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Open Access Highly Accessed Research article

Increased risk of traffic accidents in subjects with latent toxoplasmosis: a retrospective case-control study

Jaroslav Flegr1*, Jan Havlícek2, Petr Kodym3, Marek Malý4 and Zbyněk Smahel5

Author Affiliations

1 Department of Parasitology, Faculty of Science, Charles University, Prague, Czech Republic

2 Research Centrum of Personality and Ethnic Studies, Faculty of Humanities, Charles University, Prague, Czech Republic

3 National Reference Laboratory for Toxoplasmosis, National Institute of Public Health, Prague, Czech Republic

4 Department of Biostatistics, National Institute of Public Health, Prague, Czech Republic

5 Department of Anthropology and Human Genetics, Faculty of Science, Charles University, Prague, Czech Republic

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BMC Infectious Diseases 2002, 2:11  doi:10.1186/1471-2334-2-11

Published: 2 July 2002



The parasite Toxoplasma gondii infects 30–60% of humans worldwide. Latent toxoplasmosis, i.e., the life-long presence of Toxoplasma cysts in neural and muscular tissues, leads to prolongation of reaction times in infected subjects. It is not known, however, whether the changes observed in the laboratory influence the performance of subjects in real-life situations.


The seroprevalence of latent toxoplasmosis in subjects involved in traffic accidents (N = 146) and in the general population living in the same area (N = 446) was compared by a Mantel-Haenszel test for age-stratified data. Correlation between relative risk of traffic accidents and level of anti-Toxoplasma antibody titre was evaluated with the Cochran-Armitage test for trends.


A higher seroprevalence was found in the traffic accident set than in the general population (Chi2MH = 21.45, p < 0.0001). The value of the odds ratio (OR) suggests that subjects with latent toxoplasmosis had a 2.65 (C.I.95= 1.76–4.01) times higher risk of an accident than the toxoplasmosis-negative subjects. The OR significantly increased with level of anti-Toxoplasma antibody titre (p < 0.0001), being low (OR = 1.86, C.I.95 = 1.14–3.03) for the 99 subjects with low antibody titres (8 and 16), higher (OR = 4.78, C.I.95 = 2.39–9.59) for the 37 subjects with moderate titres (32 and 64), and very high (OR = 16.03, C.I.95 = 1.89–135.66) for the 6 subjects with titres higher than 64.


The subjects with latent toxoplasmosis have significantly increased risk of traffic accidents than the noninfected subjects. Relative risk of traffic accidents decreases with the duration of infection. These results suggest that 'asymptomatic' acquired toxoplasmosis might in fact represent a serious and highly underestimated public health problem, as well as an economic problem.