• Risk factors for Toxoplasma gondii seropositivity in the Old Order Amish

      Markon, A O; Ryan, K A; Wadhawan, A; Pavlovich, M; Groer, M W; Punzalan, C; Gensheimer, K; Jones, J; Daue, M L; Dagdag, A; et al. (Cambridge University Press, 2020-11-25)
      Toxoplasma gondii is an important human disease-causing parasite. In the US, T. gondii infects >10% of the population, accrues economic losses of US$3.6 billion/year, and ranks as the second leading culprit of foodborne illness-related fatalities. We assessed toxoplasmosis risk among the Old Order Amish, a mostly homogenous population with high prevalence of T. gondii seropositivity, using a questionnaire focusing on food consumption/preparation behaviours and environmental risk factors. Analyses were conducted using multiple logistic regression. Consuming raw meat, rare meat, or unpasteurized cow or goat milk products were associated with increased odds of seropositivity [unadjusted ORs: 2.192, 1.613, 1.718, and 1.741, respectively). In separate models by sex, consuming raw meat, or consuming unpasteurized cow or goat milk products, were associated with increased odds of seropositivity among women; washing hands and touching meat with decreased odds of seropositivity among women [adjusted OR (AOR): 0.462]; and cleaning cat litterbox with increased odds of seropositivity among men (AOR: 5.241). This is the first study to assess associations between behavioural and environmental risk factors and T. gondii seropositivity in a US population with high seroprevalence for T. gondii. Our study emphasizes the importance of proper food safety behaviours to avoid risk of infection.