Jones JL, Roberts JM, 2012. Toxoplasmosis hospitalizations in the United States 2008, and trends 1993–2008. Clin Infect Dis 54: e58–e61.
Holland GN, 2003. Ocular toxoplasmosis: a global reassessment. Part I: epidemiology and course of disease. Am J Ophthalmol 136: 973–988.
Jones JL, Parise ME, Fiore AE, 2014. Neglected parasitic infections in the United States: toxoplasmosis. Am J Trop Med Hyg 90: 794–799.
Torrey EF, Bartko JJ, Yolken RH, 2012. Toxoplasma gondii and other risk factors for schizophrenia: an update. Schizophr Bull 38: 642–647.
Pearce BD, Kruszon-Moran D, Jones JL, 2012. The relationship between Toxoplasma gondii infection and mood disorders in the Third National Health and Nutrition Survey. Biol Psychiatry 72: 290–295.
Bharti AR, McCutchan A, Deutsch R, Smith DM, Ellis RJ, Cherner M, Woods SP, Heaton RK, Grant I, Letendre SL, 2016. Latent Toxoplasma infection and higher Toxoplasma gondii immunoglobulin G levels are associated with worse neurocognitive functioning in HIV-infected adults. Clin Infect Dis 63: 1655–1660.
Rougier S, Montoya JG, Peyron F, 2017. Lifelong persistence of Toxoplasma cysts: a question of dogma? Trends Parasitol 33: 93–101.
Dubey JP, 2010. Toxoplasmosis of Animals and Humans. Boca Raton, FL: CRC Press, Taylor and Francis Group, 77.
Wilson M, Remington JS, Clavet C, Varney G, Press C, Ware D, 1997. Evaluation of six commercial kits for detection of human immunoglobulin M antibodies to Toxoplasma gondii. The FDA toxoplasmosis Ad Hoc Working Group. J Clin Microbiol 35: 3112–3115.
Dhakal R, Gajurel K, Pomares C, Talucod J, Press CJ, Montoya JG, 2015. Significance of a positive Toxoplasma immunoglobulin M test result in the United States. J Clin Microbiol 53: 3601–3605.
Centers for Disease Control and Prevention, 2016. NHANES Documentation. Available at: http://www.cdc.gov/nchs/nhanes/about_nhanes.htm. Accessed August 23, 2017.
Jones JL, Kruszon-Moran D, Wilson M, McQuillan G, Navin T, McAuley JB, 2001. Toxoplasma gondii in the United States, seroprevalence and risk factors. Am J Epidemiol 154: 357–365.
Montoya JG, Huffman HB, Remington JS, 2004. Evaluation of the immunoglobulin G avidity test for diagnosis of toxoplasmic lymphadenopathy. J Clin Microbiol 42: 4627–4631.
Findal G, Stray-Pedersen B, Holter EK, Berge T, Jenum PA, 2015. Persistent low toxoplasma IgG avidity is common in pregnancy: experience from antenatal testing in Norway. PLoS One 10: e0145519.
Flori P, Tardy L, Patural H, Bellete B, Varlet MN, Hafid J, Raberin H, Sung RT, 2004. Reliability of immunoglobulin G antitoxoplasma avidity test and effects of treatment on avidity indexes of infants and pregnant women. Clin Diagn Lab Immunol 11: 669–674.
Johnson CL, Paulose-Ram R, Ogden CL, Carroll MD, Kruszon-Moran D, Dohrmann SM, Curtin LR, 2013. National health and nutrition examination survey: analytic guidelines, 1999–2010. Vital Health Statistics Series 2, Number 161. Available at: http://www.cdc.gov/nchs/data/series/sr_02/sr02_161.pdf. Accessed August 23, 2017.
United States Department of Health and Human Services, 2016. Poverty Guidelines. Available at: https://aspe.hhs.gov/poverty-guidelines. Accessed August 23, 2017.
Pappas G, Roussos N, Falagas ME, 2009. Toxoplasmosis snapshots: global status of Toxoplasma gondii seroprevalence and implications for pregnancy and congenital toxoplasmosis. Int J Parasitol 39: 1385–1394.
Caballero-Ortega H, Uribe-Salas FJ, Conde-Glez CJ, Cedillo-Pelaez C, Vargas-Villavicencio JA, Luna-Paste’n H, Cañedo-Solares I, Ortiz-Alegría LB, Correa D, 2012. Seroprevalence and national distribution of human toxoplasmosis in Mexico: analysis of the 2000 and 2006 National Health Surveys. Trans R Soc Trop Med Hyg 106: 653–659.
Research Triangle Institute, 2016. SUDAAN User’s Manual Release 11.1. Research Triangle Park, NC: Research Triangle Institute.
Korn EL, Graubard BI, 1998. Confidence intervals for proportions with small expected number of positive counts estimated from survey data. Surv Methodol 24: 193–201.
Jones JL, Kruszon-Moran D, Rivera H, Price C, Wilkins P, 2014. Toxoplasma gondii seroprevalence in the United States 2009–2010 and comparison with the past two decades. Am J Trop Med Hyg 90: 1135–1139.
Jones JL, Kruszon-Moran D, Sanders-Lewis K, Wilson M, 2007. Toxoplasma gondii infection in the United States, 1999–2004, decline from the prior decade. Am J Trop Med Hyg 77: 405–410.
National Gardening Association, 2014. National Gardening Association Special Report, Garden to Table, a 5-Year Look at Food Gardening in America. Available at: https://garden.org/special/pdf/2014-NGA-Garden-to-Table.pdf. Accessed August 23, 2017.
U.S. Census Bureau, 2014. Population Projections. Available at: https://www.census.gov/data/tables/2014/demo/popproj/2014-summary-tables.html. Accessed August 23, 2017.
Sabin AB, Feldman HA, 1948. Dyes as microchemical indicators of a new immunity phenomenon affecting a protozoan parasite (Toxoplasma). Science 108: 660–663.
Villard O, Cimon B, L’Ollivier C, Fricker-Hidalgo H, Godineau N, Houze S, Paris L, Pelloux H, Villena I, Candolfi E, 2016. Help in the choice of automated or semiautomated immunoassays for serological diagnosis of toxoplasmosis: evaluation of nine immunoassays by the French national reference center for toxoplasmosis. J Clin Microbiol 54: 3034–3042.
Fricker-Hidalgo H et al. 2013. Toxoplasma seroconversion with negative or transient immunoglobulin M in pregnant women: myth or reality? A French multicenter retrospective study. J Clin Microbiol 51: 2103–2111.
Montoya JG, 2002. Laboratory diagnosis of Toxoplasma gondii infection and toxoplasmosis. J Infect Dis 185 (Suppl 1): S73–S82.
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Toxoplasma gondii can cause severe neurologic and ocular disease when transmitted congenitally and in immunosuppressed persons. Sera collected in the National Health and Nutrition Examination Survey 2011 through 2014 in 13,507 persons ≥ 6 years old were tested for T. gondii immunoglobulin (Ig) G and IgM antibodies, and in those both IgG and IgM antibody positive, for IgG avidity. Overall, 11.14% (95% confidence limits [CL] 9.88%, 12.51%) were seropositive for T. gondii IgG antibody (age-adjusted seroprevalence 10.42% [95% CL 9.19%, 11.76%]); in women aged 15–44 years, the age-adjusted T. gondii IgG seroprevalence was 7.50% (95% CL 6.00%, 9.25%). In multivariable analysis, risk for IgG seropositivity increased with age and was higher in males; persons living below the poverty level; persons with ≤ a high school education compared with those with > a high school education; and non-Hispanic black, Mexican American, and foreign born non-Hispanic white persons compared with U.S.-born non-Hispanic white persons. Overall, 1.16% (95% CL 0.94%, 1.42%) were T. gondii IgM antibody positive and 0.71%, (95% CL 0.54%, 0.92%) were both IgM and IgG antibody positive. In multivariable analysis, the significant risk factors for being both IgM and IgG positive were older age, crowding, and non-U.S. birth origin compared with U.S.-born persons. Among those positive for both IgM and IgG antibody, almost all had high avidity (all women aged 15–44 years had high avidity). Toxoplasma gondii antibody prevalence remains relatively low in the United States, although it is higher in non-U.S.–born persons, males, and some minority and socioeconomically disadvantaged groups.
Financial support: The work was done by staff at the Centers for Disease Control and Prevention, Atlanta, Georgia, and Hyattsville, Maryland, and the Palo Alto Medical Foundation, Toxoplasma Serology Laboratory, Palo Alto, CA.
Authors’ addresses: Jeffery L. Jones, Scott Elder, and Hilda N. Rivera, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, 30329, E-mails: c/o igi2@cdc.gov, ivy3@cdc.gov, and igi2@cdc.gov. Deanna Kruszon-Moran and Geraldine M. McQuillan, Division of Health and Nutrition Examination Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD; E-mails: ddk0@cdc.gov and mgmm2@cdc.gov. Cindy Press and Jose G. Montoya, Palo Alto Medical Foundation, Toxoplasma Serology Laboratory, Palo Alto, California; E-mails: pressc@sutterhealth.org and Gilberto@stanford.edu.
Jones JL, Roberts JM, 2012. Toxoplasmosis hospitalizations in the United States 2008, and trends 1993–2008. Clin Infect Dis 54: e58–e61.
Holland GN, 2003. Ocular toxoplasmosis: a global reassessment. Part I: epidemiology and course of disease. Am J Ophthalmol 136: 973–988.
Jones JL, Parise ME, Fiore AE, 2014. Neglected parasitic infections in the United States: toxoplasmosis. Am J Trop Med Hyg 90: 794–799.
Torrey EF, Bartko JJ, Yolken RH, 2012. Toxoplasma gondii and other risk factors for schizophrenia: an update. Schizophr Bull 38: 642–647.
Pearce BD, Kruszon-Moran D, Jones JL, 2012. The relationship between Toxoplasma gondii infection and mood disorders in the Third National Health and Nutrition Survey. Biol Psychiatry 72: 290–295.
Bharti AR, McCutchan A, Deutsch R, Smith DM, Ellis RJ, Cherner M, Woods SP, Heaton RK, Grant I, Letendre SL, 2016. Latent Toxoplasma infection and higher Toxoplasma gondii immunoglobulin G levels are associated with worse neurocognitive functioning in HIV-infected adults. Clin Infect Dis 63: 1655–1660.
Rougier S, Montoya JG, Peyron F, 2017. Lifelong persistence of Toxoplasma cysts: a question of dogma? Trends Parasitol 33: 93–101.
Dubey JP, 2010. Toxoplasmosis of Animals and Humans. Boca Raton, FL: CRC Press, Taylor and Francis Group, 77.
Wilson M, Remington JS, Clavet C, Varney G, Press C, Ware D, 1997. Evaluation of six commercial kits for detection of human immunoglobulin M antibodies to Toxoplasma gondii. The FDA toxoplasmosis Ad Hoc Working Group. J Clin Microbiol 35: 3112–3115.
Dhakal R, Gajurel K, Pomares C, Talucod J, Press CJ, Montoya JG, 2015. Significance of a positive Toxoplasma immunoglobulin M test result in the United States. J Clin Microbiol 53: 3601–3605.
Centers for Disease Control and Prevention, 2016. NHANES Documentation. Available at: http://www.cdc.gov/nchs/nhanes/about_nhanes.htm. Accessed August 23, 2017.
Jones JL, Kruszon-Moran D, Wilson M, McQuillan G, Navin T, McAuley JB, 2001. Toxoplasma gondii in the United States, seroprevalence and risk factors. Am J Epidemiol 154: 357–365.
Montoya JG, Huffman HB, Remington JS, 2004. Evaluation of the immunoglobulin G avidity test for diagnosis of toxoplasmic lymphadenopathy. J Clin Microbiol 42: 4627–4631.
Findal G, Stray-Pedersen B, Holter EK, Berge T, Jenum PA, 2015. Persistent low toxoplasma IgG avidity is common in pregnancy: experience from antenatal testing in Norway. PLoS One 10: e0145519.
Flori P, Tardy L, Patural H, Bellete B, Varlet MN, Hafid J, Raberin H, Sung RT, 2004. Reliability of immunoglobulin G antitoxoplasma avidity test and effects of treatment on avidity indexes of infants and pregnant women. Clin Diagn Lab Immunol 11: 669–674.
Johnson CL, Paulose-Ram R, Ogden CL, Carroll MD, Kruszon-Moran D, Dohrmann SM, Curtin LR, 2013. National health and nutrition examination survey: analytic guidelines, 1999–2010. Vital Health Statistics Series 2, Number 161. Available at: http://www.cdc.gov/nchs/data/series/sr_02/sr02_161.pdf. Accessed August 23, 2017.
United States Department of Health and Human Services, 2016. Poverty Guidelines. Available at: https://aspe.hhs.gov/poverty-guidelines. Accessed August 23, 2017.
Pappas G, Roussos N, Falagas ME, 2009. Toxoplasmosis snapshots: global status of Toxoplasma gondii seroprevalence and implications for pregnancy and congenital toxoplasmosis. Int J Parasitol 39: 1385–1394.
Caballero-Ortega H, Uribe-Salas FJ, Conde-Glez CJ, Cedillo-Pelaez C, Vargas-Villavicencio JA, Luna-Paste’n H, Cañedo-Solares I, Ortiz-Alegría LB, Correa D, 2012. Seroprevalence and national distribution of human toxoplasmosis in Mexico: analysis of the 2000 and 2006 National Health Surveys. Trans R Soc Trop Med Hyg 106: 653–659.
Research Triangle Institute, 2016. SUDAAN User’s Manual Release 11.1. Research Triangle Park, NC: Research Triangle Institute.
Korn EL, Graubard BI, 1998. Confidence intervals for proportions with small expected number of positive counts estimated from survey data. Surv Methodol 24: 193–201.
Jones JL, Kruszon-Moran D, Rivera H, Price C, Wilkins P, 2014. Toxoplasma gondii seroprevalence in the United States 2009–2010 and comparison with the past two decades. Am J Trop Med Hyg 90: 1135–1139.
Jones JL, Kruszon-Moran D, Sanders-Lewis K, Wilson M, 2007. Toxoplasma gondii infection in the United States, 1999–2004, decline from the prior decade. Am J Trop Med Hyg 77: 405–410.
National Gardening Association, 2014. National Gardening Association Special Report, Garden to Table, a 5-Year Look at Food Gardening in America. Available at: https://garden.org/special/pdf/2014-NGA-Garden-to-Table.pdf. Accessed August 23, 2017.
U.S. Census Bureau, 2014. Population Projections. Available at: https://www.census.gov/data/tables/2014/demo/popproj/2014-summary-tables.html. Accessed August 23, 2017.
Sabin AB, Feldman HA, 1948. Dyes as microchemical indicators of a new immunity phenomenon affecting a protozoan parasite (Toxoplasma). Science 108: 660–663.
Villard O, Cimon B, L’Ollivier C, Fricker-Hidalgo H, Godineau N, Houze S, Paris L, Pelloux H, Villena I, Candolfi E, 2016. Help in the choice of automated or semiautomated immunoassays for serological diagnosis of toxoplasmosis: evaluation of nine immunoassays by the French national reference center for toxoplasmosis. J Clin Microbiol 54: 3034–3042.
Fricker-Hidalgo H et al. 2013. Toxoplasma seroconversion with negative or transient immunoglobulin M in pregnant women: myth or reality? A French multicenter retrospective study. J Clin Microbiol 51: 2103–2111.
Montoya JG, 2002. Laboratory diagnosis of Toxoplasma gondii infection and toxoplasmosis. J Infect Dis 185 (Suppl 1): S73–S82.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 1447 | 1200 | 90 |
Full Text Views | 1340 | 32 | 3 |
PDF Downloads | 632 | 26 | 3 |