Sources of toxoplasma infection in pregnant women: European multicentre case-control study

Objective To determine the odds ratio and population attributable fraction associated with food and environmental risk factors for acute toxoplasmosis in pregnancy. Design Case-control study. Setting Six large European cities. Participants Pregnant women with acute infection (cases) detected by seroco nversion or positive for anti-Toxoplasma gondii IgM were compared with preg nant women seronegative for toxoplasma (controls). Main outcome measures Odds ratios for acute infection adjusted for confound ing variables; the population attributable fraction for risk factors. Results Risk factors most strongly predictive of acute infection in pregnan t women were eating undercooked lamb, beef, or game, contact with soil, and travel outside Europe and the United States and Canada. Contact with cats was not a risk factor. Between 30% and 63% of infections in different centr es were attributed to consumption of undercooked or cured meat products and 6% to 17% to soil contact. Conclusions Inadequately cooked or cured meat is Naples, Italy the main ris k factor for infection with toxoplasma in consultant all centres. Preventiv e strategies should aim to reduce Paediatrician prevalence of infection in meat, improve labelling of Institute of meat according to farming and proce ssing methods, and improve the quality and consistency of health informatio n given to pregnant women.