Chapter 25 : Protozoan Parasites

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in

Protozoan Parasites, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555819972/9781555819965.ch25-1.gif /docserver/preview/fulltext/10.1128/9781555819972/9781555819965.ch25-2.gif


Protozoan parasites have been linked to human illnesses since antiquity and have been associated with outbreaks of foodborne and waterborne illness. Microorganisms such as amoebas, flagellates, ciliates, and coccidians are the most common in this group. and are most frequently associated with consumption of undercooked meats, whereas , , , , and the amoebas are mostly associated with consumption of contaminated water and fresh produce (vegetables and fruits). Foodborne transmission of has also been reported, particularly in South and Central America, when infected insects or their feces are consumed in fruit juice preparations. , a coccidian parasite, is endemic to various locations worldwide and was responsible for a number of U.S. foodborne-illness outbreaks in the 1990s as a result of consumption of imported berries and in the past 5 years after consumption of imported salad greens and cilantro. infection has been diagnosed in ill travelers complaining of muscular pains; transmission was associated with consumption of improperly cooked meats from Southeast Asia. Most parasites are inactivated by heating at high temperatures and in some instances by prolonged storage under freezing conditions, but parasites are highly resistant to chemical disinfection. Increased travel to tropical areas and consumer demands for off-season produce have resulted in globalization of the food supply. Along with the advantages of globalization, the incidental spread of foodborne parasites has also increased. The biology, epidemiology, inactivation, treatment, and control of foodborne parasites are addressed in this chapter.

Citation: Ortega Y. 2019. Protozoan Parasites, p 667-691. In Doyle M, Diez-Gonzalez F, Hill C (ed), Food Microbiology: Fundamentals and Frontiers, 5th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819972.ch25
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


Image of Figure 25.1
Figure 25.1

Scanning electron micrographs of oocysts and excysting sporozoites of . (A) Intact oocyst prior to excystation (magnification, ×11,200). (B) Three sporozoites (Sp) excysting from oocyst simultaneously via the cleaved suture (Su) (magnification, ×11,200). (C) Empty oocyst (magnification, ×11,200). (D) Excysted sporozoite (magnification, ×9,800). Ae, apical end. Reprinted from reference .

Citation: Ortega Y. 2019. Protozoan Parasites, p 667-691. In Doyle M, Diez-Gonzalez F, Hill C (ed), Food Microbiology: Fundamentals and Frontiers, 5th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819972.ch25
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 25.2
Figure 25.2

Life cycle of . From reference .

Citation: Ortega Y. 2019. Protozoan Parasites, p 667-691. In Doyle M, Diez-Gonzalez F, Hill C (ed), Food Microbiology: Fundamentals and Frontiers, 5th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819972.ch25
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 25.3
Figure 25.3

Acid-fast staining. (A) . (B) . (C) . Bars = 20 μm.

Citation: Ortega Y. 2019. Protozoan Parasites, p 667-691. In Doyle M, Diez-Gonzalez F, Hill C (ed), Food Microbiology: Fundamentals and Frontiers, 5th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819972.ch25
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 25.4
Figure 25.4

oocysts. (A) Phase-contrast microscopy of unsporulated oocysts. (B) Oocysts (OO) in the process of excystation. Note the two sporozoites (SP) free of the sporocyst (SC). (C) Transmission electron microscopy of human small intestine showing intracellular stages. ME, merozoite.

Citation: Ortega Y. 2019. Protozoan Parasites, p 667-691. In Doyle M, Diez-Gonzalez F, Hill C (ed), Food Microbiology: Fundamentals and Frontiers, 5th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819972.ch25
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 25.5
Figure 25.5

Bright-field photomicrograph of unsporulated (A) and sporulated (B) oocysts.

Citation: Ortega Y. 2019. Protozoan Parasites, p 667-691. In Doyle M, Diez-Gonzalez F, Hill C (ed), Food Microbiology: Fundamentals and Frontiers, 5th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819972.ch25
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 25.6
Figure 25.6

Life cycle of . From Dubey and Beattie ( ).

Citation: Ortega Y. 2019. Protozoan Parasites, p 667-691. In Doyle M, Diez-Gonzalez F, Hill C (ed), Food Microbiology: Fundamentals and Frontiers, 5th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819972.ch25
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 25.7
Figure 25.7

Transmission electron micrographs of . (A) Sporozoite in parasitophorous vacuole (Pv) of host cell (Hc) at 24 h after inoculation. Am, amylopectin granule; Co, conoid; Mn, microneme; Nu, nucleus of sporozoite; Rh, rhoptry. (B) Final stage of endodyogeny to form two daughter tachyzoites that are still attached to the posterior ends (arrowheads). DG, dense granules; HC, host cell; IT, intravacuolar tubules; M, mitochondrion; MC, microneme; MI, micropore; N, nucleus; RO, rhoptry. From Dubey and Beattie ( ).

Citation: Ortega Y. 2019. Protozoan Parasites, p 667-691. In Doyle M, Diez-Gonzalez F, Hill C (ed), Food Microbiology: Fundamentals and Frontiers, 5th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819972.ch25
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 25.8
Figure 25.8

Scanning electron micrograph of trophozoites. One trophozoite shows the dorsal surface and the other shows the ventral surface with sucking disk and flagella.

Citation: Ortega Y. 2019. Protozoan Parasites, p 667-691. In Doyle M, Diez-Gonzalez F, Hill C (ed), Food Microbiology: Fundamentals and Frontiers, 5th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819972.ch25
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 25.9
Figure 25.9

Hematoxylin and eosin staining. (A) cyst with two nuclei and a trophozoite (a) and showing two nuclei and the median body visible at one pole (b). (B) cyst showing a large macronucleus and cilia beneath the cyst wall and trophozoite (a) and showing an oval macronucleus (b). (C) trophozoite showing a nucleus and a few red blood cells in the cytoplasm and cyst (a) and showing two of four nuclei and rod-shaped inclusion bodies with rounded ends (b). Courtesy of Lynne S. Garcia.

Citation: Ortega Y. 2019. Protozoan Parasites, p 667-691. In Doyle M, Diez-Gonzalez F, Hill C (ed), Food Microbiology: Fundamentals and Frontiers, 5th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819972.ch25
Permissions and Reprints Request Permissions
Download as Powerpoint


1. Miles MA . 2010. Orally acquired Chagas disease: lessons from an urban school outbreak. J Infect Dis 201 : 1282 1284[CrossRef].[PubMed]
2. Alarcón de Noya B, Díaz-Bello Z, Colmenares C, Ruiz-Guevara R, Mauriello L, Zavala-Jaspe R, Suarez JA, Abate T, Naranjo L, Paiva M, Rivas L, Castro J, Márques J, Mendoza I, Acquatella H, Torres J, Noya O . 2010. Large urban outbreak of orally acquired acute Chagas disease at a school in Caracas, Venezuela. J Infect Dis 201 : 1308 1315[CrossRef].[PubMed]
3. Nóbrega AA, Garcia MH, Tatto E, Obara MT, Costa E, Sobel J, Araujo WN . 2009. Oral transmission of Chagas disease by consumption of açaí palm fruit, Brazil. Emerg Infect Dis 15 : 653 655[CrossRef].[PubMed]
4. Diaz JH . 2007. Chagas disease in the United States: a cause for concern in Louisiana? J La State Med Soc 159 : 21 23, 25–29.[PubMed]
5. Hoft DF, Farrar PL, Kratz-Owens K, Shaffer D . 1996. Gastric invasion by Trypanosoma cruzi and induction of protective mucosal immune responses. Infect Immun 64 : 3800 3810.[PubMed]
6. Soave R . 1988. Cryptosporidiosis and isosporiasis in patients with AIDS. Infect Dis Clin North Am 2 : 485 493.[PubMed]
7. Morgan-Ryan UM, Fall A, Ward LA, Hijjawi N, Sulaiman I, Payer R, Thompson RC, Olson M, Lal A, Xiao L . 2002. Cryptosporidium hominis n. sp. (Apicomplexa: Cryptosporidiidae) from Homo sapiens. J Eukaryot Microbiol 49 : 433 440[CrossRef].[PubMed]
8. Peng MM, Xiao L, Freeman AR, Arrowood MJ, Escalante AA, Weltman AC, Ong CS, Mac Kenzie WR, Lal AA, Beard CB . 1997. Genetic polymorphism among Cryptosporidium parvum isolates: evidence of two distinct human transmission cycles. Emerg Infect Dis 3 : 567 573[CrossRef].[PubMed]
9. Cacciò S, Pinter E, Fantini R, Mezzaroma I, Pozio E . 2002. Human infection with Cryptosporidium felis: case report and literature review. Emerg Infect Dis 8 : 85 86[CrossRef].[PubMed]
10. Ditrich O, Palkovic L, Stĕrba J, Prokopic J, Loudová J, Giboda M . 1991. The first finding of Cryptosporidium baileyi in man. Parasitol Res 77 : 44 47[CrossRef].[PubMed]
11. Fayer R, Trout JM, Xiao L, Morgan UM, Lal AA, Dubey JP . 2001. Cryptosporidium canis n. sp. from domestic dogs. J Parasitol 87 : 1415 1422[CrossRef].[PubMed]
12. Gatei W, Ashford RW, Beeching NJ, Kamwati SK, Greensill J, Hart CA . 2002. Cryptosporidium muris infection in an HIV-infected adult, Kenya. Emerg Infect Dis 8 : 204 206[CrossRef].[PubMed]
13. Matos O, Alves M, Xiao L, Cama V, Antunes F . 2004. Cryptosporidium felis and C. meleagridis in persons with HIV, Portugal. Emerg Infect Dis 10 : 2256 2257[CrossRef].[PubMed]
14. Pedraza-Díaz S, Amar CF, McLauchlin J, Nichols GL, Cotton KM, Godwin P, Iversen AM, Milne L, Mulla JR, Nye K, Panigrahl H, Venn SR, Wiggins R, Williams M, Youngs ER . 2001. Cryptosporidium meleagridis from humans: molecular analysis and description of affected patients. J Infect 42 : 243 250[CrossRef].[PubMed]
15. Posada G, Pizarro D, Mohs E. 1987. Oral rehydration in children with Cryptosporidium muris diarrhea. Bol Méd Hosp Infant México 44 : 740 744. (In Spanish.)
16. Xiao L . 2010. Molecular epidemiology of cryptosporidiosis: an update. Exp Parasitol 124 : 80 89[CrossRef].[PubMed]
17. Current WL, Bick PH . 1989. Immunobiology of Cryptosporidium spp. Pathol Immunopathol Res 8 : 141 160[CrossRef].[PubMed]
18. Zu SX, Guerrant RL . 1993. Cryptosporidiosis. J Trop Pediatr 39 : 132 136[CrossRef].[PubMed]
19. Carreno RA, Matrin DS, Barta JR . 1999. Cryptosporidium is more closely related to the gregarines than to coccidia as shown by phylogenetic analysis of apicomplexan parasites inferred using small-subunit ribosomal RNA gene sequences. Parasitol Res 85 : 899 904[CrossRef].[PubMed]
20. Hijjawi NS, Meloni BP, Ryan UM, Olson ME, Thompson RC . 2002. Successful in vitro cultivation of Cryptosporidium andersoni: evidence for the existence of novel extracellular stages in the life cycle and implications for the classification of Cryptosporidium. Int J Parasitol 32 : 1719 1726[CrossRef].[PubMed]
21. Rosales MJ, Cordón GP, Moreno MS, Sánchez CM, Mascaró C . 2005. Extracellular like-gregarine stages of Cryptosporidium parvum. Acta Trop 95 : 74 78. CORRIGENDUM Acta Trop 96 : 64[CrossRef].[PubMed]
22. Xiao L, Fayer R . 2008. Molecular characterisation of species and genotypes of Cryptosporidium and Giardia and assessment of zoonotic transmission. Int J Parasitol 38 : 1239 1255[CrossRef].[PubMed]
23. Elwin K, Hadfield SJ, Robinson G, Chalmers RM . 2012. The epidemiology of sporadic human infections with unusual cryptosporidia detected during routine typing in England and Wales, 2000-2008. Epidemiol Infect 140 : 673 683[CrossRef].[PubMed]
24. López-Vélez R, Tarazona R, Garcia Camacho A, Gomez-Mampaso E, Guerrero A, Moreira V, Villanueva R . 1995. Intestinal and extraintestinal cryptosporidiosis in AIDS patients. Eur J Clin Microbiol Infect Dis 14 : 677 681[CrossRef].[PubMed]
25. Furio MM, Wordell CJ . 1985. Treatment of infectious complications of acquired immunodeficiency syndrome. Clin Pharm 4 : 539 554.[PubMed]
26. Mac Kenzie WR, Schell WL, Blair KA, Addiss DG, Peterson DE, Hoxie NJ, Kazmierczak JJ, Davis JP . 1995. Massive outbreak of waterborne cryptosporidium infection in Milwaukee, Wisconsin: recurrence of illness and risk of secondary transmission. Clin Infect Dis 21 : 57 62[CrossRef].[PubMed]
27. Hayes EB, Matte TD, O'Brien TR, McKinley TW, Logsdon GS, Rose JB, Ungar BLP, Word DM, Wilson MA, Long EG, Hurwitz ES, Juranek DD . 1989. Large community outbreak of cryptosporidiosis due to contamination of a filtered public water supply. N Engl J Med 320 : 1372 1376[CrossRef].[PubMed]
28. Centers for Disease Control and Prevention . 1996. Foodborne outbreak of diarrheal illness associated with Cryptosporidium parvum—Minnesota, 1995. MMWR Morb Mortal Wkly Rep 45 : 783784.[PubMed]
29. Centers for Disease Control and Prevention . 1997. Outbreaks of Escherichia coli O157:H7 infection and cryptosporidiosis associated with drinking unpasteurized apple cider—Connecticut and New York, October 1996. MMWR Morb Mortal Wkly Rep 46 : 48.[PubMed]
30. Millard PS, Gensheimer KF, Addiss DG, Sosin DM, Beckett GA, Houck-Jankoski A, Hudson A . 1994. An outbreak of cryptosporidiosis from fresh-pressed apple cider. JAMA 272 : 1592 1596[CrossRef].[PubMed]
31. Quiroz ES, Bern C, MacArthur JR, Xiao L, Fletcher M, Arrowood MJ, Shay DK, Levy ME, Glass RI, Lal A . 2000. An outbreak of cryptosporidiosis linked to a foodhandler. J Infect Dis 181 : 695 700[CrossRef].[PubMed]
32. Pönka A, Kotilainen H, Rimhanen-Finne R, Hokkanen P, Hänninen ML, Kaarna A, Meri T, Kuusi M . 2009. A foodborne outbreak due to Cryptosporidium parvum in Helsinki, November 2008. Euro Surveill 14 : 19269[CrossRef].[PubMed]
33. Ethelberg S, Lisby M, Vestergaard LS, Enemark HL, Olsen KE, Stensvold CR, Nielsen HV, Porsbo LJ, Plesner AM, Mølbak K . 2009. A foodborne outbreak of Cryptosporidium hominis infection. Epidemiol Infect 137 : 348 356[CrossRef].[PubMed]
34. Robertson LJ, Gjerde B . 2001. Occurrence of parasites on fruits and vegetables in Norway. J Food Prot 64 : 1793 1798[CrossRef].[PubMed]
35. Robertson LJ, Greig JD, Gjerde B, Fazil A . 2005. The potential for acquiring cryptosporidiosis or giardiosis from consumption of mung bean sprouts in Norway: a preliminary step-wise risk assessment. Int J Food Microbiol 98 : 291 300[CrossRef].[PubMed]
36. Ortega YR, Roxas CR, Gilman RH, Miller NJ, Cabrera L, Taquiri C, Sterling CR . 1997. Isolation of Cryptosporidium parvum and Cyclospora cayetanensis from vegetables collected in markets of an endemic region in Peru. Am J Trop Med Hyg 57 : 683 686[CrossRef].[PubMed]
37. Kniel KE, Jenkins MC . 2005. Detection of Cryptosporidium parvum oocysts on fresh vegetables and herbs using antibodies specific for a Cryptosporidium parvum viral antigen. J Food Prot 68 : 1093 1096[CrossRef].[PubMed]
38. Scallan E, Hoekstra RM, Angulo FJ, Tauxe RV, Widdowson MA, Roy SL, Jones JL, Griffin PM . 2011. Foodborne illness acquired in the United States—major pathogens. Emerg Infect Dis 17 : 7 15[CrossRef].[PubMed]
39. Sáez-Llorens X, Odio CM, Umaña MA, Morales MV . 1989. Spiramycin vs. placebo for treatment of acute diarrhea caused by Cryptosporidium. Pediatr Infect Dis J 8 : 136 140.[PubMed]
40. Portnoy D, Whiteside ME, Buckley E III, MacLeod CL . 1984. Treatment of intestinal cryptosporidiosis with spiramycin. Ann Intern Med 101 : 202 204[CrossRef].[PubMed]
41. Moskovitz BL, Stanton TL, Kusmierek JJ. 1988. Spiramycin therapy for cryptosporidial diarrhoea in immunocompromised patients. J Antimicrob Chemother 22 : 189 191.
42. Bissuel F, Cotte L, Rabodonirina M, Rougier P, Piens MA, Trepo C . 1994. Paromomycin: an effective treatment for cryptosporidial diarrhea in patients with AIDS. Clin Infect Dis 18 : 447 449[CrossRef].[PubMed]
43. Danziger LH, Kanyok TP, Novak RM . 1993. Treatment of cryptosporidial diarrhea in an AIDS patient with paromomycin. Ann Pharmacother 27 : 1460 1462[CrossRef].[PubMed]
44. Galvagno G, Cattaneo G, Reverso-Giovantin E . 1993. Chronic diarrhea due to Cryptosporidium: the efficacy of spiramycin treatment. Pediatr Med Chir 15 : 297 298. (In Italian.)[PubMed]
45. Giacometti A, Burzacchini F, Cirioni O, Barchiesi F, Dini M, Scalise G . 1999. Efficacy of treatment with paromomycin, azithromycin, and nitazoxanide in a patient with disseminated cryptosporidiosis. Eur J Clin Microbiol Infect Dis 18 : 885 889[CrossRef].[PubMed]
46. Cama VA, Sterling CR . 1991. Hyperimmune hens as a novel source of anti- Cryptosporidium antibodies suitable for passive immune transfer. J Protozool 38 : 42S 43S.[PubMed]
47. Fayer R, Tilley M, Upton SJ, Guidry AJ, Thayer DW, Hildreth M, Thomson J . 1991. Production and preparation of hyperimmune bovine colostrum for passive immunotherapy of cryptosporidiosis. J Protozool 38 : 38S 39S.[PubMed]
48. Perryman LE, Bjorneby JM . 1991. Immunotherapy of cryptosporidiosis in immunodeficient animal models. J Protozool 38 : 98S 100S.[PubMed]
49. Cabada MM, White AC Jr . 2010. Treatment of cryptosporidiosis: do we know what we think we know? Curr Opin Infect Dis 23 : 494 499[CrossRef].[PubMed]
50. Anusz KZ, Mason PH, Riggs MW, Perryman LE . 1990. Detection of Cryptosporidium parvum oocysts in bovine feces by monoclonal antibody capture enzyme-linked immunosorbent assay. J Clin Microbiol 28 : 2770 2774.[PubMed]
51. Arrowood MJ, Sterling CR . 1989. Comparison of conventional staining methods and monoclonal antibody-based methods for Cryptosporidium oocyst detection. J Clin Microbiol 27 : 1490 1495.[PubMed]
52. Casemore DP, Armstrong M, Sands RL . 1985. Laboratory diagnosis of cryptosporidiosis. J Clin Pathol 38 : 1337 1341[CrossRef].[PubMed]
53. Balatbat AB, Jordan GW, Tang YJ, Silva J Jr . 1996. Detection of Cryptosporidium parvum DNA in human feces by nested PCR. J Clin Microbiol 34 : 1769 1772.[PubMed]
54. Coupe S, Sarfati C, Hamane S, Derouin F . 2005. Detection of cryptosporidium and identification to the species level by nested PCR and restriction fragment length polymorphism. J Clin Microbiol 43 : 1017 1023[CrossRef].[PubMed]
55. Deng MQ, Cliver DO . 2000. Comparative detection of Cryptosporidium parvum oocysts from apple juice. Int J Food Microbiol 54 : 155 162[CrossRef].[PubMed]
56. Gómez-Couso H, Freire-Santos F, Amar CF, Grant KA, Williamson K, Ares-Mazás ME, McLauchlin J . 2004. Detection of Cryptosporidium and Giardia in molluscan shellfish by multiplexed nested-PCR. Int J Food Microbiol 91 : 279 288[CrossRef].[PubMed]
57. Karasudani T, Aoki S, Takeuchi J, Okuyama M, Oseto M, Matsuura S, Asai T, Inouye H . 2001. Sensitive detection of Cryptosporidium oocysts in environmental water samples by reverse transcription-PCR. Jpn J Infect Dis 54 : 122 124.[PubMed]
58. Laberge I, Griffiths MW, Griffiths MW . 1996. Prevalence, detection and control of Cryptosporidium parvum in food. Int J Food Microbiol 32 : 1 26[CrossRef].[PubMed]
59. Fayer R, Trout JM, Lewis EJ, Santin M, Zhou L, Lal AA, Xiao L . 2003. Contamination of Atlantic coast commercial shellfish with Cryptosporidium. Parasitol Res 89 : 141 145[CrossRef].[PubMed]
60. Gomez-Bautista M, Ortega-Mora LM, Tabares E, Lopez-Rodas V, Costas E . 2000. Detection of infectious Cryptosporidium parvum oocysts in mussels ( Mytilus galloprovincialis) and cockles ( Cerastoderma edule). Appl Environ Microbiol 66 : 1866 1870[CrossRef].[PubMed]
61. Gómez-Couso H, Méndez-Hermida F, Castro-Hermida JA, Ares-Mazés E . 2006. Cryptosporidium contamination in harvesting areas of bivalve molluscs. J Food Prot 69 : 185 190[CrossRef].[PubMed]
62. Graczyk TK, Schwab KJ . 2000. Foodborne infections vectored by molluscan shellfish. Curr Gastroenterol Rep 2 : 305 309[CrossRef].[PubMed]
63. MacRae M, Hamilton C, Strachan NJ, Wright S, Ogden ID . 2005. The detection of Cryptosporidium parvum and Escherichia coli O157 in UK bivalve shellfish. J Microbiol Methods 60 : 395 401[CrossRef].[PubMed]
64. Gómez-Couso H, Freire-Santos F, Hernández-Córdova GA, Ares-Mazás ME . 2005. A histological study of the transit of Cryptosporidium parvum oocysts through clams ( Tapes decussatus). Int J Food Microbiol 102 : 57 62[CrossRef].[PubMed]
65. Gómez-Couso H, Freire-Santos F, Ortega-Iñarrea MR, Castro-Hermida JA, Ares-Mazás ME . 2003. Environmental dispersal of Cryptosporidium parvum oocysts and cross transmission in cultured bivalve molluscs. Parasitol Res 90 : 140 142.[PubMed]
66. Atwill ER, Tate KW, Pereira MD, Bartolome J, Nader G . 2006. Efficacy of natural grassland buffers for removal of Cryptosporidium parvum in rangeland runoff. J Food Prot 69 : 177 184[CrossRef].[PubMed]
67. Chauret CP, Radziminski CZ, Lepuil M, Creason R, Andrews RC . 2001. Chlorine dioxide inactivation of Cryptosporidium parvum oocysts and bacterial spore indicators. Appl Environ Microbiol 67 : 2993 3001[CrossRef].[PubMed]
68. Korich DG, Mead JR, Madore MS, Sinclair NA, Sterling CR . 1990. Effects of ozone, chlorine dioxide, chlorine, and monochloramine on Cryptosporidium parvum oocyst viability. Appl Environ Microbiol 56 : 1423 1428.[PubMed]
69. Hayes J, Kirf D, Garvey M, Rowan N . 2013. Disinfection and toxicological assessments of pulsed UV and pulsed-plasma gas-discharge treated-water containing the waterborne protozoan enteroparasite Cryptosporidium parvum. J Microbiol Methods 94 : 325 337[CrossRef].[PubMed]
70. Murphy JL, Haas CN, Arrowood MJ, Hlavsa MC, Beach MJ, Hill VR . 2014. Efficacy of chlorine dioxide tablets on inactivation of cryptosporidium oocysts. Environ Sci Technol 48 : 5849 5856[CrossRef].[PubMed]
71. Deng MQ, Cliver DO . 2001. Inactivation of Cryptosporidium parvum oocysts in cider by flash pasteurization. J Food Prot 64 : 523 527[CrossRef].[PubMed]
72. Ashford RW . 1979. Occurrence of an undescribed coccidian in man in Papua New Guinea. Ann Trop Med Parasitol 73 : 497 500[CrossRef].[PubMed]
73. Long EG, Ebrahimzadeh A, White EH, Swisher B, Callaway CS . 1990. Alga associated with diarrhea in patients with acquired immunodeficiency syndrome and in travelers. J Clin Microbiol 28 : 1101 1104.[PubMed]
74. Long EG, White EH, Carmichael WW, Quinlisk PM, Raja R, Swisher BL, Daugharty H, Cohen MT . 1991. Morphologic and staining characteristics of a cyanobacterium-like organism associated with diarrhea. J Infect Dis 164 : 199 202[CrossRef].[PubMed]
75. Shlim DR, Cohen MT, Eaton M, Rajah R, Long EG, Ungar BL . 1991. An alga-like organism associated with an outbreak of prolonged diarrhea among foreigners in Nepal. Am J Trop Med Hyg 45 : 383 389[CrossRef].[PubMed]
76. Ortega YR, Gilman RH, Sterling CR . 1994. A new coccidian parasite (Apicomplexa: Eimeriidae) from humans. J Parasitol 80 : 625 629[CrossRef].[PubMed]
77. Ortega YR, Sterling CR, Gilman RH, Cama VA, Díaz F . 1993. Cyclospora species—a new protozoan pathogen of humans. N Engl J Med 328 : 1308 1312[CrossRef].[PubMed]
78. Eberhard ML, da Silva AJ, Lilley BG, Pieniazek NJ . 1999. Morphologic and molecular characterization of new Cyclospora species from Ethiopian monkeys: C. cercopitheci sp.n., C. colobi sp.n., and C. papionis sp.n. Emerg Infect Dis 5 : 651 658[CrossRef].[PubMed]
79. Lopez FA, Manglicmot J, Schmidt TM, Yeh C, Smith HV, Relman DA . 1999. Molecular characterization of Cyclospora-like organisms from baboons. J Infect Dis 179 : 670 676[CrossRef].[PubMed]
80. Smith HV, Paton CA, Girdwood RW, Mtambo MM . 1996. Cyclospora in non-human primates in Gombe, Tanzania. Vet Rec 138 : 528.[PubMed]
81. Shlim DR, Hoge CW, Rajah R, Scott RM, Pandy P, Echeverria P . 1999. Persistent high risk of diarrhea among foreigners in Nepal during the first 2 years of residence. Clin Infect Dis 29 : 613 616[CrossRef].[PubMed]
82. Madico G, McDonald J, Gilman RH, Cabrera L, Sterling CR . 1997. Epidemiology and treatment of Cyclospora cayetanensis infection in Peruvian children. Clin Infect Dis 24 : 977 981[CrossRef].[PubMed]
83. Jinneman KC, Wetherington JH, Hill WE, Adams AM, Johnson JM, Tenge BJ, Dang NL, Manger RL, Wekell MM . 1998. Template preparation for PCR and RFLP of amplification products for the detection and identification of Cyclospora sp. and Eimeria spp. oocysts directly from raspberries. J Food Prot 61 : 1497 1503[CrossRef].[PubMed]
84. Shields JM, Olson BH . 2003. PCR-restriction fragment length polymorphism method for detection of Cyclospora cayetanensis in environmental waters without microscopic confirmation. Appl Environ Microbiol 69 : 4662 4669[CrossRef].[PubMed]
85. Murphy HR, Lee S, da Silva AJ . 2017. Evaluation of an improved U.S. Food and Drug Administration method for the detection of Cyclospora cayetanensis in produce using real-time PCR. J Food Prot 80 : 1133 1144[CrossRef].[PubMed]
86. Connor BA, Reidy J, Soave R . 1999. Cyclosporiasis: clinical and histopathologic correlates. Clin Infect Dis 28 : 1216 1222[CrossRef].[PubMed]
87. Ortega YR, Nagle R, Gilman RH, Watanabe J, Miyagui J, Quispe H, Kanagusuku P, Roxas C, Sterling CR . 1997. Pathologic and clinical findings in patients with cyclosporiasis and a description of intracellular parasite life-cycle stages. J Infect Dis 176 : 1584 1589[CrossRef].[PubMed]
88. Sun T, Ilardi CF, Asnis D, Bresciani AR, Goldenberg S, Roberts B, Teichberg S . 1996. Light and electron microscopic identification of Cyclospora species in the small intestine. Evidence of the presence of asexual life cycle in human host. Am J Clin Pathol 105 : 216 220[CrossRef].[PubMed]
89. Centers for Disease Control . 1991. Outbreaks of diarrheal illness associated with cyanobacteria (blue-green algae)-like bodies—Chicago and Nepal, 1989 and 1990. MMWR Morb Mortal Wkly Rep 40 : 325327.[PubMed]
90. Huang P, Weber JT, Sosin DM, Griffin PM, Long EG, Murphy JJ, Kocka F, Peters C, Kallick C . 1995. The first reported outbreak of diarrheal illness associated with Cyclospora in the United States. Ann Intern Med 123 : 409 414[CrossRef].[PubMed]
91. Rabold JG, Hoge CW, Shlim DR, Kefford C, Rajah R, Echeverria P . 1994. Cyclospora outbreak associated with chlorinated drinking water. Lancet 344 : 1360 1361[CrossRef].[PubMed]
92. Chu DM, Sherchand JB, Cross JH, Orlandi PA . 2004. Detection of Cyclospora cayetanensis in animal fecal isolates from Nepal using an FTA filter-base polymerase chain reaction method. Am J Trop Med Hyg 71 : 373 379[CrossRef].[PubMed]
93. García-López HL, Rodríguez-Tovar LE, Medina-De la Garza CE . 1996. Identification of Cyclospora in poultry. Emerg Infect Dis 2 : 356 357[CrossRef].[PubMed]
94. Yai LE, Bauab AR, Hirschfeld MP, de Oliveira ML, Damaceno JT . 1997. The first two cases of Cyclospora in dogs, São Paulo, Brazil. Rev Inst Med Trop São Paulo 39 : 177 179[CrossRef].[PubMed]
95. Zerpa R, Uchima N, Huicho L . 1995. Cyclospora cayetanensis associated with watery diarrhoea in Peruvian patients. J Trop Med Hyg 98 : 325 329.[PubMed]
96. Eberhard ML, Ortega YR, Hanes DE, Nace EK, Do RQ, Robl MG, Won KY, Gavidia C, Sass NL, Mansfield K, Gozalo A, Griffiths J, Gilman R, Sterling CR, Arrowood MJ . 2000. Attempts to establish experimental Cyclospora cayetanensis infection in laboratory animals. J Parasitol 86 : 577 582[CrossRef].[PubMed]
97. Anonymous . 1997. Outbreak of cyclosporiasis—northern Virginia-Washington, D.C.-Baltimore, Maryland, Metropolitan area, 1997. Can Commun Dis Rep 23 : 166168.[PubMed]
98. Centers for Disease Control and Prevention . 1997. Outbreaks of cyclosporiasis—United States, 1997. MMWR Morb Mortal Wkly Rep 46 : 451452.[PubMed]
99. Herwaldt BL . 2000. Cyclospora cayetanensis: a review, focusing on the outbreaks of cyclosporiasis in the 1990s. Clin Infect Dis 31 : 1040 1057[CrossRef].[PubMed]
100. Herwaldt BL, Ackers ML The Cyclospora Working Group . 1997. An outbreak in 1996 of cyclosporiasis associated with imported raspberries. N Engl J Med 336 : 1548 1556[CrossRef].[PubMed]
101. Abanyie F, , et al . 2015. 2013 multistate outbreaks of Cyclospora cayetanensis infections associated with fresh produce: focus on the Texas investigations. Epidemiol Infect 143 : 3451 3458.
102. Lopez AS, Dodson DR, Arrowood MJ, Orlandi PA Jr, da Silva AJ, Bier JW, Hanauer SD, Kuster RL, Oltman S, Baldwin MS, Won KY, Nace EM, Eberhard ML, Herwaldt BL . 2001. Outbreak of cyclosporiasis associated with basil in Missouri in 1999. Clin Infect Dis 32 : 1010 1017[CrossRef].[PubMed]
103. Bern C, Hernandez B, Lopez MB, Arrowood MJ, de Mejia MA, de Merida AM, Hightower AW, Venczel L, Herwaldt BL, Klein RE . 1999. Epidemiologic studies of Cyclospora cayetanensis in Guatemala. Emerg Infect Dis 5 : 766 774[CrossRef].[PubMed]
104. Sherchand JB, Cross JH, Jimba M, Sherchand S, Shrestha MP . 1999. Study of Cyclospora cayetanensis in health care facilities, sewage water and green leafy vegetables in Nepal. Southeast Asian J Trop Med Public Health 30 : 58 63.[PubMed]
105. Döller PC, Dietrich K, Filipp N, Brockmann S, Dreweck C, Vonthein R, Wagner-Wiening C, Wiedenmann A . 2002. Cyclosporiasis outbreak in Germany associated with the consumption of salad. Emerg Infect Dis 8 : 992 994[CrossRef].[PubMed]
106. Ho AY, Lopez AS, Eberhart MG, Levenson R, Finkel BS, da Silva AJ, Roberts JM, Orlandi PA, Johnson CC, Herwaldt BL . 2002. Outbreak of cyclosporiasis associated with imported raspberries, Philadelphia, Pennsylvania, 2000. Emerg Infect Dis 8 : 783 788[CrossRef].[PubMed]
107. Hoang LM, Fyfe M, Ong C, Harb J, Champagne S, Dixon B, Isaac-Renton J . 2005. Outbreak of cyclosporiasis in British Columbia associated with imported Thai basil. Epidemiol Infect 133 : 23 27[CrossRef].[PubMed]
108. Centers for Disease Control and Prevention . 2004. Outbreak of cyclosporiasis associated with snow peas—Pennsylvania, 2004. MMWR Morb Mortal Wkly Rep 53 : 876878.[PubMed]
109. Insulander M, Svenungsson B, Lebbad M, Karlsson L, de Jong B . 2010. A foodborne outbreak of Cyclospora infection in Stockholm, Sweden. Foodborne Pathog Dis 7 : 1585 1587[CrossRef].[PubMed]
110. CDC. 2013. Cyclosporiasis outbreak investigations—United States, 2013 (Final update). http://www.cdc.gov/parasites/cyclosporiasis/outbreaks/investigation-2013.html.
111. CDC. 2014. Cyclosporiasis outbreak investigations—United States, 2014. http://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2014/index.html. Accessed 1 May 2018.
112. CDC. 2015. Cyclosporiasis outbreak investigations—United States, 2015. http://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2015/. Accessed 1 December 2017.
113. FDA. 2016. Import Alert #24-23. Detention without physical examination of fresh cilantro from the State of Puebla, Mexico. https://www.accessdata.fda.gov/cms_ia/importalert_1148.html. Accessed 1 December 2017.
114. CDC. 2016. Cyclosporiasis update. https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2016/index.html. Accessed 1 December 2017.
115. CDC. 2017. Cyclosporiasis Outbreak Investigations - United States, 2017. https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2017/index.html. Accessed 1 December 2017.
116. Centers for Disease Control and Prevention . 2018. Domestically acquired cases of cyclosporiasis—United States, May–August 2018. https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2018/c-082318/index.html. Accessed 1 May 2018.
117. Dixon B, Parrington L, Cook A, Pollari F, Farber J . 2013. Detection of Cyclospora, Cryptosporidium, and Giardia in ready-to-eat packaged leafy greens in Ontario, Canada. J Food Prot 76 : 307 313[CrossRef].[PubMed]
118. Caradonna T, Marangi M, Del Chierico F, Ferrari N, Reddel S, Bracaglia G, Normanno G, Putignani L, Giangaspero A . 2017. Detection and prevalence of protozoan parasites in ready-to-eat packaged salads on sale in Italy. Food Microbiol 67 : 67 75[CrossRef].[PubMed]
119. Alfano-Sobsey EM, Eberhard ML, Seed JR, Weber DJ, Won KY, Nace EK, Moe CL . 2004. Human challenge pilot study with Cyclospora cayetanensis. Emerg Infect Dis 10 : 726 728[CrossRef].[PubMed]
120. Jinneman KC, Wetherington JH, Hill WE, Omiescinski CJ, Adams AM, Johnson JM, Tenge BJ, Dang NL, Wekell MM . 1999. An oligonucleotide-ligation assay for the differentiation between Cyclospora and Eimeria spp. polymerase chain reaction amplification products. J Food Prot 62 : 682 685[CrossRef].[PubMed]
121. Orlandi PA, Lampel KA . 2000. Extraction-free, filter-based template preparation for rapid and sensitive PCR detection of pathogenic parasitic protozoa. J Clin Microbiol 38 : 2271 2277.[PubMed]
122. Adam RD, Ortega YR, Gilman RH, Sterling CR . 2000. Intervening transcribed spacer region 1 variability in Cyclospora cayetanensis. J Clin Microbiol 38 : 2339 2343.[PubMed]
123. Olivier C, van de Pas S, Lepp PW, Yoder K, Relman DA . 2001. Sequence variability in the first internal transcribed spacer region within and among Cyclospora species is consistent with polyparasitism. Int J Parasitol 31 : 1475 1487[CrossRef].[PubMed]
124. Eberhard ML, Nace EK, Freeman AR, Streit TG, da Silva AJ, Lammie PJ . 1999. Cyclospora cayetanensis infections in Haiti: a common occurrence in the absence of watery diarrhea. Am J Trop Med Hyg 60 : 584 586[CrossRef].[PubMed]
125. Kaminsky RG, Lagos J, Raudales Santos G, Urrutia S . 2016. Marked seasonality of Cyclospora cayetanensis infections: ten-year observation of hospital cases, Honduras. BMC Infect Dis 16 : 66[CrossRef].[PubMed]
126. Orozco-Mosqueda GE, Martínez-Loya OA, Ortega YR . 2014. Cyclospora cayetanensis in a pediatric hospital in Morelia, México. Am J Trop Med Hyg 91 : 537 540[CrossRef].[PubMed]
127. Zhou Y, Lv B, Wang Q, Wang R, Jian F, Zhang L, Ning C, Fu K, Wang Y, Qi M, Yao H, Zhao J, Zhang X, Sun Y, Shi K, Arrowood MJ, Xiao L . 2011. Prevalence and molecular characterization of Cyclospora cayetanensis, Henan, China. Emerg Infect Dis 17 : 1887 1890[CrossRef].[PubMed]
128. Pape JW, Verdier RI, Boncy M, Boncy J, Johnson WD Jr . 1994. Cyclospora infection in adults infected with HIV. Clinical manifestations, treatment, and prophylaxis. Ann Intern Med 121 : 654 657[CrossRef].[PubMed]
129. Verdier RI, Fitzgerald DW, Johnson WD Jr, Pape JW . 2000. Trimethoprim-sulfamethoxazole compared with ciprofloxacin for treatment and prophylaxis of Isospora belli and Cyclospora cayetanensis infection in HIV-infected patients. A randomized, controlled trial. Ann Intern Med 132 : 885 888[CrossRef].[PubMed]
130. Guo Y, Li N, Ortega YR, Zhang L, Roellig DM, Feng Y, Xiao L . 2017. Population genetic characterization of Cyclospora cayetanensis from discrete geographical regions. Exp Parasitol 184 : 121 127.[PubMed]
131. Li J, Chang Y, Shi KE, Wang R, Fu K, Li S, Xu J, Jia L, Guo Z, Zhang L . 2017. Multilocus sequence typing and clonal population genetic structure of Cyclospora cayetanensis in humans. Parasitology 144 : 1890 1897[CrossRef].[PubMed]
132. Liu S, Wang L, Zheng H, Xu Z, Roellig DM, Li N, Frace MA, Tang K, Arrowood MJ, Moss DM, Zhang L, Feng Y, Xiao L . 2016. Comparative genomics reveals Cyclospora cayetanensis possesses coccidia-like metabolism and invasion components but unique surface antigens. BMC Genomics 17 : 316[CrossRef].[PubMed]
133. Ballal M, Prabhu T, Chandran A, Shivananda PG . 1999. Cryptosporidium and Isospora belli diarrhoea in immunocompromised hosts. Indian J Cancer 36 : 38 42.[PubMed]
134. Chui DW, Owen RL . 1994. AIDS and the gut. J Gastroenterol Hepatol 9 : 291 303[CrossRef].[PubMed]
135. Comin CE, Santucci M . 1994. Submicroscopic profile of Isospora belli enteritis in a patient with acquired immune deficiency syndrome. Ultrastruct Pathol 18 : 473 482[CrossRef].[PubMed]
136. DeHovitz JA, Pape JW, Boncy M, Johnson WD Jr . 1986. Clinical manifestations and therapy of Isospora belli infection in patients with the acquired immunodeficiency syndrome. N Engl J Med 315 : 87 90[CrossRef].[PubMed]
137. Dubey JP, Beattie CP. 1988. Toxoplasmosis of Animals and Man. CRC Press, Inc, Boca Raton, FL.
138. Dubey JP, Miller NL, Frenkel JK . 1970. Toxoplasma gondii life cycle in cats. J Am Vet Med Assoc 157 : 1767 1770.[PubMed]
139. Barcán LA, Dallurzo ML, Clara LO, Valledor A, Macías S, Zorkin E, Gerona S, Livellara B . 2002. Toxoplasma gondii pneumonia in liver transplantation: survival after a severe case of reactivation. Transpl Infect Dis 4 : 93 96[CrossRef].[PubMed]
140. Brinkman K, Debast S, Sauerwein R, Ooyman F, Hiel J, Raemaekers J . 1998. Toxoplasma retinitis/encephalitis 9 months after allogeneic bone marrow transplantation. Bone Marrow Transplant 21 : 635 636[CrossRef].[PubMed]
141. Conrath J, Mouly-Bandini A, Collart F, Ridings B . 2003. Toxoplasma gondii retinochoroiditis after cardiac transplantation. Graefes Arch Clin Exp Ophthalmol 241 : 334 338[CrossRef].[PubMed]
142. Räisänen S . 1978. Toxoplasmosis transmitted by blood transfusions. Transfusion 18 : 329 332[CrossRef].[PubMed]
143. Derouin F, Debure A, Godeaut E, Lariviere M, Kreis H . 1987. Toxoplasma antibody titers in renal transplant recipients. Pretransplant evaluation and posttransplant follow-up of 73 patients. Transplantation 44 : 515 518[CrossRef].[PubMed]
144. Reiter-Owona I, Seitz H, Gross U, Sahm M, Rockstroh JK, Seitz HM . 2000. Is stage conversion the initiating event for reactivation of Toxoplasma gondii in brain tissue of AIDS patients? J Parasitol 86 : 531 536[CrossRef].[PubMed]
145. Ades AE . 1991. Evaluating the sensitivity and predictive value of tests of recent infection: toxoplasmosis in pregnancy. Epidemiol Infect 107 : 527 535[CrossRef].[PubMed]
146. Amos CS . 1977. The ocular manifestations of congenital infections produced by toxoplasma and cytomegalovirus. J Am Optom Assoc 48 : 532 538.[PubMed]
147. Brady-McCreery KM, Hussein MA, Paysse EA . 2003. Congenital toxoplasmosis with unusual retinal findings. Arch Ophthalmol 121 : 1200 1201[CrossRef].[PubMed]
148. De Marco R, Ceccarelli R, Frulio R, Palmero C, Vittone P . 2003. Retinochoroiditis associated with congenital toxoplasmosis in children: IgG antibody profiles demonstrating the synthesis of local antibodies. Eur J Ophthalmol 13 : 74 79[CrossRef].[PubMed]
149. Berlin OGW, Ash LR, Conteas CN, Peter JB . 1999. Rapid, hot chromotrope stain for detecting microsporidia. Clin Infect Dis 29 : 209 210[CrossRef].[PubMed]
150. Lundén A, Uggla A . 1992. Infectivity of Toxoplasma gondii in mutton following curing, smoking, freezing or microwave cooking. Int J Food Microbiol 15 : 357 363[CrossRef].[PubMed]
151. Marchioro AA, Tiyo BT, Colli CM, de Souza CZ, Garcia JL, Gomes ML, Falavigna-Guilherme AL . 2016. First detection of Toxoplasma gondii DNA in the fresh leafs of vegetables in South America. Vector Borne Zoonotic Dis 16 : 624 626[CrossRef].[PubMed]
152. Gallant JE, Moore RD, Chaisson RE . 1994. Prophylaxis for opportunistic infections in patients with HIV infection. Ann Intern Med 120 : 932 944[CrossRef].[PubMed]
153. Alvarado-Esquivel C, Rico-Almochantaf YDR, Sanchez-Anguiano LF, Quinones-Canales G, Hernandez-Tinoco J, Torres-Gonzalez J, Gonzalez-Silva MF, Ramirez-Valles EG . 2018. Toxoplasma gondii infection and headache: a matched case-control study in a public hospital in Durango City, Mexico. J Clin Med Res 10 : 27 31.[PubMed]
154. Zarean M, Shafiei R, Gholami M, Fata A, Rahmati Balaghaleh M, Kariminik A, Tehranian F, Hasani A, Akhavan A . 2017. Seroprevalence of anti- Toxoplasma gondii antibodies in healthy voluntary blood donors from Mashhad City, Iran. Arch Iran Med 20 : 441 445.[PubMed]
155. Barros GB, Lemos EM, E Silva-Dos-Santos PP, Dietze R, Zandonade E, Mineo JR, de Oliveira Silva DA, Pajuaba ACM, de Souza Gomes M, do Amaral LR, Coelho-Dos-Reis JG, Martins-Filho OA, Serufo JC . 2017. Proposed panel of diagnostic tools for accurate temporal classification of symptomatic T. gondii infection. J Immunol Methods 451 : 61 70[CrossRef].[PubMed]
156. Baschirotto PT, Krieger MA, Foti L . 2017. Preliminary multiplex microarray IgG immunoassay for the diagnosis of toxoplasmosis and rubella. Mem Inst Oswaldo Cruz 112 : 428 436[CrossRef].[PubMed]
157. Nakano S, Sugita S, Tomaru Y, Hono A, Nakamuro T, Kubota T, Takase H, Mochizuki M, Takahashi M, Shimizu N . 2017. Establishment of multiplex solid-phase strip PCR test for detection of 24 ocular infectious disease pathogens. Invest Ophthalmol Vis Sci 58 : 1553 1559[CrossRef].[PubMed]
158. Sun XM, Ji YS, Liu XY, Xiang M, He G, Xie L, Suo JX, Suo X . 2017. Improvement and evaluation of loop-mediated isothermal amplification for rapid detection of Toxoplasma gondii infection in human blood samples. PLoS One 12 : e0169125[CrossRef].[PubMed]
159. Armengol C, Cassaing S, Roques-Malecaze C, Chauvin P, Iriart X, Berry A, Fillaux J . 2017. Time before anti- Toxoplasma IgG seroconversion detection by 7 commercial assays in French pregnant women. Diagn Microbiol Infect Dis 87 : 103 107[CrossRef].[PubMed]
160. Sroka J, Wójcik-Fatla A, Zając V, Sawczyn A, Cisak E, Karamon J, Dutkiewicz J, Bojar I . 2016. Comparison of the efficiency of two commercial kits—ELFA and Western blot in estimating the phase of Toxoplasma gondii infection in pregnant women. Ann Agric Environ Med 23 : 570 575[CrossRef].[PubMed]
161. Capobiango JD, Monica TC, Ferreira FP, Mitsuka-Breganó R, Navarro IT, Garcia JL, Reiche EM . 2016. Evaluation of the Western blotting method for the diagnosis of congenital toxoplasmosis. J Pediatr (Rio J) 92 : 616 623[CrossRef].[PubMed]
162. Holec-Gąsior L, Ferra B, Czechowska J, Serdiuk IE, Krzymiński K, Kur J . 2016. A novel chemiluminescent immunoassay for detection of Toxoplasma gondii IgG in human sera. Diagn Microbiol Infect Dis 85 : 422 425[CrossRef].[PubMed]
163. Zhuo X, Sun H, Zhang Z, Luo J, Shan Y, Du A . 2017. Development and application of an indirect enzyme-linked immunosorbent assay using recombinant Mag1 for serodiagnosis of Toxoplasma gondii in dogs. J Parasitol 103 : 237 242[CrossRef].[PubMed]
164. Yang YR, Feng YJ, Lu YY, Dong H, Li TY, Jiang YB, Zhu XQ, Zhang LX . 2017. Antibody detection, isolation, genotyping, and virulence of Toxoplasma gondii in captive felids from China. Front Microbiol 8 : 1414[CrossRef].[PubMed]
165. Dubey JP, Brown J, Verma SK, Cerqueira-Cézar CK, Banfield J, Kwok OCH, Ying Y, Murata FHA, Pradhan AK, Su C . 2017. Isolation of viable Toxoplasma gondii, molecular characterization, and seroprevalence in elk ( Cervus canadensis) in Pennsylvania, USA. Vet Parasitol 243 : 1 5[CrossRef].[PubMed]
166. Lopes AP, Oliveira AC, Granada S, Rodrigues FT, Papadopoulos E, Schallig H, Dubey JP, Cardoso L . 2017. Antibodies to Toxoplasma gondii and Leishmania spp. in domestic cats from Luanda, Angola. Vet Parasitol 239 : 15 18[CrossRef].[PubMed]
167. Ying Y, Verma SK, Kwok OCH, Alibana F, Mcleod R, Su C, Dubey JP, Pradhan AK . 2017. Prevalence and genetic characterization of Toxoplasma gondii in free-range chickens from grocery stores and farms in Maryland, Ohio and Massachusetts, USA. Parasitol Res 116 : 1591 1595[CrossRef].[PubMed]
168. Gennari SM, Niemeyer C, Soares HS, Musso CM, Siqueira GC, Catão-Dias JL, Dias RA, Dubey JP . 2016. Seroprevalence of Toxoplasma gondii in seabirds from Abrolhos Archipelago, Brazil. Vet Parasitol 226 : 50 52[CrossRef].[PubMed]
169. SG, Lima DC, Silva LT, Pinheiro Júnior JW, Dubey JP, Silva JC, Mota RA . 2016. Seroprevalence of Toxoplasma gondii among turkeys on family farms in the state of Northeastern Brazil. Acta Parasitol 61 : 401 405[CrossRef].[PubMed]