The significance of Medical Parasitology医学寄生虫学的意义.pptVIP

Protozoan parasite of human importance Disease : Toxoplasmosis Agent : Toxoplasma gondii Diverse routes of transmission Tissue-inhabiting Apicomplexan. Zoonosis. At risk groups. Life cycle of Toxoplasma Toxoplasma life cycle stages Toxoplasma gondii : Modes of transmission Ingestion of cyst-containing meat (carnivores) Ingestion of oocysts (environmental contamination) Congenital infection Transfusion (rare) Raw goat’s milk, lambing, transplantation Percentage of Toxoplasma infection associated with type of meat consumed Country Beef (%) Pork (%) Lamb (%) Salami (%) Belgium 6 2 10 10 Denmark 27 2 8 4 Italy 12.5 3 0.5 12.5 Norway 19 3 21 3 Switz. 8 13 10 5 Adapted from Sukthana, 2006 Seropositivity rates Continents and countries Seropositivity (%) Europe Spain Austria France Norway UK Poland 28.6% 43% up to 75% 10.9% 57-93% 46.4-58.5% USA 16-40% Central and South America Costa Rica Argentina 76% 72% S.E. Asia Indonesia Thailand 58% 2.3-21.9% Symptomatology : Toxoplasma Most infections benign Rarely severe hepatitis, encephalomyelitis, myocarditis Few cases of retinochoroiditis which can progress to blindness At risk groups (see over) Intra-uterine infections Severe clinical picture : retinochoroiditis, encephalomyelitis, hydrocephalus, microcephaly Most infections result in blindness, severe visual impairment and/or mental retardation Estimates 50-70 seriously affected births UK ; approx 3000 congenital cases USA Toxoplasma in the immunocompromised host Immunosuppression, malignancy, AIDS, organ transplantation Neurological complications - meningoencephalitis or cerebral mass lesions : cerebral toxoplasmosis Headache, confusion, ataxia, hemiparesis, retinochoroiditis Endogenous versus exogenous infection Cerebral toxoplasmosis : Centre for Disease Control (CDC) criteria for diagnosis Recent onset of focal neurological abnormality consistent with intercranial disease or reduced consciousness Evidence from brain imaging of a lesion (CT or MRI) Positive se