Despite a widespread prevalence of toxoplasmosis among humans and other vertebrates, overt outbreaks are rarely reported. The following chronology is abstracted from Gideon (www.GideonOnline.com) and the Gideon e-book series. [1] (Primary references available on request)

Outbreaks among humans:
1967 (publication year) – Brazil. An outbreak at a Paulist seminary in Braganza, Sao Paulo State.
1969 (publication year) – Brazil. An outbreak of toxoplasmosis at a university in Sao-Jose-dos Campos, Sao Paulo.
1977 – United States. An outbreak (37 cases) in Georgia among patrons of a riding stable.
1978 – United States. An outbreak (10 cases) among members of a family in California, associated with consumption of raw goat’s milk.
1979 – Italy. An outbreak (5 cases) among members of a family.
1980 (publication year) – United States. An outbreak (10 cases) in an extended family, related to cat contact.
1981 (publication year) – United States. An outbreak in Georgia.
1982 (publication year) – Brazil. An outbreak in a rural area.
1984 (publication year) – United States. An outbreak (9 cases) among family members on an Illinois farm.
1984 (publication year) – Australia. An outbreak (5 cases) among members of a Lebanese family in Australia was ascribed to contaminated Kibbi (a traditional meat dish)
1990 (publication year) – Canada. 4 cases among pregnant women in Quebec, associated with consumption of raw meat.
1993 – Brazil. An outbreak (20 cases) in Parana was ascribed to ingestion of contaminated mutton.
1995 – Canada. An outbreak (2,895 to 7,118) cases in the Greater Victoria area of British Columbia. This was the largest recorded outbreak of toxoplasmosis from water
1997 (publication year) – Republic of Korea. Two outbreaks (8 cases) associated with consumption of uncooked pork.
2001 – Brazil. A water-borne outbreak (176 cases) in Parana
2002 – Brazil. A water-borne outbreak (426 cases) in Parana
2002 – Turkey. An outbreak (171 cases) at a boarding school in Izmir.
2003 to 2004 – French Guiana. An outbreak (11 cases, 3 fatal) in Patam, among immunocompetent patients.
2010 (publication year) – India. An outbreak (248 cases) of Toxoplasma retinitis in Tamil Nadu was ascribed to ingestion of contaminated water

Veterinary outbreaks:
1953 (publication year) – Norway. An outbreak among chickens
1964 (publication year) – Canada. An outbreak (44 cases) chinchillas (Chinchilla lanigera) in Ontario.
1977 (publication year) – Sweden. An outbreak of among pigs.
1977 – United States. An outbreak (4 cases) among wallaroos (Macropus robustus) in a California zoo.
1986 (publication year) – United States. An outbreak among captive kangaroos, wallabies, and potaroos.
1986 (publication year) – Italy. An outbreak on an bird-farm in Vicenza involved small passerine birds (Serinus canaria, Carduelis chloris, Carduelis carduelis, Carduelis spinus, Carduelis cannabina and Pyrrhula pyrrhula).
1992 (publication year) – United States. An outbreak among wallabies on an exotic animal farm.
1992 (publication year) – United Kingdom. An outbreak of toxoplasmosis among captive squirrel monkeys (Saimiri sciureus)
1996 – Czezh Republic. An outbreak among Angora goats.
1999 – United States. An outbreak among Wisconsin mink (Mustela vison).
2004 – China. An outbreak among swine in Ganzu Province.
2008 (publication year) – Israel. An outbreak (19 cases) among captive squirrel monkeys (Saimiri sciureus) was ascribed to contaminated feed.
2008 (publication year) – South Africa. An outbreak (8 cases) among Nicobar pigeons (Caloenas nicobaria) in an aviary collection.
2009 (publication year) – Italy. An outbreak among ovines on a farm.
2009 (publication year) – Republic of Korea. An outbreak of porcine abortion due to toxoplasmosis was reported in Jeju Island.

Reference:
1. Berger SA. Toxoplasmosis: Global Status, 2011. 92 pp, 74 graphs, 950 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/toxoplasmosis-global-status/

Notwitstanding a recent outbreak in Utah, infant botulism has accounted for an growing percentage of total cases in recent years. [1,2] In the following graph, I’ve summarized trends for botulism in the United States. Note that total case numbers have been increasing since 1995, despite a decrease in the incidence of food-borne botulism.

(See the Graph tool tutorial at www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps )

References:
1. Berger SA. Infectious Diseases of the United States, 2011. 1030 pp, 464 graphs, 8237 references. Gideon e-books, www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/
2. Berger SA. Botulism: Global Status, 2011. 80 pages, 86 graphs, 510 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/botulism-global-status/

Although Listeria monocytogenes is a relatively uncommon cause of food-borne infection in the United States, this species is associated with a disproportionate mortality rate. In recent years, Salmonella and Listeria have been associated with more cases of fatal bacterial food related disease than any other agent, despite the the relative rarity of listeriosis as a disease. [1,2] In fact, case-fatality rates of the most common agent, Salmonella, have not paralleled increases in disease incidence. See graphs 1 and 2.

(See the Graph tool tutorial at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps )

References:
1. Berger SA. Infectious Diseases of the United States, 2011. 1030 pp, 464 graphs, 8237 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states
2. Berger SA. Listeriosis: Global Status, 2011. 93 pp, 103 graphs, 487 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/listeriosis-global-status/

Note disussed in Promed

A recent outbreak in Viljandi belies the fact that rates of Hepatitis A and Hepatitis B in the Baltic region have been decreasing since the 1990′s. [1,2] See graphs:

(graph tool tutorial at http://www.GIDEONonline.com/wp/wp-content/uploads/Gideon-Graphs.pps )

The last major outbreak of Hepatitis A in Estonia was reported in 1998 (989 cases).

References:
1. Berger SA. Infectious Diseases of Estonia, 2011. 357 pp, 97 graphs, 887 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-estonia/
2. Berger SA. Hepatitis A: Global Status, 2011. 163 pp, 180 graphs, 1073 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/hepatitis-a-global-status/

Note featured in ProMED: Note reproduced in ProMED

The growing contribution of Nigeria and Pakistan to global poliomyelitis incidence reflects decreasing incidence in India, rather than an absolute increase in Nigeria and Pakistan. [1-4] These trends continue to illustrate the relative success of mass vaccination. *

Health care workers in Nigeria and Pakistan might find the last two graphs useful in convincing citizens who hesitate to vaccinate their children.

* Custom graphs are generated using an interactive module in Gideon http://www.gideononline.com/cases/video/multi-graphs/

References:
1. Berger SA. Infectious Diseases of India, 2011. 480 pp, 65 graphs, 3503 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-india/
2. Berger SA. Infectious Diseases of Nigeria, 2011. 410 pp, 60 graphs, 1684 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-nigeria/
3. Berger SA. Infectious Diseases of Pakistan, 2011. 354 pp, 39 graphs, 1243 references. Gideon e-books, http://www.gideononline.com/ebooks/country/infectious-diseases-of-pakistan/
4. Berger SA. Poliomyelitis: Global Status, 2011. 540 pp, 867 graphs, 994 references. Gideon e-books, http://www.gideononline.com/ebooks/disease/poliomyelitis-global-status/

Featured in ProMED

Although the world is currently focused on a serious outbreak of cholera in Haiti, the disease continues to be active in several other areas of the world. The following outbreaks were posted during November, concurrent to the events in Haiti:

• Benin – An outbreak (846 cases, 7 fatal) was reported.
• Cameroon – An outbreak (10,000 cases, 597 fatal)
• Chad – An outbreak (4,000 cases, 135 fatal) was reported.
• China – Outbreaks were reported in Jiangsu and Anhui
• Ghana – An outbreak was reported in the Eastern region
• Haiti – 16,799 cases, 1,034 fatal
• India – Outbreaks were reported in Jammu and Kashmir, Maharashtra, Assam, Orissa, Tamil Nadu and Gujarat.
• Nigeria – Outbreaks (38,173 cases, 1,555 fatal) involved 11 states.
• Pakistan – Large outbreaks have followed local flooding.
• Papua New Guinea – Outbreaks (2,000 cases, 40 fatal) were reported in East Sepik, Madang and Morobe Provinces.
• Zambia – An outbreak (70 cases) was reported in Copperbelt.
• Zimbabwe – Multiple outbreaks, over 100,000 cases (4,500 fatal) total since 2008.

Although sporadic cases of shigellosis are common among travelers and expatriates, overt outbreaks are relatively uncommon. The following chronology was abstracted from reference [1]. Primary references are available on request.

1969 (publication year) – An outbreak of shigellosis was reported among Australian soldiers in Vietnam.
1976 – An outbreak (386 cases) of diarrhea due to Salmonella, Vibrio, Shigella, ETEC and EIEC was reported among passengers of a cruise ship following a visit to Haiti.
1987 – An outbreak (15 cases) of Shigella dysenteriae infection was reported among American tourists in Mexico.
1988 – An outbreak (240 cases) of shigellosis was reported among domestic and international passengers aboard an airline based in the United States.
1989 – An outbreak (84 cases) of Shigella flexneri infection aboard an American cruise ship was caused by contaminated potato salad.
1991 (publication year) – An outbreak (11 cases) of Shigella sonnei infection was reported among children from a Danish day-care institution on tour in Sweden.
1992 – An outbreak of shigellosis was reported among passengers on a cruise ship following a restaurant meal in Saint Lucia.
1994 – An outbreak (610 cases, 1 fatal) of Shigella flexneri infection occurred on a cruise ship sailing between California and Mexico.
1994 – An outbreak (1,062 cases) was reported among Rwandan refugees in Dem. Rep. Congo. A parallel outbreak (77 cases) involved Dutch military personnel who had eaten at an on-site hotel.
1996 – An outbreak (350 cases) was reported on a cruise ship en route from Venice to Crete.
2001 – Outbreaks (30 cases) were reported among travelers returning to New Zealand from Samoa.
2002 – An outbreak (78 cases) of food-borne Shigella sonnei infection was reported among tourists at a hotel resort in the Turks and Caicos Islands.
2003 – An outbreak (99 cases) was reported among Taiwanese tourists on tour in Indonesia.
2004 – An outbreak (45 cases) of Shigella sonnei infection in the United States, Japan, Australia and American Samoa was associated with food served on air flights serviced by a supplier in Hawaii.
2005 – An outbreak (71 cases) was reported among Irish tourists in Egypt.
2005 – An outbreak (6 cases) was reported among Japanese students and family members traveling to Malaysia and Singapore.
2005 (publication year) – An outbreak (14 cases) was reported among tourists at a rural hotel in the Canary Islands.
2006 – An outbreak (23 cases) of Shigella sonnei infection was reported among passengers on a bus from Norway to the Russian Federation.
2008 – Outbreaks (18 cases) were reported among tourists from Hong Kong in Cambodia (11 cases) and Egypt (7 cases).

1. Berger SA. Shigellosis: Global Status. 150 pp., 891 refs. 2010, Gideon e-book series http://www.gideononline.com/ebooks/disease/shigellosis-global-status/

Update: Posted in ProMED