Do you love to pet animals for example dogs and cats? Do you now have a plan to get pregnant? I think you should consider the risk of toxoplasmosis especially if you have pet, because it can cause problems with pregnancy, including abortion. Let’s find out more about toxoplasmosis…
Toxoplasmosis is caused by a parasite called toxoplasma gondii. This is found in different forms in raw meat, within cats who eat raw meat and their faeces. Toxoplasmosis infection is common in both men and women outside of pregnancy, however it is infection during pregnancy that is of most concern as it can lead to infection in the unborn infant: congenital toxoplasmosis.
Once you have had toxoplasmosis, the body develops immunity and new exposure during pregnancy is not an issue. Peak incidence is between ages 25 and 30 years and in the UK by this time, about 30% of people will have had toxoplasmosis, hence will not be at risk of any problems during pregnancy. In the US, about 30-35% have antibodies and in France more than 65% of women will have already had toxoplasmosis. Because infection is more common in France, congenital toxoplasmosis occurs at over twice the rate in the UK or US.
It is not known for sure how many women catch toxoplasmosis during pregnancy, but some research suggests it is of the order 2 in every 1000, which means about 1400 each year in the UK. Direct contact can occur if a person touches the feces while cleaning the litter box or when gardening in an area where a cat has relieved itself. A person may breathe in the Toxoplasma gondii if the feces are disturbed, causing the organisms in the feces to become airborne. For example, if a cat scratches the litter and the sacs containing the Toxoplasma gondii become airborne, a nearby person may inhale the sacs.
It is unusual for otherwise healthy people to be ill when infection occurs. The most common symptoms are a viral, glandular fever-like illness or swollen glands in the neck.
A blood test can indicate whether you are susceptible to getting an infection, hence at risk. It can also diagnose new infection in the mother. In France all women are screened at the beginning of pregnancy to see if they are susceptible to infection. In the UK this is not the case as the incidence of infection is low. Women can also have a Toxoplasmosis test done before or once they know they are pregnant. In any case, risk can be avoided with simple measures, and although ascertaining your antibody status may reassure you if you are immune, it’s not as though there is a vaccine to prevent infection, as is the case with Rubella, for example.
If toxoplasmosis crosses the placenta in the first few months of pregnancy, it can severely damage the fetus. Problems may range from premature birth or low birth weight to serious central nervous system defects (and even stillbirths). In only about 30-40% of women who catch toxoplasmosis during pregnancy, does the infection pass to the unborn baby. The actual risk appears to be related to the gestation at which it is acquired. It is greatest in the third trimester at 70%, whereas in early pregnancy only 15% of infants will become infected.
Toxoplasmosis infection may lead to miscarriage, stillbirth, or survival with growth problems, blindness, water on the brain (hydrocephalus), brain damage, epilepsy, or deafness. This often develops after birth, so even normally born infants of women with known infection should be kept under observation for some time.
If a woman is found to have acquired toxoplasmosis during pregnancy, she will be offered an ultrasound scan to look for signs of fetal infection. After 20 weeks gestation, she may be offered a definitive test – cordocentesis. This involves a scan and blood sample being taken from the umbilical cord.
Well, talking about the treatment, the fact about antibiotic treatment can help to prevent some of the sequelae of toxoplasmosis infection is unfortunately contradictory. If a scan suggests severe damage, the woman is offered the option of terminating the pregnancy.
Although toxoplasmosis is quite serious when it occurs, as you will see from the figures above, it is relatively rare. Women with cats do not need to get rid of them when they become pregnant; it is just necessary to take a few precautions. Here some suggestions for a pet lover:
* If you own a cat, have a non-pregnant person change the litter box every day. If there is no one else to change the litter box, wear gloves and wash hands with soap and running water after changing the litter.
* Risk may be reduced if the litter box is changed every day.
* Keep cats indoors.
* Avoid adopting or handling stray cats.
* Feed cats only canned or dried commercial cat food, never undercooked or raw meat.
* Do not bring a new cat into your house that might have been an outdoor cat or might have been fed raw meat.
If you think you are not a pet lover, always be sure to only eat meat which has been cooked right through. Wash your hands, cooking utensils and food surfaces after preparing raw meat and wash all the soil from fruit and vegetables before eating. Keep raw meat and cooked foods on separate plates. If possible get someone else to clean out the dirty cat litter or use gloves and wash your hands afterwards. Always use gloves when gardening and wash your hands afterwards.
Try not to worry excessively or become paranoid about this – if you take these precautions, chance of infection is practically eliminated – you can still pet your cat, without fear!
Finally, it is important for pregnant farmers to be aware that toxoplasmosis can be caught from sheep at lambing time.