Toxoplasmosis is caused by the parasite Toxoplasma gondii. This parasite is a single-celled organism that usually enters the body from ingestion of infected meat or dairy products, or contact with infected cat feces. Most people who are infected with this parasite are not aware of it because the body's immune system can fight it. In this case, the infected person is then immune to the parasite. However, toxoplasmosis is very dangerous for fetuses, infants, and people with weakened immune systems.
Step
Part 1 of 4: Determining If You Are Infected
Step 1. Recognize the symptoms of acute infection
About 80-90% of people infected with toxoplasmosis do not show any symptoms and never notice it. Some people experience flu-like symptoms that may last for several weeks. However, toxoplasmosis is very dangerous for the fetus in the womb. So, you should check with your doctor if you experience any of the following symptoms during pregnancy:
- Fever
- Muscle ache
- Fatigue
- Sore throat
- Swollen lymph nodes
Step 2. Get tested if you are at high risk for a dangerous infection
Toxoplasmosis is a serious threat to those with weak immune systems, as well as infants. You may need to undergo a blood test at the doctor's office. Ask your doctor to examine you if:
- You are pregnant or planning to become pregnant. Toxoplasmosis can be passed from mother to fetus in the womb and cause serious birth defects.
- You have HIV/AIDS. HIV/AIDS can weaken your immune system and make you more susceptible to complications of toxoplasmosis.
- You are undergoing chemotherapy. Chemotherapy will weaken the body's immune system so that an infection that under normal conditions is not a problem will turn into a serious problem.
- You are taking immunosuppressant drugs or steroids. These medicines will make you more susceptible to serious infections and complications from toxoplasmosis.
Step 3. Ask the doctor to explain the results of the examination
A blood test will show whether you have antibodies to toxoplasmosis. Antibodies are proteins that the body produces to fight infection. This means that the blood test does not check for the presence of the parasite itself, so the results are difficult to conclude.
- A negative result may mean that you are not infected or that you have recently been infected and so the body has not yet produced antibodies. The second guess can be confirmed by repeating the blood test a few weeks later. On the other hand, a negative result indicates that your body does not have the immunity to ward off infection in the future.
- A positive result may mean one of two things. This result may mean that you have recently been infected, or have been infected with the presence of antibodies that indicate immunity. If your blood test results are positive, the US Centers for Disease Control and Prevention recommends further tests to analyze various types of antibodies so that you can determine whether the infection is still ongoing.
Part 2 of 4: Diagnosing and Treating Mother and Baby
Step 1. Discuss the risks to the baby with the doctor
Toxoplasmosis can be passed to your baby during pregnancy even if you don't feel sick. The risks of toxoplasmsis infection for the baby include:
- Miscarriage and death in the womb
- Seizure
- Swelling of the liver and spleen
- Jaundice
- Eye infections and blindness
- Hearing loss that occurs later in life
- Mental disability that occurs later in life.
Step 2. Talk to your doctor about examining the fetus in the womb
There are fetal examinations that the doctor may suggest.
- ultrasound. This examination uses sound waves to produce an image of the fetus in the womb. This test is harmless to neither mother nor baby, and can show signs of infection such as excess fluid around the fetal brain. However, ultrasound examination cannot confirm the possibility of an infection that is asymptomatic at that time.
- Amniocentesis. This procedure involves inserting a needle through the mother's abdominal wall into the sac of fluid that surrounds the baby to extract some of it. Amniotic fluid (amniotic fluid) can be used in the examination of toxoplasmosis. This procedure carries a 1% risk of miscarriage and can confirm toxoplasmosis infection, but does not show signs of fetal harm.
Step 3. Ask your doctor about medications for you
The doctor may recommend the use of various medications, depending on whether the infection has been transmitted to the fetus.
- If the infection has not spread to the fetus, the doctor may recommend the use of the antibiotic spiramycin. This medicine can also sometimes prevent the transmission of infection to the fetus.
- If the fetus is infected, your doctor may recommend that you replace spiramycin with pyrimethamine (Daraprim) and sulfadiazine. These medications will likely only be prescribed after 16 weeks of gestation. Pyrimethamine can inhibit the absorption of folic acid which is important for the development of the baby, as well as suppress the bone marrow and cause problems with the liver. Ask your doctor about the side effects of the drug for you and your baby before using it.
Step 4. Check the baby after birth
If you are infected with toxoplasmosis during pregnancy, your doctor will examine your baby at birth for signs of eye problems or brain damage. However, many children do not show symptoms until they grow up. So, your doctor may recommend a blood test.
- In the US, the Centers for Disease Control and Prevention recommends sending all newborn blood samples to a specialized toxoplasma serology laboratory in California for examination there.
- Your baby may need to be checked regularly for the first year to make sure he is not infected.
Step 5. Follow the doctor's advice in terms of care for the newborn
If your baby was infected with toxoplasmosis at birth, your doctor may recommend regular monitoring and medication. Unfortunately, if the baby has been disturbed by the infection, this problem cannot be reversed. However, the use of drugs can help prevent problems in babies from getting worse.
- Pyrimethamine (Daraprim)
- Sulfadiazine
- Folic acid supplements. This supplement will be given because pyrimethamine will inhibit the absorption of folic acid by the baby.
Part 3 of 4: Diagnosing and Treating People with Weak Immune Systems
Step 1. Discuss treatment options with your doctor
Your doctor will likely recommend different medications according to the condition of your infection (active/dormant). A dormant infection occurs when the parasite is inactive, but can reactivate when your immune system is weak.
- Your doctor may recommend taking pyrimethamine (Daraprim), sulfadiazine, and folic acid supplements to treat an active infection. Another possibility is pyrimethamine (Daraprim) along with the antibiotic clindamycin (Cleocin). Clindamycin may cause diarrhea.
- If the infection in your body is dormant, your doctor may recommend trimethoprim and sulfamethoxazole to prevent the infection from coming back.
Step 2. Recognize the signs of toxoplasmosis
Toxoplasmosis can cause serious eye infections in people with weakened immune systems. This parasite can live dormantly on the retina and cause an active infection several years later. If this happens, you will be given medication to fight the infection, as well as steroids to reduce swelling in the eye. Scar tissue that forms in the eye may be permanent. So, see a doctor immediately if you experience:
- Blurred vision
- Spotted view
- Decreased vision
Step 3. Identify brain toxoplasmosis
This occurs when the parasite causes lesions or cysts in the brain. If you have brain toxoplasmosis, you may be given drugs that can kill the infection and reduce swelling in the brain.
- Toxoplasmosis can cause headaches, confusion, loss of coordination of movements, seizures, fever, and difficulty speaking.
- This disease will be diagnosed by a doctor using an MRI scan. During this examination, a large machine that uses magnetic and radio waves will form an image of the brain. This check is harmless to you, but should be performed lying on a table that goes into a machine. This can be scary if you have claustrophobia. Although rare, in cases that do not respond to treatment, a brain biopsy may be necessary.
Part 4 of 4: Preventing Toxoplasmosis
Step 1. Reduce the risk of consuming infected food
Meat, dairy products, and plants can become infected with toxoplasmosis.
- Avoid consuming raw meat. This includes rare and smoked meats, especially lamb, pork, beef and mutton, as well as sausages. If an animal is infected with toxoplasmosis, the parasite that causes it may still be alive and can be contagious.
- Cook cuts of meat to at least 63 °C, ground beef to at least 72 °C, and poultry to at least 74 °C. Measure the temperature of the meat with a cooking thermometer at the thickest part. After cooking, make sure the meat reaches the temperature as stated above or above for at least 3 minutes.
- Freeze the meat for several days at a temperature below -18°C. This process will reduce, but not eliminate, the risk of infection.
- Wash and/or peel all fruits and vegetables. If you have come into contact with contaminated soil, fruit or vegetables can transmit toxoplasmosis to your body unless they are washed or peeled first.
- Don't drink unpasteurized milk, eat cheese made from pasteurized milk, and don't drink raw water.
- Clean all cooking utensils (such as knives and cutting boards) that come into contact with raw or unwashed food.
Step 2. Avoid contact with infected soil
Toxoplasma parasites can be transferred to the soil from the feces of infected animals. You can reduce transmission by:
- Wear gloves when gardening, and wash your hands thoroughly afterward.
- Cover the litter box to prevent the cat from defecating there.
Step 3. Deal with the risks that pet cats have
The US Centers for Disease Control and Prevention states that you don't need to stop having a cat while you're pregnant. Some things you can do to reduce your risk of toxoplasmosis include:
- Checking the cat to see if it carries toxoplasmosis.
- Keeping cats indoors. A cat will become infected if it comes into contact with the feces of another infected cat or eats game. Keep the cat indoors to reduce both risks.
- Give your cat canned or packaged dry food. Do not give raw or undercooked meat to cats. If the cat's food is infected, the cat will also become infected.
- Do not touch stray cats, especially kittens.
- Avoid keeping a cat with an unclear medical history.
- Do not change the cat litter box during pregnancy. Have someone else do it. If you have to change your cat's litter box, put on disposable gloves, a face mask and wash your hands thoroughly afterwards. Cat litter boxes should be changed daily as parasites generally take one to five days to infect cat feces.
