Sources of toxoplasma infection in pregnant women: European multicentre case-control study
Eating undercooked, raw or cured meat during pregnancy is the main risk factor for the common parasite infection - toxoplasmosis - which can lead to brain damage in the unborn child, according to a study in this week's BMJ.
Researchers interviewed over 1,000 pregnant women, both with and without toxoplasma infection, across six European cities about their occupations, lifestyle and eating habits. Their knowledge about sources of infection was also assessed. The authors found that eating raw, undercooked or cured meat contributed to between 30% and 63% of infections. Contact with soil contributed to up to 17% of infections and travel outside Europe or the United States and Canada was also a significant risk factor. Weaker associations were also seen in women who reported tasting raw meat during preparation of meals, drinking unpasteurised milk and working with animals. Contact with cats was not a risk factor for infection.
Interestingly, say the authors, women listed contact with cats, eating raw meat and eating raw or unwashed fruit or vegetables as the main sources of infection. Few women mentioned contact with soil. Despite some limitations of the study, the need for preventative strategies is clear, conclude the authors. They call for improved quality and consistency of information available to pregnant women, better labelling of meat according to farming and processing methods and improved farm hygiene to reduce infection in animals.
In an accompanying commentary, Richard Holliman of St George's Hospital and Medical School in London reinforces the need for preventative strategies "to reduce the infectivity of meat products." He believes that "current health education may benefit from focus and refinement, concentrating on the principal risk factors at the expense of less important issues" and concludes "the health implications of consuming raw, undercooked or cured meats in pregnancy require careful consideration."
Contacts:
[Paper] R E Gilbert, Senior Lecturer in Clinical Epidemiology, Department of Paediatric Epidemiology and Biostatistics, Institute of Child Health, London WC1N 1EH Email: r.gilbert@ich.ucl.ac.uk
[Commentary] Richard Holliman, Consultant and Reader in Clinical Microbiology, St George's Hospital and Medical School, London SW17 0QT Email: rhollima@sghms.ac.uk