Epidemiological studies on toxoplasma gondii infection in a one health perspective

The objective of the present Ph.D. thesis was to investigate with a One Health approach the epidemiological patterns of T. gondii infection in Italy, to better understand the transmission dynamics of the parasite, following different research lines. The results of a retrospective analysis in animals and human showed the widespread distribution of T. gondii in the study area, with specific antibodies found in various animal species and human populations, indicating its constant presence across diverse environments. The environment plays a significant role in T. gondii's epidemiology. Migratory aquatic birds, rodents, wolves, and wild boars were investigated as sentinels of their spread, highlighting the potential transmission across geographic areas and infection risks for wildlife in natural settings. The study also provided insights into seroprevalence in wolves. Dogs, subjected to serological investigations exhibited risk factors for T. gondii infection, such as cohabitation with cats, coprophagy behaviours, and continuous outdoor. Correlation between serological evidence of exposure to T. gondii and pathological anxiety in large-size dogs was observed, and the consumption of raw meat was associated with a higher risk of infection in these animals. Results of the investigations conducted in this thesis, demonstrate the dynamic nature of T. gondii infection in cattle, characterized by new infections and declining antibody levels over the production cycle. The study also describes a co-infection between T. gondii and Sarcocystis hominis in bovine eosinophilic myositis. In the final part of the Thesis, a comprehensive genotyping of T. gondii in Italy reveals the predominance of Type II strains, particularly in cases of ovine abortion and fatal toxoplasmosis among captive Lemur catta. This approach enhances our understanding of the parasite's genetic diversity and transmission patterns, vital for effective management of its impact on human and animal health in Italy.

Toxoplasma gondii in animals and the environment

Toxoplasma gondii is an obligate intracellular parasite capable of infecting virtually all warm-blooded species, including humans, but cats are the only definitive hosts. Humans or animals acquire T. gondii infection by ingesting food or water contaminated with sporulated oocysts or by ingesting tissue cysts containing bradyzoites. Toxoplasmosis has the highest human incidence among zoonotic parasitic diseases, but it is still considered an underreported zoonosis. The importance of T. gondii primary infection in livestock is related to the ability of the parasite to produce tissue cysts in infected animals, which may represent important sources of infection for humans. Consumption of undercooked mutton and pork are considered important sources of human Toxoplasma gondii. The first aim of this thesis was to develop a rapid and sensitive in- house indirect ELISA for the detection of antibodies against T. gondii in sheep sera. ROC-curve analysis showed high discriminatory power (AUC=0.999) and high sensitivity (99.4%) and specificity (99.8%) of the method. The ELISA was used to test a batch of sheep sera (375) collected in the Forli-Cesena district. The overall prevalence was estimated at 41.9% demonstrating that T. gondii infection is widely distributed in sheep reared in Forli-Cesena district. Since the epidemiological impact of waterborne transmission route of T.gondii to humans is now thought to be more significant than previously believed, the second aim of the thesis was to evaluate PCR based methods for detecting T. gondii DNA in raw and finished drinking water samples collected in Scotland. Samples were tested using a quantitative PCR on 529 bp repetitive elements. Only one raw water sample (0.3%), out of the 358 examined, tested T. gondii positive demonstrating that there is no evidence that tap water is a source of Toxoplasma infection in Scotland.

Caratterizzazione clinica, eziopatogenetica e ricerca di marker diagnostici nella poliradicoloneurite acuta idiopatica del cane

La poliradicoloneurite acuta idiopatica (ACIP) è una patologia infiammatoria che interessa le radici di più nervi spinali, descritta soprattutto nel cane, più raramente nel gatto, caratterizzata da insorgenza acuta di paresi/paralisi flaccida. L’ACIP mostra notevoli similitudini con la sindrome di Guillan-Barrè dell’uomo (GBS), in cui la patogenesi è su base autoimmunitaria ed è stata correlata con la presenza di alcuni fattori scatenanti (trigger). Lo scopo di questo lavoro è stato quello di caratterizzare l’ACIP in 26 cani, descrivendone la sintomatologia, l’evoluzione clinica, i risultati degli esami diagnostici. La diagnosi si è basata sui riscontri dell’anamnesi, della visita neurologica e del decorso confermata, quando possibile, dai rilievi elettrodiagnostici. Su tutti i cani è stata valutata l’esposizione a specifici agenti infettivi (Toxoplasma gondii, Neospora canunim, Ehrlichia canis, Leishmania infantum), o altri fattori (come vaccinazioni) che potrebbero aver agito da “trigger” per l’instaurarsi della patologia; sull’intera popolazione e su 19 cani non neurologici (gruppo di controllo), si è proceduto alla ricerca degli anticorpi anti-gangliosidi. La sintomatologia di più frequente riscontro (25/26) ha coinvolto la funzione motoria (paresi/plegia) con prevalente interessamento dei 4 arti (24/25) . Sei cani hanno ricevuto una terapia farmacologica, che non ne ha influenzato il decorso, favorevole in 24/26 casi. In 9 pazienti è stata rilevata una precedente esposizione a potenziali trigger; in 10 casi si è riscontrato un titolo anticorpale positivo ad almeno un agente infettivo testato. In 17/26 cani si è ottenuto un titolo anticorpale anti-GM2 e anti-GA1; nella popolazione di controllo solo un caso è risultato positivo. Questi risultati hanno contribuito a consolidare le conoscenze di questa patologia, validando l’utilità della ricerca anticorpale anti-gangliosidica per la diagnosi di ACIP e facendo intravedere la possibilità che l’ACIP possa essere assimilate alla GBS anche dal punto di vista patogenetico, per la quale potrebbe essere considerata come modello animale spontaneo.