Toxoplasmosis is a parasitic disease widespread in the temperate zone. The definitive hosts of Toxoplasma gondii, which causes the disease, are cats. All warm-blooded vertebrates, including humans, can be intermediate hosts. A person is usually infected by ingesting oocysts, e.g. by consuming along with vegetables some contaminated soil, by drinking contaminated water, or by ingesting tissue cysts contained, for instance, in poorly cooked meat. Less common is congenital transmission or transmission via organ transplant from an infected donor. Recently, it has been suggested that toxoplasmosis could also be transmitted sexually from infected men to uninfected women. In this article, we discuss and present evidence for an alternative hypothesis, which suggests that toxoplasmosis could be transmitted by oral sex (via fellatio) from an infected man to an uninfected person (male or female), especially if the uninfected individual swallows the infected ejaculate. This hypothesis finds support in the following facts and findings: (1) Toxoplasma has been found in male ejaculate. (2) In several animal species, presence of the parasite in the seminal fluid of infected males can lead to infection of uninfected females during mating. (3) A higher prevalence of toxoplasmosis has been reported in both homosexuals and promiscuous individuals, i.e. in populations which practice a broader spectrum of sexual activities, including oral sex. (4) In heterosexual couples, a partner's infection seems to be a risk factor for infection in women but not in men. (5) A higher prevalence of toxoplasmosis in females compared to males has been observed in adolescents aged 10 to 14, where oral sex, including fellatio, is highly prevalent among those who have not yet engaged in penetrative intercourse. (6) On a theoretical level, one could expect that when an uninfected person swallows ejaculate containing Toxoplasma tissue cysts, this results in a similar infection pattern to ingestion of Toxoplasma-contaminated undercooked meat. (7) Approximately two-thirds of Toxoplasma infections in pregnant women cannot be explained by any of the known risk factors. (8) In both women and men who report practicing fellatio with men, there is a higher prevalence of toxoplasmosis than in corresponding controls. If our hypothesis is correct, an effective public health campaign with emphasis on early sexual education about the risks of unprotected oral sex will be necessary, especially in pregnant women and HIV-positive people. This route of toxoplasmosis transmission could be experimentally verified by force-feeding laboratory mice with the ejaculate of infected men.
- MeSH
- kočky MeSH
- lidé MeSH
- mladiství MeSH
- prevalence MeSH
- rizikové faktory MeSH
- sexuální chování MeSH
- těhotenství MeSH
- Toxoplasma * MeSH
- toxoplazmóza * epidemiologie MeSH
- zvířata MeSH
- Check Tag
- kočky MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Latent toxoplasmosis, the life-long presence of dormant stages of Toxoplasma in immunoprivileged organs and of anamnestic IgG antibodies in blood, affects about 30% of humans. Infected subjects have an increased incidence of various disorders, including schizophrenia. Several studies, as well as the character of toxoplasmosis-associated disturbance of neurotransmitters, suggest that toxoplasmosis could also play an etiological role in Obsessive-Compulsive Disorder (OCD). METHODS: The aim of the present cross-sectional study performed on a population of 7471 volunteers was to confirm the association between toxoplasmosis and OCD, and toxoplasmosis and psychological symptoms of OCD estimated by the standard Obsessive-Compulsive Inventory-Revised (OCI-R). RESULTS: Incidence of OCD was 2.18% (n=39) in men and 2.28% (n=83) in women. Subjects with toxoplasmosis had about a 2.5 times higher odds of OCD and about a 2.7 times higher odds of learning disabilities. The incidence of 18 other neuropsychiatric disorders did not differ between Toxoplasma-infected and Toxoplasma-free subjects. The infected subjects, even the OCD-free subjects, scored higher on the OCI-R. LIMITATIONS: Examined subjects provided the information about their toxoplasmosis and OCD statuses themselves, which could result in underrating the strength of observed associations. CONCLUSIONS: The results confirmed earlier reports of the association between toxoplasmosis and OCD. They also support recent claims that latent toxoplasmosis is in fact a serious disease with many impacts on quality of life of patients.
- MeSH
- dospělí MeSH
- kočky MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- neparametrická statistika MeSH
- obsedantně kompulzivní porucha diagnóza parazitologie psychologie MeSH
- průřezové studie MeSH
- schizofrenie diagnóza parazitologie MeSH
- Toxoplasma MeSH
- toxoplazmóza komplikace přenos MeSH
- zvířata MeSH
- Check Tag
- dospělí MeSH
- kočky MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
The protozoan Toxoplasma gondii infects about one-third of the world's population. The consumption of raw meat, contact with cats, contact with soil, and ingestion of food or water contaminated with soil are considered to be the most important sources of infection. Still in most women who were infected during pregnancy, no definitive source of infection is found. In 2014-2016, independent sources of T. gondii infection were searched for by gathering epidemiological data from 1865 (519 infected) responders. Touching garden soil (odds ratio (OR) 3·14, 95% confidence interval (CI) 1·3-6·35), sustaining cat-related injuries (OR 2·16, 95% CI 1·25-3·74), and eating improperly washed root vegetables (OR 1·71, 95% CI 1·02-2·87), but not risky sexual behavior (OR 1·22, 95% CI 0·79-1·90), were the predictors of infection. The seroprevalence of T. gondii infection had been increasing up to ages 35-50 in men and ages 50-54 in women. Past those ages, seroprevalence of toxoplasmosis has been decreasing. This suggests that the natural decrease of anamnestic antibodies concentrations over time leads to positivity-to-negativity seroconversion in many subjects. If this is true, then the prevalence of T. gondii infection in a general population and its potential impacts on public health could be much larger than generally believed.
- MeSH
- dospělí MeSH
- kočky MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- prevalence MeSH
- průzkumy a dotazníky MeSH
- psi MeSH
- riskování * MeSH
- rizikové faktory MeSH
- senioři MeSH
- séroepidemiologické studie MeSH
- sexuální chování * MeSH
- Toxoplasma fyziologie MeSH
- toxoplazmóza zvířat epidemiologie parazitologie MeSH
- toxoplazmóza epidemiologie parazitologie MeSH
- věkové faktory MeSH
- zvířata MeSH
- Check Tag
- dospělí MeSH
- kočky MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- psi MeSH
- senioři MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- Slovenská republika epidemiologie MeSH
Toxoplasma gondii infects about 30% of the human population. Common sources of infection are oocysts in cat faeces contaminating drinking water or unwashed vegetables, undercooked meat containing tissue cysts, and organ transplants from infected donors containing tissue cysts. However, very often, it is not possible to identify any potential source of infection in mothers of children with congenital toxoplasmosis. Here we present a hypothesis suggesting that toxoplasmosis is transmitted from infected men to noninfected women during unprotected sexual intercourse, which can result in the most serious form of disease, congenital toxoplasmosis. Arguments for the hypothesis: (1) Toxoplasma tachyzoites are present in the seminal fluid and tissue of the testes of various animals including humans. In some species infection of females by artificial insemination with semen from infected males has been observed. (2) Up to two thirds of Toxoplasma infections in pregnant women cannot be explained by the known risk factors. (3) Prevalence of toxoplasmosis in women in child-bearing age covaries with the incidence of sexually transmitted diseases in particular countries. (4) In some countries, an increased incidence of toxoplasmosis has been reported in women (but not men) aged 25-35 years. This second peak of infection could be associated with women having regular unprotected sex after marriage. (5) Toxoplasmosis triggers schizophrenia in predisposed subjects. Onset of schizophrenia is about 2-3 years earlier in men than in women. However, this difference in the onset can be found only between Toxoplasma-infected patients. The increased onset of schizophrenia in infected women could be associated with the already mentioned second peak of toxoplasmosis incidence. (6) The prevalence of toxoplasmosis decreases in developed countries in last 20 years. This trend could be a result of decrease in promiscuity and increase in safe sex practices, both associated with the AIDS pandemics. (7) In women, probability of being Toxoplasma-infected correlates positively with the amount of unprotected sex with the child's father before the conception. Evidence against the hypothesis: Questionnaire study showed negative association between Toxoplasma infection and the number of earlier partners with whom the woman had unprotected sex. If our hypothesis turns out to be true, then sexual route of transmission, even if rare, could be responsible for a large part of cases of congenital toxoplasmosis. Women should be warned that having unprotected sex with men of positive or unknown toxoplasmosis status should be avoided during pregnancy.
- MeSH
- dospělí MeSH
- kočky MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- rizikové faktory MeSH
- rizikový sex MeSH
- schizofrenie etiologie MeSH
- sexuálně přenosné nemoci parazitologie MeSH
- sexuální chování MeSH
- sexuální partneři MeSH
- sperma parazitologie MeSH
- těhotenství MeSH
- Toxoplasma MeSH
- toxoplazmóza přenos MeSH
- transplantace orgánů MeSH
- zvířata MeSH
- Check Tag
- dospělí MeSH
- kočky MeSH
- lidé MeSH
- mužské pohlaví MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVE: Toxoplasmosis is a lifelong parasitic disease that appears to be associated to schizophrenia. However, no distinguishing attributes in Toxoplasma-infected schizophrenia patients have been described as yet. METHOD: We searched for differences in symptom profile, cognitive performance and treatment response between 194 Toxoplasma-free and 57 (22.7%) Toxoplasma-infected schizophrenia patients treated in Prague Psychiatric Centre between 2000 and 2010. RESULTS: Infected and non-infected patients differed in severity of symptoms (P = 0.032) measured with the Positive and Negative Symptom Scale (PANSS). Infected patients scored higher in positive subscale of PANSS, but not in the general and negative subscales. Infected men scored higher also in Total PANSS score, and negative, reality distortion, disorganisation and cognitive scores. Higher PANSS scores of positive, negative and disorganised psychopathology were associated with the lower titres of anti-Toxoplasma antibodies suggesting that psychopathology deteriorates with duration of parasitic infection. Infected patients remained about 33 days longer in hospital during their last admission than uninfected ones (P = 0.003). Schizophrenia started approximately 1 year earlier in infected men and about 3 years later in infected women, no such difference was observed in uninfected subjects. CONCLUSION: Latent toxoplasmosis in schizophrenia may lead to more severe positive psychopathology and perhaps less favourable course of schizophrenia.
- MeSH
- délka pobytu statistika a číselné údaje MeSH
- dospělí MeSH
- kognitivní poruchy epidemiologie parazitologie psychologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mozková toxoplazmóza epidemiologie psychologie MeSH
- psychiatrické posuzovací škály MeSH
- rozložení podle pohlaví MeSH
- schizofrenie (psychologie) * MeSH
- schizofrenie epidemiologie parazitologie MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Publikační typ
- abstrakt z konference MeSH
