Toxoplasmosis: What You Need to Know
By Dusty Prater, 05 December 2022
By Dusty Prater, 05 December 2022
By using the latest in genetic technologies, researchers are discovering the current epidemiology, the historical evolution, and future prevention strategies for a global pathogen.
One of these researchers is Dr. Chunlei Su of the University of Tennessee, Knoxville. He is an Associate Professor, the Director of Undergraduate Studies of the Microbiology Department, and has been studying this pathogen, Toxoplasma gondii, for the past 23 years by mapping and modeling its global genetic diversity.
T. gondii cycles between house mice and domestic cats in its main lifecycle but tends to end up in any warm-blooded host, including humans, often, through contact with contaminated cat feces. When it does jump from its normal hosts, it can cause the disease Toxoplasmosis. Although the pathogen and disease are found all over the world, many people don’t know either exists.
“Most healthy people in the United States and Europe don’t know they have it, as the pathogen mainly presents signs of the disease in two cases, immunocompromised or pregnant individuals,” Dr. Su stated. The CDC describes these symptoms in HIV immunocompromised people as severe flu-like symptoms, poor coordination, and even seizures. Additionally, they note some birth defects, which occur in the unborn children of recently infected women, that can be seen at birth, such as an enlarged or small head, and possible conditions that can arise as the child grows, like mental disabilities and vision loss.
A map showing the global population of women, of childbearing age, who are infected with the pathogen, edited from Pappes et al, 2009.
Although the symptoms and possible outcomes of Toxoplasmosis can be jarring, it isn’t a huge concern for people living in Western countries, as healthy people only suffer mild flu-like symptoms and medications can help suppress the more extreme outcomes. Further, the CDC provides many simple precautions to reduce risk of infection. These vary from proper handwashing and food safety, to keeping your cat indoors and making sure pregnant or immunocompromised individuals don't clean out litter boxes. So, there is no need to worry about your health or to kick out your beloved cat.
However, in certain countries, such as Brazil, otherwise healthy people who become infected with Toxoplasma face the same severe clinical symptoms that immunocompromised people face in the northern hemisphere. Dr. Su and colleagues are unravelling this perplexing mystery through the use of population genetics.
Toxoplasma gondii is a diverse species, and certain genetic markers within populations can offer insights into the clinical aspects of the disease in specific regions, Dr. Su explained his research group’s methodology as, “We collect data from around the world and look for patterns of how different genetic markers are distributed. Then, if we find one, we ask why do we see this pattern.” The most relevant genetic pattern regarding the severe cases in South America is the development of civilization.
In areas where humans have tamed the wilderness, such as Europe and the United States, the dominant genetic markers, collectively called the Type 2 strain, are associated with milder clinical symptoms. Conversely, in areas where humans have not expanded into the wilderness, the dominant genetic markers are associated with more severe symptoms seen in South America, making up the Type 1 strain. The reason we see this pattern is likely due to humans’ impact on the evolution of Toxoplasma.
T. gondii has its origins in the Old World long before humans were in the picture. It is likely that the pathogen was very virulent, similar to the Type 1 strain. However, genetic data from Dr. Su’s research points to a shift in virulence around the time humans began to develop agriculture in that area. Dr. Su recalled, “We ran a computer simulation of this time with estimated numbers of house mice and domestic cats present due to the rise of agriculture, and we found that a very virulent strain could not survive. It killed the mouse host before it could spread.”
Artist Rendition of the computer simulation. "Cats", by BioRender.com (2022), Retrieved from https://app.biorender.com/biorender-templates
This simulation showed how human actions created an environment, full of house mice and domestic cats, that favored more transmissible and less virulent strains of Toxoplasma, such as Type 2, in the Old World. Although there is limited evidence, it is possible that a similar pattern could explain the pattern of virulence we see in the Western Hemisphere. The more developed and industrialized North America has a less virulent strain compared to the developing nations of South America. Dr. Su put it best, “It’s a very interesting possibility of how human behaviors might have influenced the genomic distribution of a disease.”
When asked about the future of Toxoplasma, Dr. Su stated that having an economically efficient way to reduce the amount of pathogen that humans encounter, mainly by having a vaccine. If a vaccine were to be effective at preventing the spread of the pathogen, then it could be a turning point in the battle against Toxoplasmosis.
To fully utilize this theoretical vaccine, Dr. Su suggests vaccinating cats, particularly those in South America. By immunizing cats, the definitive host of the pathogen, the parasite will be unable to reproduce sexually, decreasing the overall number of parasites, ultimately, reducing chance that a human becomes infected. Although work is being done to make a vaccine, as seen here, Dr. Su notes that development is slow and funding is scarce.
As he and fellow researchers continue to unravel the mysteries of Toxoplasma and work on future preventative measures, humanity continues to push into wilderness and to encounter novel pathogens that will spread across the world because of us.
Sources:
“CDC - Toxoplasmosis - Disease.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 5 Sept. 2018, https://www.cdc.gov/parasites/toxoplasmosis/disease.html.
“CDC - Toxoplasmosis - Prevention & Control.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 27 Sept. 2018, https://www.cdc.gov/parasites/toxoplasmosis/prevent.html.
Pappas, Georgios, et al. “Toxoplasmosis Snapshots: Global Status of Toxoplasma Gondii Seroprevalence and Implications for Pregnancy and Congenital Toxoplasmosis.” International Journal for Parasitology, vol. 39, no. 12, 2009, pp. 1385–1394., https://doi.org/10.1016/j.ijpara.2009.04.003.