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/

The following background data on spotted fever in Brazil are abstracted from the Gideon e-book series. [1,2] (Primary references are available on request)

Time and Place:
Rickettsial spotted fever is known locally as Brazilian spotted fever, Sao Paulo fever and Febre maculosa brasileira.
- Rickettsial spotted fever was first reported in Brazil in 1920.
- Cases are reported in Minas Gerais, Bahia, Goias, Rio Grande do Sul and Espirito Santo.
- The disease has re-emerged in Rio de Janeiro in recent years.

Disease incidence and rates per 100,000 are depicted in the following graph. Between 6 and 27 fatal cases per year were registered during 2007 to 2010.

Geographical notes:
Outbreaks were reported in Minas Gerais during 1929 to 1944, but not during 1945 to 1980.
- Subsequent outbreaks were reported in Minas Gerais in 1981, 1984, 1992, 1995 and 2000.
- 92 cases (40% fatal) were confirmed in Minas Gerais during 1981 to 1989; 78 during 1992 to 1997 (including 3 fatal cases in 1996, and 2 in 1997).
67 cases were reported in Sao Paulo during 1985 to 2000; 224 (including 6 case-clusters) during 2001 to 2008 5 ; 5,949 suspected cases (206 confirmed) during 2003 to 2006.
- 17 cases (8 fatal) were reported in Pedreira county, Sao Paulo during 1985 to 1995.
- Five fatal cases were reported in Sao Paulo State in 2003.
- Eight outbreaks were reported in Sao Paulo State during 2005.
- A case of eschar-associated spotted fever rickettsiosis (species not determined) was reported in Bahia in 2007.

Prevalence surveys:
1.3% of Rhipicephalus sanguineus ticks in metropolitan Sao Paulo are infected by Rickettsia rickettsii (2009 publication)
1.3% of Amblyomma cajennense in Minas Gerais (1997 publication)
Rickettsia parkeri was identified in 9.7% of Amblyomma triste (a non-human biting tick) in Pauliceia County, Sao Paulo (2005).

Seroprevalence surveys:
10.6% of healthy students and 4.11% of dogs in the endemic areas of Minas Gerais (1998)
38.4% of humans, 7.6% of dogs and 25.9% of horses (Espirito Santo, Rickettsia spp., 2010 publication)
77.3% of horses and 31.3% of dogs in Pedreira Municipality, Sao Paulo State (2001)
1.6% of healthy persons in Minas Gerais (2005 publication)
25.7% of dogs in southern Brazil (Rickettsia parkeri, 2002 to 2003)
69.6% of dogs in metropolitan Sao Paulo (2009 publication)
4.4% of dogs from Sao Jose dos Pinhais, Parana State (2006 to 2007)

Reservoirs:
- The principal reservoir hosts are capybara (Hydrochaeris hydrochaeris) , horses and occasionally dogs.
- Natural infection has been identified in dogs in Sao Paulo.
- R. parkeri antibodies have been documented in dogs from urban areas in the western Brazilian Amazon. (Monte Negro, Rondonia)

Vectors:
The principal vectors are Amblyomma aureolatum (areas of Sao Paulo) and Amblyomma cajennense.
- Amblyomma cooperi has also been implicated (in Sao Paulo).
- Spotted fever-group rickettsiae have been found in Rhipicephalus sanguineus in Rio de Janeiro state.

Notable outbreaks:
1993 (publication year) – An outbreak (6 cases, 4 confirmed) was reported in Espirito Santo.
2004 (publication year) – An outbreak was reported in Campinas.
2004 – An outbreak (3 fatal cases) was reported in Maua (Grande Sao Paulo).
2005 – An outbreak (7 cases, 2 fatal) was reported in a mountain resort near Rio de Janeiro.
2008 – An outbreak (3 fatal cases) was reported in Sao Paulo State.

References:
1. Berger SA. Infectious Diseases of Brazil, 2011. 530 pp. Gideon e-book series, http://www.gideononline.com/ebooks/country/infectious-diseases-of-brazil/
2. Berger SA. Rocky Mountain Spotted Fever: Global Status, 2011. 18 pp. Gideon e-book series, http://www.gideononline.com/ebooks/disease/rocky-mountain-spotted-fever-global-status/

Rickettsial spotted fever was first reported in Brazil in 1920.

The disease is known locally as ‘Brazilian spotted fever’ and ‘Febre maculosa brasileira’

Cases are reported in Minas Gerais, Rio de Janeiro, Bahia, Goias, Rio Grande do Sul and Espirito Santo.

Seroprevalence surveys:
10.6% of healthy students and 4.11% of dogs in the endemic areas of Minas Gerais (1998)
77.3% of horses and 31.3% of dogs in Pedreira Municipality, Sao Paulo State (2001)
1.6% of healthy persons in Minas Gerais (2005 publication)
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Quoted in ProMED:

Visceral leishmaniasis was 1st described in Brazil in 1934 and 1st reported from Rio de Janeiro state in 1977.

90 percent of cases are reported from the north (mouth of the Amazon) and eastern regions. The disease is endemic to Alagoas, Bahia, Ceara, Espirito Santo, Goias, Maranhao, Mato Grosso do Sul, Minas Gerais, Para, Paraiba, Pernambuco, Piaui, Rio Grande do Norte, Roraima and Sergipe. Urban transmission was 1st reported in 1981, from Teresina (Piaui State). A large focus extends from Roraima into Venezuela and Guyana.

The reported incidence has increased from 164 cases (35 fatal) in 1980 to 3220 (223 fatal) in 2005; see graph . A total of 44 289 cases were reported during 1980 to 2000, 39 823 of these from the northeast. Brazil accounts for over 90 percent of cases in the New World.
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