Toxoplasmosis during pregnancy

What is toxoplasmosis?

Toxoplasmosis is a parasitic disease of birds, animals and humans.

For most people, the disease does not cause serious health problems. But for a pregnant woman and her developing baby, toxoplasmosis during pregnancy can lead to impaired brain function and vision loss. Still, the risk of a pregnant woman contracting the infection and passing it on to her fetus is low.

If you are already pregnant or planning to become a mother and are worried about toxoplasmosis, consult a doctor and undergo the necessary testing. If you have previously been treated for toxoplasmosis, the chances of recurrence of the disease and its transmission to the child are reduced to zero, since your body has developed antibodies.

But otherwise, you need to take safety measures during pregnancy: do not touch potentially infected foods and objects, such as meat or pet feces.

Causes of toxoplasmosis

Toxoplasmosis is caused by a pathogen - a parasitic organism. The infection is transmitted during:

• consumption of infected meat that is half-raw and frozen;
• cleaning up animal excrement (cat);
• work on a site where the soil contains contaminated animal excrement (cat);
• eating anything that has come into contact with cat feces, including unwashed fruits and vegetables, as well as food that has been on surfaces where pets (cats) have walked.

Symptoms of toxoplasmosis

Toxoplasmosis causes flu-like symptoms. But in most cases, people may not even know about it. In a healthy body with a strong immune system, the disease goes away on its own. In newborns, the body is not yet fighting the infection, so the doctor prescribes medications to prevent complications.

Diagnosis of toxoplasmosis

A blood test will show whether toxoplasmosis is present or whether the infection has occurred in the past. If a woman becomes infected during pregnancy, the baby should also be tested. The doctor will take amniotic fluid and test it for infection.

Infection

If toxoplasmosis occurs during pregnancy, your doctor will prescribe antibiotics that:

• protect the child from infection;
• will reduce the child's chances of developing serious complications.

If a woman undergoes treatment during pregnancy, the child's health will not be affected. If the child has toxoplasmosis, he will have to take antibiotics for a year.

Prevention of toxoplasmosis during pregnancy

• If you have pets (a cat) at home, ask your relatives to clean up after it during pregnancy. Wipe down the tables and work surfaces in the kitchen, as cats can easily get there. If you still need to change the cat's excrement box, put on gloves and a mask, and be sure to wash your hands with soap afterwards.
• Eat well-done meat and avoid beef jerky.
• Avoid contact with pet feces in the garden. If you must touch the soil, wear gloves and wash your hands with soap afterwards.
• Fruits and vegetables should be washed thoroughly before consumption.
• Pre-wash your hands and any utensils used to prepare meat, chicken, fish, fruits or vegetables.

Toxoplasmosis During Pregnancy - Causes

Toxoplasmosis is a widespread parasitic disease of humans and animals caused by protozoa. Cats are the only carriers of this pathogen. If a cat is infected, its feces contain toxoplasma eggs for two weeks. They can survive in damp soil for a year and a half. When in soil and sand, they contaminate food and water. Cats that are constantly in the house and do not catch mice are considered safe.

Infection through the mouth

Infection occurs through cat feces, contaminated water and food.

Other routes of infection:

• Toxoplasma eggs enter the human intestinal tract after they come into contact with food or other surfaces that the cat has touched. Eating contaminated food, such as unwashed vegetables, or not maintaining proper hygiene before eating often leads to infection.
• Eating infected animal meat. Undercooked or raw animal meat may contain toxoplasma eggs.

Fetal infection

If toxoplasmosis manifests itself during pregnancy or 8 weeks before conception, there is a possibility of its transmission to the fetus. In case of acquired immunity before conception, re-infection or transmission of the disease to the fetus is impossible.

Toxoplasmosis during pregnancy - symptoms

With a healthy immune system

Most people do not become ill the first time they are infected with toxoplasmosis. Some may have mild flu-like symptoms that last for several months. That's why people don't know they have the disease right away.

Symptoms:

• Swollen tonsils
• Muscle pain
• Fatigue
• Temperature increase
• Sore throat
• Skin rash

Symptoms of toxoplasmosis in a newborn

Most newborns show no symptoms. But if left untreated, complications can develop - vision problems and brain damage. Sometimes blindness develops after 20 years.

Some infected infants have severe illness, including:

• eye pain, blurred vision, or blindness;
• destruction of the brain that leads to mental retardation and sometimes seizures.

With a weak immune system

People with a weakened immune system (HIV, after organ transplantation or lymphoma) can develop a fatal form of the disease (toxoplasmosis). Therefore, a course of antibiotics is prescribed to prevent it. Severe forms of the disease require intensive care. In very rare cases, the disease affects organs such as the brain, eyes, lungs and heart.

Toxoplasmosis during pregnancy - clinical picture

Reinfection is impossible because the body produces antibodies and fights the infection. The probability of transmitting the disease to the child in this case is zero. But with a weakened immune system (HIV or chemotherapy treatment), re-infection and transmission to the fetus are possible.

Infection before and during pregnancy

The fetus cannot resist the infection. The parasite enters the fetus's body two months after the mother is infected. If this occurs in the first half of pregnancy, serious complications may develop - the brain and eyes are affected. If the infection occurs in the second half of pregnancy, the harm may be less.

If infected children are not treated with antibiotics after birth, they may develop serious complications in the first 20 years of life, often leading to mental retardation, visual impairment, and sometimes even blindness.

Toxoplasmosis during pregnancy - risk factors

The risk of infection with toxoplasma parasites is significantly reduced by observing hygiene rules, but increases in the case of:

• Eating bloody meat or foods that have come into contact with raw meat. Any meat is potentially dangerous.
• Consumption of contaminated fruits, vegetables or water;
• Failure to observe hygiene before eating (unwashed hands after using the toilet or touching raw meat).
• Cleaning up pet (cat) feces without washing your hands afterwards or inhaling contaminated dust.
• Gardening without gloves and without proper hygiene: parasites can survive in soil and sand for 18 months.

Risk of infection of the fetus

The longer the pregnancy when infected with toxoplasmosis, the higher the risk of transmitting the disease to the fetus. But the earlier it occurs, the higher the risk of developing serious complications after birth. Any child with toxoplasmosis should be treated with antibiotics.

Toxoplasmosis During Pregnancy - When to Seek Medical Help

During your first visit to the doctor, discuss your risk factors for toxoplasmosis and decide whether to get tested for it. Call your doctor right away if you have swollen tonsils, fever, sore throat, or flu-like symptoms.

Observation

Sometimes a woman is under the supervision of a doctor. Screening for toxoplasmosis is done if there is a risk of infection of the fetus. In some countries with a high number of cases, experts recommend early testing and treatment to avoid complications later. If you are pregnant or planning to have a baby, think about possible risk factors and discuss with your doctor when it is best to get tested.

Who to contact

If toxoplasmosis is suspected, tests should be taken. If toxoplasmosis is detected during pregnancy, the attending physician will prescribe a course of treatment. If a newborn is infected during pregnancy, a neonatologist or infectious disease specialist will treat the newborn.

Toxoplasmosis During Pregnancy - Diagnosis and Testing

Fetal infection with toxoplasmosis is very rare. Between 1 and 10 babies out of 10,000 are infected with toxoplasmosis before birth. That is why screening for the disease is not an essential part of the pregnancy care program. Testing for toxoplasmosis during pregnancy or before conception is necessary if:

• You are concerned about possible infection.
• You think you can't avoid getting infected.

In countries where toxoplasmosis is rare, screening for the infection is limited to newborns. In countries where the disease is more common, all pregnant women are screened for toxoplasmosis.

A blood test is performed to detect antibodies that resist infection. Their presence in the blood indicates that you have previously been infected and your immune system is now producing antibodies that will further protect the future child from toxoplasmosis. In some cases, to be absolutely sure, the blood test is performed several times.

Toxoplasmosis testing

• A blood test for toxoplasmosis is performed to detect antibodies to toxoplasma. If the results or symptoms indicate infection, a repeat test is performed to confirm the diagnosis.
• Amniocentesis is the collection of amniotic fluid for analysis. The polymerase chain reaction (PCR) blot hybridization test is used to detect toxoplasma DNA (in the fetus).
• Ultrasound is aimed at identifying signs of organ damage in the fetus.

Early diagnosis of the disease

Birth defects mostly develop when the fetus is infected between 10 and 24 weeks of pregnancy. That is why early detection of toxoplasmosis in the fetus is important in preventing serious complications. (If infection occurs late in pregnancy, severe complications are unlikely, but treatment is essential to prevent future problems.)

Toxoplasmosis During Pregnancy - Treatment Overview

If you are pregnant and have a strong immune system, you will not need to treat toxoplasmosis, as symptoms usually go away on their own. However, if you become infected during pregnancy, you will need to undergo treatment to protect your developing baby. The fetus's immune system is not yet able to fight off toxoplasmosis, so antibiotics are given to kill the parasitic organisms. Newborns who are treated in the womb appear healthier after birth.

Children who have not been diagnosed and treated before birth are at risk of developing brain and vision diseases while still in the womb or in the first two years of life.

Ultrasound sometimes reveals severe fetal damage from toxoplasmosis early in pregnancy. In such cases, parents may decide to terminate the pregnancy.

Toxoplasmosis during pregnancy - prevention

If you are not pregnant and have a strong immune system, you do not need to prevent toxoplasmosis, as the disease may be mild or cause no symptoms at all.

Reinfection is impossible because the body has learned to resist the infection, and the mother's immune system also protects the fetus. A blood test is performed to determine antibodies to this disease.

During pregnancy and before conception:

• If you are not sure that your immune system can fight the infection, avoid contact with the disease provocateurs to protect your future child from infection.
• Try to avoid touching cat excrement, both in the house and in the garden.
• If you have a cat in your home and you are pregnant or planning to become a mother, ask a relative to clean up its excrement. If this is not possible, clean it daily, since toxoplasma eggs become dangerous within 1-5 days.
• Wear gloves and a mask and wash your hands thoroughly with soap.
• Regularly clean the table and work surfaces in the kitchen where the cat might have been.
• Consider keeping a cat indoors. Outdoor cats can become infected with the parasitic organism Toxoplasma gondii by eating infected birds or rodents. (But you also shouldn't let your cat catch pets, as they can also be infected.)
• When working in the garden, wear gloves and wash your hands thoroughly with soap afterwards.
• Rinse all foods that could potentially come into contact with your cat's feces, including fruits and vegetables.
• Eat only thoroughly cooked (not rare) meat. Avoid dried meat. The parasitic organism Toxoplasma gondii is killed by high temperatures.
• Wash your hands and kitchen utensils well after handling raw meat, poultry, seafood, fruits and vegetables.
• Avoid drinking untreated water when outdoors or while traveling.

Toxoplasmosis During Pregnancy - Medications

Medicines for the treatment of toxoplasmosis are necessary only in cases where the developing child (fetus) may be infected or the person has a weak immune system. Even if the pregnant woman is healthy and has a strong immune system, a course of treatment is recommended for the safety of the fetus.

If the disease is diagnosed during pregnancy, antibiotics are prescribed.

• Antibiotic treatment reduces the risk of fetal infection.
• If the fetus is infected (diagnosed by amniocentesis), the doctor may prescribe a different antibiotic or add another one.

If a newborn is diagnosed with toxoplasmosis, the child should undergo treatment in the first year of life, which will reduce the risk of brain damage and vision problems (including blindness).

Choosing a medicine

If a pregnant woman takes antibiotics, this does not mean that they will have the same effect on the fetus' infection.