1. DISCUSSION AND CONCLUSION BIBLIOGRAPHIC REFERENCES
Investigation of toxoplasmose outbreak in a research institution in the north of Paraná.
Felippe Danyel Martins1, Thaís Cabral Monica1, Ricardo Luís Nascimento de Matos1, Fernanda Ferreira, Marcelle Mareze1, Andressa Maria Rorato Nascimento de Matos1, Beatriz de Souza Lima Nino1, Leia Pereira2, Simone Garani Narciso2, Regina Mitsuka-Breganó1, Roberta Lemos Freire1, Italmar Teodorico Navarro1.
Departamento de Medicina Veterinária Preventiva – DMVP/UEL
Secretaria de Saúde Municipal de Londrina
INTRODUCTION
Toxoplasmosis is an infectious disease, endemic in Brazil, caused by the protozoan Toxoplasma gondii and can be transmitted to humans mainly through ingestion of raw or undercooked meat containing cysts, food contaminated with oocysts and transplacental transmission. It is not a compulsory notification disease, being reported only the occurrence of outbreaks, gestational and congenital toxoplasmosis. The prevalence varies from 10% to 80%, depending on the area studied (DUBEY, 2009, HILL and DUBEY, 2002).
In the state of Paraná, from November 2001 to January 2002, a large-scale outbreak occurred in the municipality of Santa Izabel do Ivaí, whose investigation showed that the causal source was the contamination of the municipal water reservoir with oocysts and it was possible Isolate the agent from toxoplasmosis. (MOURA et al, 2002). The objective of this study was to conduct an investigation of a toxoplasmosis outbreak at a research institution in the city of Londrina - PR.
Figure 1. Distribution of toxoplasmosis cases by date of first symptoms.
Table1. Exposure statically associated with the outbreak of Toxoplasmosis at the research institution in Londrina PR
MATERIAL AND METHODS
The suspicion was reported to the Epidemiological Surveillance of the municipality at the end of October 2015, however, the first cases occurred in the first week of August (Figure 1). The type of case-control study was used to analyze the epidemiological results. Blood samples were collected from 694 people among employees, trainees or residents of the institution, samples of soil, water (water box), food (vegetables) served in the restaurant and felines living in the environment.
Each participant responded to an epidemiological questionnaire. In the blood samples the Microparticle Chemiluminescent Immunoassay (CMIA) was performed to detect IgM, IgG and specific IgG avidity test.
RESULTS
Of the laboratory results, 10.7% (72/694) presented positive IgM serology with low avidity IgG, and 41.3% (298/694) were IgG positive. Statistical analysis showed a significant association (p <0.001) for people who ate lunch in the restaurant of the establishment, in relation to the types of food offered daily in the restaurant during the period, there was a significant association between consuming raw salad (p <0.001), vegetables (P <0.001) and became ill (Table 1). The PCR of the car and of the environment samples was negative.
DISCUSSION AND CONCLUSION
ACKNOWLEDGMENT
Through the case study and control it was possible to conclude that the transmission occurred through food and that the source of infection was probably conveyed by vegetables, vegetables or raw vegetables served in the cafeteria, but due to the long time elapsed between the beginning of the first cases and the beginning of the investigation identification of the transmission source has been hampered. It was recommended to intensify the actions of sanitary surveillance regarding the supervision and guidance to food suppliers and to supervise and advise on the importance of good practices to kitchen staff. The acute cases were followed up by the municipal health department.
BIBLIOGRAPHIC REFERENCES
MOURA, L. et al. Surto de toxoplasmose no município de Santa Isabel do Ivaí Paraná. Boletim Eletrônico Epidemiológico FUNASA, v. 3, p. 1-3, 2002.
HILL, D.; DUBEY, J. P. Toxoplasma gondii: transmision, diagnosis and prevention. Clinical Microbiologic Infectious, v. 8, p. 634–640, 2002.
DUBEY, J.P.Toxoplasmosis of Animals and Humans. 2º ed. CRC Press; 2009, 313 páginas.