Dynamics and epidemiology of Toxoplasma gondii oocyst shedding in domestic and wild felids

Oocyst shedding in domestic and wild felids is a critical yet understudied topic in Toxoplasma gondii ecology and epidemiology that shapes human and animal disease burden. We synthesized published literature dating from the discovery of felids as the definitive hosts of T. gondii in the 1960s through March 2021 to examine shedding prevalence, oocyst genotypes, and risk factors for shedding. Oocyst shedding prevalence in many geographic regions exceeded the commonly accepted 1% reported for domestic cats; crude prevalence from cross-sectional field studies of domestic cat shedding ranged from 0% in Australia to 18.8% in Africa, with greater variation in reports of oocyst shedding in free-ranging, wild felids. Shedding in wild felid species has primarily been described in captive animals, with attempted detection of oocyst shedding reported in at least 31 species. Differences in lifestyle and diet play an important role in explaining shedding variation between free-ranging unowned domestic cats, owned domestic cats and wild felids. Additional risk factors for shedding include the route of infection, diet, age and immune status of the host. It is widely reported that cats only shed oocysts after initial infection with T. gondii, but experimental studies have shown that repeat oocyst shedding can occur. Factors associated with repeat shedding are common amongst free-ranging felids (domestic and wild), which are more likely to eat infected prey, be exposed to diverse T. gondii genotypes, and have coinfections with other parasites. Repeat shedding events could play a significant yet currently ignored role in shaping environmental oocyst loading with implications for human and animal exposure. Oocyst presence in the environment is closely linked to climate variables such as temperature and precipitation, so in quantifying risk of exposure, it is important to consider the burden of T. gondii oocysts that can accumulate over time in diverse environmental matrices and sites, as well as the spatial heterogeneity of free-ranging cat populations. Key directions for future research include investigating oocyst shedding in under-sampled regions, genotyping of oocysts detected in faeces and longitudinal studies of oocyst shedding in free-ranging felids.