoplasmose-na-cidade. Accessed 25 Apr 2021"},{"key":"4769_CR45","unstructured":"Menegolla IA, Difante CM, Ramos L, Dorneles D, Streb A, Mello L et al. Investiga\u00e7\u00e3o de surto de toxoplasmose em Santa Maria\/RS, 2018. IV Simp\u00f3sio Brasileiro de toxoplasmose, Brasilia, DF. 2018:60\u201361. http:\/\/bvsms.saude.gov.br\/bvs\/publicacoes\/simposio_toxoplasmose_resumos.pdf. Accessed 25 Apr 2021"},{"key":"4769_CR46","unstructured":"Cardoso FB, Menegolla IA. Toxoplasmose adquirida em surto de doen\u00e7a de transmiss\u00e3o h\u00eddrica ou alimentar: Um problema de sa\u00fade p\u00fablica. 7 Simp\u00f3sio de Seguran\u00e7a Alimentar, 27 a 29 de outubro de 2020. 2020. http:\/\/schenautomacao.com.br\/ssa7\/envio\/files\/trabalho3_236.pdf. Accessed 25 Apr 2021"},{"key":"4769_CR47","unstructured":"Estado do Rio Grande do Sul, Prefeitura Municipal de Santa Maria, Secretaria de Munic\u00edpio de Sa\u00fade. Relat\u00f3rio de gest\u00e3o anual 2018. 2018. https:\/\/www.santamaria.rs.gov.br\/saude\/658-520relatorios-anuais-de-gestao. Accessed 25Apr 2021"},{"issue":"Suppl 1","key":"4769_CR48","doi-asserted-by":"crossref","first-page":"S74","DOI":"10.1017\/S1049023X19001602","volume":"34","author":"S Dal Ponte","year":"2019","unstructured":"Dal Ponte S, Burguez D, Andrioli G. Outbreak of toxoplasmosis in the city of Santa Maria, Brazil. Prehosp Disaster Med. 2019;34(Suppl 1):S74.","journal-title":"Prehosp Disaster Med"},{"key":"4769_CR49","doi-asserted-by":"crossref","unstructured":"Minuzzi CE, Portella LP, Br\u00e4unig P, Sangioni LA, Ludwig A, Ramos LS, et al. Isolation and molecular characterization of Toxoplasma gondii from placental tissues of pregnant women who received toxoplasmosis treatment during an outbreak in southern Brazil. PLoS ONE. 2020;15:e0228442.","DOI":"10.1371\/journal.pone.0228442"},{"key":"4769_CR50","doi-asserted-by":"crossref","unstructured":"Pinto-Ferreira F, Nino BSL, Martins FDC, Monica TC, Britto IC, Signori A, et al. Isolation, genetic and immunohistochemical identification of Toxoplasma gondii from human placenta in a large toxoplasmosis outbreak in southern Brazil, 2018. Infect Genet Evol. 2020; 85:104589.","DOI":"10.1016\/j.meegid.2020.104589"},{"key":"4769_CR51","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2021.03.009","author":"AR Concei\u00e7\u00e3o","year":"2021","unstructured":"Concei\u00e7\u00e3o AR, Belucik DN, Missio L, Brenner LG, Monteiro MH, Ribeiro KS, et al. Ocular findings in infants with congenital toxoplasmosis following a toxoplasmosis outbreak. Ophthalmology. 2021. https:\/\/doi.org\/10.1016\/j.ophtha.2021.03.009.","journal-title":"Ophthalmology"},{"key":"4769_CR52","doi-asserted-by":"crossref","unstructured":"Nunes do Rego e Silva G, Branco MRFC, Rodrigues ZMR, dos Santos AM, Pereira PRM, da Silva MS, et al. Toxoplasmosis outbreak in Brazil, 2006\u2014Revisited. Parasite Epidemiol Control. 2019;7: e00117.","DOI":"10.1016\/j.parepi.2019.e00117"},{"key":"4769_CR53","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1001\/jama.1969.03160060072008","volume":"208","author":"BH Kean","year":"1969","unstructured":"Kean BH, Kimball AC, Christenson WN. An epidemic of acute toxoplasmosis. J Am Med Assoc. 1969;208:1002\u20134.","journal-title":"J Am Med Assoc"},{"key":"4769_CR54","first-page":"285","volume":"24","author":"WG Lord","year":"1975","unstructured":"Lord WG, Boni F, Bodek A, Hilberg RW, Rosini R, Clack FB. Toxoplasmosis - Pennsylvania. Morbid Mortal. 1975;24:285\u20136.","journal-title":"Morbid Mortal"},{"key":"4769_CR55","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/0002-9343(78)90218-8","volume":"64","author":"H Masur","year":"1978","unstructured":"Masur H, Jones TC, Lempert JA, Cherubini TD. Outbreak of toxoplasmosis in a family and documentation of acquired retinochoroiditis. Am J Med. 1978;64:396\u2013402.","journal-title":"Am J Med"},{"key":"4769_CR56","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1093\/oxfordjournals.aje.a113701","volume":"118","author":"JJ Sacks","year":"1983","unstructured":"Sacks JJ, Delgado DG, Lobel HO, Parker RL. Toxoplasmosis infection associated with eating undercooked venison. Am J Epidemiol. 1983;118:832\u20138.","journal-title":"Am J Epidemiol"},{"key":"4769_CR57","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1093\/ofid\/ofy338","volume":"6","author":"JH England","year":"2019","unstructured":"England JH, Bailin SS, Gehlhausen JR, Rubin DH. Toxoplasmosis: The heart of the diagnosis. Open Forum Infect Dis. 2019;6:338. https:\/\/doi.org\/10.1093\/ofid\/ofy338.","journal-title":"Open Forum Infect Dis."},{"key":"4769_CR58","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1097\/00006982-200106000-00005","volume":"21","author":"RD Ross","year":"2001","unstructured":"Ross RD, Stec LA, Werner JC, Blumenkranz MS, Glazer L, Williams GA. Presumed acquired ocular toxoplasmosis in deer hunters. Retina. 2001;21:226\u20139.","journal-title":"Retina"},{"key":"4769_CR59","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1017\/S0031182020000451","volume":"147","author":"JP Dubey","year":"2020","unstructured":"Dubey JP, Cerqueira-C\u00e9zar CK, Murata FHA, Verma SK, Kwok OCH, Pedersen K, et al. White-tailed deer (Odocoileus virginianus) are a reservoir of a diversity of Toxoplasma gondii strains in the USA and pose a risk to consumers of undercooked venison. Parasitology. 2020;147:775\u201381.","journal-title":"Parasitology"},{"key":"4769_CR60","doi-asserted-by":"publisher","DOI":"10.1080\/09273948.2020.1854316","author":"CD Conrady","year":"2021","unstructured":"Conrady CD, Besirli CG, Baumal CR, Kovach JL, Etzel JD, Tsui JC, et al. Ocular toxoplasmosis after exposure to wild game. Ocul Immunol Inflamm. 2021. https:\/\/doi.org\/10.1080\/09273948.2020.1854316.","journal-title":"Ocul Immunol Inflamm"},{"key":"4769_CR61","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1590\/S0037-86821997000100005","volume":"30","author":"AM Bonametti","year":"1997","unstructured":"Bonametti AM, Passos JN, da Silva EMK, Bortoliero AL. Surto de toxoplasmose aguda transmitida atrav\u00e9s da ingest\u00e3o de carne crua de gado ovino. Rev Soc Bras Med Trop. 1997;30:21\u20135.","journal-title":"Rev Soc Bras Med Trop"},{"key":"4769_CR62","first-page":"516","volume":"19","author":"JMB Robson","year":"1995","unstructured":"Robson JMB, Wood RN, Sullivan JJ, Nicolaides NJ, Lewis BR. A probable foodborne outbreak of toxoplasmosis. Comm Dis Intell. 1995;19:516\u201322.","journal-title":"Comm Dis Intell"},{"key":"4769_CR63","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1086\/593702","volume":"175","author":"WY Choi","year":"1997","unstructured":"Choi WY, Nam HW, Kwak NH, Huh W, Kim YR, Kang MW, et al. Foodborne outbreaks of human toxoplasmosis. J Infect Dis. 1997;175:1280\u20132.","journal-title":"J Infect Dis"},{"key":"4769_CR64","unstructured":"de Almeida MAB, de Alencar J\u00fanior LR, do Carmo GMI, de Ara\u00fajo WN, Garcia MHO, Reis AKV, et al. Surto intra familiar de toxoplasmose, Santa Vit\u00f3ria do Palmar-RS, Julho de 2005. Minist\u00e9rio da Sa\u00fade. Secretaria da Vigil\u00e2ncia em Sa\u00fade. Boletim Eletr\u00f4nico Epidemiol\u00f3gico. 2006;6:1\u20137."},{"key":"4769_CR65","first-page":"2","volume":"4","author":"MBP Eduardo","year":"2007","unstructured":"Eduardo MBP, Katsuya EM, Ramos SRTS, Pavanello EI, Paiva OR, Brito SN, et al. Investiga\u00e7\u00e3o do surto de toxoplasmose associado ao consumo de prato \u00e0 base de carne crua (\u201csteak tartar\u201d), nos munic\u00edpios de S\u00e3o Paulo e Guaruj\u00e1, SP - Novembro de 2006. Boletim Epidemiol\u00f3gico Paulista. 2007;4:2\u20137.","journal-title":"Boletim Epidemiol\u00f3gico Paulista"},{"key":"4769_CR66","unstructured":"Ginsbourger M, Guinard A, Villena I, King LA, El-Eid N, Schwoebel V. Toxi-infection alimentaire collective \u00e0 Toxoplasma gondii li\u00e9e \u00e0 la consommation d'agneau. Aveyron (France), novembre 2010. BEH. 2012;16:195\u201397."},{"key":"4769_CR67","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1136\/bmj.1.6068.1064","volume":"1","author":"A Fertig","year":"1977","unstructured":"Fertig A, Selwyn S, Tibble MJK. Tetracycline treatment in a food-borne outbreak of toxoplasmosis. Br Med J. 1977;1:1064.","journal-title":"Br Med J"},{"key":"4769_CR68","doi-asserted-by":"crossref","first-page":"e88","DOI":"10.1086\/521246","volume":"45","author":"M Demar","year":"2007","unstructured":"Demar M, Ajzenberg D, Maubon D, Djossou F, Panchoe D, Punwasi W, et al. Fatal outbreak of human toxoplasmosis along the Maroni River: epidemiological, clinical, and parasitological aspects. Clin Infect Dis. 2007;45:e88\u201395.","journal-title":"Clin Infect Dis"}],"container-title":["Parasites &amp; Vectors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13071-021-04769-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13071-021-04769-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13071-021-04769-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T09:06:55Z","timestamp":1636708015000},"score":1,"resource":{"primary":{"URL":"https:\/\/parasitesandvectors.biomedcentral.com\/articles\/10.1186\/s13071-021-04769-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,19]]},"references-count":68,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["4769"],"URL":"https:\/\/doi.org\/10.1186\/s13071-021-04769-4","relation":{},"ISSN":["1756-3305"],"issn-type":[{"value":"1756-3305","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,19]]},"assertion":[{"value":"13 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 May 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 May 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable<b>.<\/b>","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Yes.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The author declares that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"263"}}