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Toxoplasmosis

Toxoplasmosis is a parasitic disease caused by the parasite Toxoplasma gondii. It infects most animals and causes human parasitic diseases, but the primary host is the felid (cat) family. People usually get infected by eating raw or undercooked meat, or more rarely, by contact with cat faeces. more...

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At least one third of the world population may have contracted a toxoplasmosis infection in their lifetime but, after the acute infection has passed, the parasite rarely causes any symptoms in otherwise healthy adults. However, people with a weakened immune system are particularly susceptible, such as people infected with HIV. The parasite can cause encephalitis (inflammation of the brain) and neurologic diseases and can affect the heart, liver, and eyes (chorioretinitis).

Transmission

Transmission may occur through:

Ingestion of raw or partly cooked meat, especially pork, lamb, or venison, or by hand to mouth contact after handling undercooked meat. Infection prevalence is higher in countries that traditionally eat undercooked meat, such as France. This seems to be by far the most common route of infection.
Accidental ingestion of contaminated cat faeces. This can occur through hand to mouth contact following gardening, cleaning a cat's litter box, children's sandpits, or touching anything that has come into contact with cat faeces.
Contamination of knives, utensils, cutting boards and other foods that have had contact with raw meat.
Drinking water contaminated with Toxoplasma.
Ingestion of raw or unpasteurized milk and milk products, particularly those containing goat's milk.
The reception of an infected organ transplant or blood transfusion, although this is extremely rare.

The cyst form of the parasite is extremely hardy, capable of surviving exposure to cooling down to subzero temperatures and chemical disinfectants such as bleach and can survive in the environment for over a year. It is, however, susceptible to high temperatures, and is killed by cooking. Cats excrete the pathogen for a number of weeks or months after contracting the disease, generally by eating an infected rodent. Even then, cat faeces are not generally contagious for the first day or two after excretion, after which the cyst 'ripens' and becomes potentially pathogenic.

Although the pathogen has been detected on the fur of cats, the pathogen has not been found in a 'ripe' form, and direct infection from handling cats is generally believed to be very rare.

Pregnancy precautions

Congenital toxoplasmosis is a special form in which an unborn child is infected via the placenta. This is the reason that pregnant women should be checked to see if they have a titer to toxoplasmosis. A titer indicates previous exposure and largely ensures the unborn baby's safety. If a woman receives her first exposure to Toxoplasma while pregnant then the baby is at particular risk. A woman with no previous exposure should avoid handling raw meat, exposure to cat faeces, and gardening (a common place to find cat faeces). Most cats are not actively shedding oocysts and so are not a danger, but the risk may be reduced further by having the litterbox emptied daily (oocysts require longer than a single day to become infective), and/or by having someone else empty the litterbox.

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Toxoplasmosis - Information from Your Family Doctor
From American Family Physician, 5/15/03

What is toxoplasmosis, and how do you get it?

Toxoplasmosis (say: tox-oh-plaz-moh-sis) is an infection caused by a tiny parasite. You would need a microscope to see it.

You can get toxoplasmosis in the following ways:

* By swallowing the parasite in cat litter or dirt that has cat droppings in it. This can happen if you put your hands to your mouth after gardening, cleaning a cat litter box, or touching anything that has been in contact with cat droppings. Cats sometimes carry the parasite that causes toxoplasmosis.

* By eating raw or partly cooked meat, especially pork, lamb, or wild game.

* By touching something, such as a cutting board or dish, that has been in contact with raw or undercooked meat and then putting your hands to your mouth.

* By eating unwashed raw fruits and vegetables, or drinking water with the parasite in it.

If you are pregnant when you first get toxoplasmosis, you can pass the infection to your unborn child. If you have toxoplasmosis before you get pregnant, you are unlikely to pass it to your baby.

People who have an organ transplant or a blood transfusion also can get toxoplasmosis. However, this rarely happens.

If you have a healthy immune system and are not pregnant, you probably do not need to worry about toxoplasmosis.

What are the symptoms of toxoplasmosis?

Most people have no symptoms because their immune system keeps the parasite from causing illness. If you have symptoms, they may be like the "flu." Your glands may be swollen, and your muscles may be sore for a few days to several weeks.

If you have a weak immune system, toxoplasmosis can cause serious medical problems, such as damage to your eyes and brain. Your immune system can become weak for a number of reasons. Human immunodeficiency virus (HIV) infection leading to AIDS can weaken the immune system. So can some kinds of cancer chemotherapy or medicines that are taken after an organ transplant.

Babies with toxoplasmosis can have brain damage, eye damage, and other physical and mental problems. Some problems may not show up for years.

How do I know I have toxoplasmosis?

Routine screening for toxoplasmosis is not recommended. However, if you are at risk for toxoplasmosis, your doctor might want you to have a blood test.

How is toxoplasmosis treated?

If the blood test shows that you have toxoplasmosis, you and your doctor can decide if you need to be treated. If you are otherwise healthy and not pregnant, you probably do not need any treatment.

If you are pregnant or have a weak immune system, you might need to take some medicines to treat toxoplasmosis.

A baby with toxoplasmosis has to be treated with medicine.

How can I keep from getting toxoplasmosis?

Here are some things you can do to protect yourself from getting toxoplasmosis:

* Wear gloves when you work in the dirt. Cats often use gardens and sandboxes as litter boxes.

* After outdoor activities, wash your hands with soap and warm water, especially before you eat or prepare food.

* Use hot soapy water to clean cutting boards, dishes, and other items after they have been in contact with raw meat, poultry, or seafood, or unwashed fruits and vegetables.

* Cook meat until it is no longer pink in the center or until the juices run clear (160 degrees Fahrenheit on a meat thermometer). Do not taste meat before it is fully cooked.

* When eating in restaurants or other places, do not eat undercooked meat.

* Avoid drinking untreated water especially when traveling in less developed countries.

I have a cat. Can I keep it?

Yes. If you are pregnant or your immune system is weak, here are some things you can do to keep from getting toxoplasmosis:

* Keep your cat indoors so that it does not pick up the toxoplasmosis parasite from the animals it hunts.

* Feed your cat only dry or canned cat food. Like humans, cats can become infected with toxoplasmosis by eating raw or undercooked meat.

* Do not bring a new cat into your house if the animal might have been an outdoor cat or might have been fed raw meat. Do not handle stray cats or kittens.

* Have a person who is healthy and not pregnant change your cat's litter box. If you have to change the cat litter yourself, wear gloves while you do it. When you finish, wash your hands well with soap and warm water. Clean the litter box daily.

Cats only spread toxoplasmosis in their droppings for a few weeks in their lives, usually after they are first infected. There is no benefit to having your cat's droppings tested for the toxoplasmosis parasite.

Where can I get more information about toxoplasmosis?

You can get more information at this Web site: www.cdc.gov/ncidod/dpd/parasites/ toxoplasmosis/default.htm

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