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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 email@example.com, firstname.lastname@example.org, and email@example.com. 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: firstname.lastname@example.org and email@example.com. Cindy Press and Jose G. Montoya, Palo Alto Medical Foundation, Toxoplasma Serology Laboratory, Palo Alto, California; E-mails: firstname.lastname@example.org and Gilberto@stanford.edu.