Summary: The apicomplexan parasite Toxoplasma gondii was discovered a little over 100 years ago, but knowledge of its biological life cycle and its medical importance has grown in the last 40 years. This obligate intracellular parasite was identified early as a pathogen responsible for congenital infection, but its clinical expression and the importance of reactivations of infections in immunocompromised patients were recognized later, in the era of organ transplantation and HIV infection. Recent knowledge of host cell-parasite interactions and of parasite virulence has brought new insights into the comprehension of the pathophysiology of infection. In this review, we focus on epidemiological and diagnostic aspects, putting them in perspective with current knowledge of parasite genotypes. In particular, we provide critical information on diagnostic methods according to the patient's background and discuss the implementation of screening tools for congenital toxoplasmosis according to health policies.

https://hal.archives-ouvertes.fr/hal-00696903/document

Epidemiology of and Diagnostic Strategies for Toxoplasmosis

Toxoplasmosis in sheep--the last 20 years.

Zoonotic protozoa: from land to sea

Microsatellite analysis of Toxoplasma gondii shows considerable polymorphism structured into two main clonal groups

Molecular tools--advances, opportunities and prospects.

High levels of congenital transmission of Toxoplasma gondii in a commercial sheep flock.

MGE-PCR : a novel approach to the analysis of toxoplasma gondii strain differentiation using mobile genetic elements

. Toxoplasma gondii is a ubiquitous parasite with a widespread distribution both in terms of geographical and host range. Although the definitive host is the cat, it is also a major health hazard to domestic animals and humans. Three routes of transmission are recognised (infection from the cat, carnivory and congenital transmission). We aimed to assess the relative importance of congenital transmission, using sheep as a model system, due to the lack of carnivory. We report, using PCR as a diagnostic tool, that congenital transmission occurs with high frequency (69%). If transmission from oocysts was important in sheep, we would expect sheep reared under the same environmental conditions (i.e. a single farm) to have a random distribution of Toxoplasma infection. Using breeding records in conjunction with PCR, some families were found to have high Toxoplasma prevalence and abortion while others were free of Toxoplasma infection and abortion (P<0.01). This supports the notion that Toxoplasma may be transmitted vertically. In humans, we conducted a similar study and showed that Toxoplasma was transmitted from mother to baby in 19.8% of cases. Vertical transmission in Toxoplasma may be more important than previously thought and this knowledge should be considered in any eradication strategies.

R. S. Terry

Papers

High levels of congenital transmission of Toxoplasma gondii in a commercial sheep flock.

MGE-PCR : a novel approach to the analysis of toxoplasma gondii strain differentiation using mobile genetic elements

Does vertical transmission contribute to the prevalence of toxoplasmosis