目标:描述圣保罗市2019年急性弓形虫病暴发,巴西,并连续三年评估弓形虫病的实验室血清学概况。还研究了暴发患者的眼科表现。
方法:对圣保罗弓形虫病爆发的横断面描述性研究,巴西,2019年2月至5月。描述了流行病学数据,以及观察到的眼部表现。作为这项研究的一部分,从大型实验室网络(DASA)连续三年获得IgM弓形虫血清学阳性的患者人数。包括疫情当年(2018年、2019年、2020年)。
结果:在疫情中确定了83个人,并研究了两个集群。至少77%的患者的临床表现,流行病学分析,潜伏期短(5-8天)提示卵囊污染。血清学实验室数据分析显示,与上一年相比,2019年弓形虫病IgM阳性增加了73%。眼科检查显示,至少有4.8%的患者发展为弓形视网膜脉络膜炎,在急性全身性疾病期间,没有人接受过治疗。
结论:我们的研究结果表明,蔬菜污染是此次疫情的可能来源,在爆发期间,圣保罗弓形虫病的患病率很高,在COVID-19大流行期间,检测数量有所下降。在至少4.8%的病例中观察到视网膜脉络炎。我们确认需要实施有效的预防手段,诊断,和疾病的治疗。这可能涉及提高民众对蔬菜卫生重要性的认识,改善食品和水的质量控制。
OBJECTIVE: To describe a 2019 acute toxoplasmosis outbreak in the city of São Paulo, Brazil, and to evaluate the laboratory serological profile for toxoplasmosis for three consecutive years. The ophthalmological manifestations of the patients involved in the outbreak were also studied.
METHODS: A cross-sectional descriptive study of a toxoplasmosis outbreak in São Paulo, Brazil, between February and May 2019. Epidemiological data were described, as were the observed ocular manifestations. As part of this study the number of patients with positive IgM toxoplasmosis serology was obtained from a large laboratory network (DASA) for three consecutive years, including the year of the outbreak (2018, 2019, 2020).
RESULTS: Eighty-three individuals were identified in the outbreak and two clusters were studied. The clinical picture of at least 77% of the patients, the epidemiological analysis, and the short incubation period (5-8 days) suggested contamination by oocysts. Serological laboratory data analysis revealed an increase of positive toxoplasmosis IgM in 2019 of 73% compared to the previous year. Ophthalmological examination revealed that at least 4.8% of the patients developed toxoplasmic retinochoroiditis, none of whom had been treated during the acute systemic disease.
CONCLUSIONS: Our findings indicate vegetable contamination as the possible source of this outbreak, a high prevalence of toxoplasmosis in São Paulo during the outbreak period, and a drop in the number of tests during the COVID-19 pandemic. Retinochoroiditis was observed in at least 4.8% of the cases. We confirm the need to implement effective means for the prevention, diagnosis, and treatment of the disease. This may involve raising awareness among the population of the importance of vegetable hygiene, and improved quality control of food and water.