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Title:   Author  item
                                            BOYER, KENNETH - University Of Chicagoitem
                                            Hill, Doloresitem
                                            MUI, ERNEST - University Of Chicagoitem
                                            WROBLEWSKI, KRISTEN - University Of Chicagoitem
                                            KARRISON, THEODORE - University Of Chicagoitem
                                            Dubey, Jitenderitem
                                            SAUTTER, MARI - University Of Chicagoitem
                                            NOBLE, GWENDOLYN - University Of Chicagoitem
                                            WITHERS, SHAWN - University Of Chicagoitem
                                            SWISHER, CHARLES - University Of Chicagoitem
                                            HEYDEMANN, PETER - Rush University Medical Centeritem
                                            HOSTEN, TIFFANY - University Of Chicagoitem
                                            BABIARZ, JOHN - University Of Chicagoitem
                                            LEE, DANIEL - University Of Chicagoitem
                                            MCLEOD, RIMA - University Of Chicago
  Submitted to: Clinical Infectious Diseases
                                    Publication Type: Peer Reviewed Journal
                                    Publication Acceptance Date: 6/1/2011
                                    Publication  Date: 12/1/2011
                                    Citation: Boyer, K., Hill, D.E., Mui, E., Wroblewski, K., Karrison, T., Dubey, J.P., Sautter, M., Noble, G., Withers, S., Swisher, C., Heydemann, P., Hosten, T., Babiarz, J., Lee, D., Mcleod, R. 2011. Unrecognized ingestion of Toxoplasma gondii oocysts causes congenital toxoplasmosis and epidemics in North America. Clinical Infectious Diseases. 53:1081-1089.Interpretive Summary: Congenital toxoplasmosis presents as severe, life-altering disease in the United States. If mothers of infants with congenital toxoplasmosis could be identified by their risk factors, it would provide strong support for educating pregnant women about risk factors in order to eliminate this disease. Conversely, if not all risk factors are recognizable or otherwise identifiable, it suggests presence of undetectable environmental risks. A new test to detect antibodies to the sporozoite form of the parasite demonstrated that oocysts were the predominant source of Toxoplasma gondii infection in 4 North American epidemics and in mothers of children in the NCCCTS between 1981 and 2004. This novel test offered the opportunity to determine whether any demographic features or risk factors could identify new mothers with toxoplasmosis infections caused by oocysts.  This test and information that results from its use will be of widespread interest to clinicians treating Toxoplasma infected pregnant women and their newborn infants. 
These data will provide a method to prevent future infections in this population through specific identification of risk factors and development of educational materials for distribution to at-risk populations, especially in medically underserved communities.
                                Technical Abstract: Undetected contamination of food and water by T. gondii oocysts frequently causes infection of humans in North America.Risks are often unrecognized by those infected. Demographic factors did not identify those with oocysts infections. Thus, although education programs describing hygienic measures may be of some benefit in preventing oocyst infection, they will not be sufficient to prevent the suffering and the adverse economic consequences associated with congenital toxoplasmosis in North America. Only a vaccine or implementation of systematic serologic testing of pregnant women and newborns followed by treatment will prevent most congenital toxoplasmosis in North America.


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