Toxoplasmosis is a parasitic infection that may occur due to contact with cats during pregnancy. It is a widespread disease caused by the Toxoplasma parasite. It usually does not cause any symptoms in non-pregnant women, but it can cause the child to develop some serious diseases such as mental disability or blindness. Mothers ask: Can toxoplasmosis be treated during pregnancy? In this article, we will tell you everything you want to know about toxoplasmosis during pregnancy and how to treat it.

What is toxoplasmosis

Toxoplasmosis, also known as toxoplasmosis, is a parasitic infection caused by the Toxoplasma gondii parasite, a single-celled parasite that is commonly found in cat feces. It can also be found in undercooked contaminated meat, especially venison and lamb.

Toxoplasmosis affects a large percentage of the world's population, but most people infected with it do not suffer from any symptoms. This is because the immune system prevents the parasite from causing disease. However, toxoplasmosis can be life-threatening and very dangerous for people with low immunity, and toxoplasmosis can be fatal or cause serious birth defects in the fetus if the mother becomes actively infected during pregnancy.

How do I know if a cat has toxoplasmosis?

Symptoms in cats include: lethargy, depression, fever, weight loss, tremors, muscle weakness, partial or complete paralysis, vomiting, diarrhea, abdominal pain, jaundice, loss of appetite, and inflammation of the eye structure (retina, iris, and cornea). Since clinical signs are not specific, a complete physical examination and blood test should be performed by a veterinarian.

When do symptoms of toxoplasmosis appear?

Symptoms of toxoplasmosis appear in pregnant women before they give birth, which increases the possibility of transmission of the infection to the fetus, and most children do not suffer from any symptoms at birth, but they may develop later in life, and may lead to serious complications in the brain and eyes.

Toxoplasma under the microscope

There are three infectious stages of Toxoplasma, namely: tachyzoite, bradyzoite and environmental stage.

They are all characterized by their crescent shape, about 5 microns long and 2 microns wide with a pointed apical end and a rounded posterior end.

Tachyzoite

It is the stage responsible for the pathological changes associated with toxoplasmosis, and is characterized by being rapidly dividing.

Bradyzoite

It is the latent stage, and divides slowly in tissue cysts, and does not cause pathological changes in the body of the infected host.

Sporozoite

It is the environmental stage, and is found in the feces of the primary host (cats), protected inside an egg.

Life cycle of Toxoplasma parasite

Before we learn about the disease, it is very important to know the life cycle of the causative parasite, and how to get infected, to avoid infection.

The feline family (cats, lions, tigers, etc.) is the only known definitive host of the parasite, in whose intestines it lives.

Cat feces contain sporozoite oocysts, which typically persist for one to three weeks, but are excreted in large quantities.

The oocysts take 1 to 5 days to mature in the environment and become infective.

The intermediate host (warm-blooded animals, including birds and rodents) becomes infected after ingesting the mature oocysts.

The oocysts develop into tachyzoites shortly after ingestion and spread throughout the body, forming bradyzoites that form tissue cysts in nerve, muscle, and eye tissues.

In the human host, these cysts may persist throughout the host's life and can be reactivated if the host becomes immunocompromised.

Does toxoplasmosis affect children?

However, when toxoplasmosis infects the fetus in the mother's womb, it causes birth defects. Also, if a nursing mother is infected with this disease during breastfeeding, she can transmit the infection to her child through milk. Therefore, prevention of this disease is better than treatment. The best way to get rid of the consequences of this disease is to prevent it.

Does the pregnancy germ cause fetal malformations?

How does the pregnancy germ affect the fetus? The effects on the fetus if infected early include the following: premature birth, low birth weight, fever and jaundice, retinal malformations, mental retardation, abnormal head size, seizures and brain calcification.

When does toxoplasmosis appear?

A blood test tests for the presence of antibodies to the infection, and it takes 3 weeks after infection to appear. The time of infection can also be determined according to the type of antibodies and whether they are stable and high in percentage or not. The results appear within a week.

How do I know if a cat is sick?

Look inside the cat's mouth. Check for changes in the color of the gums in particular. If you notice that the cat's gums, especially cats with black gums, have become very pale, the cat may be sick. You should also smell the cat's breath. If you notice a strange smell that is not caused by food the cat is eating, the cat may have a problem.

How do I know if a cat is sick?

Look inside the cat's mouth. Check for changes in the color of the gums in particular. If you notice that the cat's gums, especially cats with black gums, have become very pale, the cat may be sick. You should also smell the cat's breath. If you notice a strange smell that is not caused by food the cat is eating, the cat may have a problem.

Preventing toxoplasmosis that affects pregnant women

When the pregnant woman cleans the cat's house, this parasite infects the pregnant woman. It is known that this parasite is found in the cat's intestines and then the parasite is in the feces coming out of it.

It is also preferable to wash hands well with soap and water after touching the cat. This parasite may be present on its body from the outside but cannot be seen with the naked eye.

Does toxoplasmosis lead to miscarriage?

Toxoplasmosis is a disease of the cat

It appears as a result of the Toxoplasma gondii parasite, which is found in cat feces and is transmitted to people as a result of water or food contamination. It usually does not cause severe symptoms, but it poses a clear risk to people with low immunity or some pregnant women who are at risk of fetal malformations in the event of infection with toxoplasmosis.

Harmful effects of cats on pregnant women

- For non-pregnant women and normal people, they may not show any symptoms of this disease except for what resembles influenza.

- Toxoplasmosis causes the pregnant woman to develop mental illnesses or blindness in the child.

- The risk increases according to the age of pregnancy at the time of infection, especially during the last third.

- The pregnant mother can transmit the infection to the fetus through the placenta, and the chances of transmission of the infection are less in the first months of pregnancy than in the last months.

- If the infection is transmitted to the fetus, symptoms usually do not appear at birth, but over time, children suffer from difficulties in learning, vision and hearing.

-There are several ways to ensure that the infection is not transmitted to the fetus by examining the amniotic fluid. Ultrasound can detect infection in approximately one-third of fetuses. A blood test can also be performed on the newborn immediately after birth.

- Toxoplasmosis can be treated during pregnancy by taking antibiotics. The earlier the infection is detected, the greater the chance of treatment and preventing its transmission to the fetus.

- If the infection is transmitted to the child, treatment can alleviate the severity of the disease with continued treatment during the child's first year or for a longer period.

Causes of toxoplasmosis

Transmission of infection through food

People get toxoplasmosis by swallowing the parasite. The most common way to get toxoplasmosis is by eating contaminated raw meat or by eating contaminated fruits and vegetables without washing them. The infection can also be transmitted through contaminated water.

Transmission of the disease from animals to humans

Cats carrying the Toxoplasma gondii parasite play an important role in the spread of toxoplasmosis. Cats can shed millions of eggs in their feces for up to 3 weeks after being infected with the parasite. It can contaminate the soil or water in the environment in which they live.

Transmission from person to person

Toxoplasmosis is not transmitted from person to person, except in cases of transmission from an infected pregnant mother to the fetus. For this reason, pregnant women are advised to avoid contact with cat droppings during pregnancy or after birth.

Rare cases

Toxoplasmosis can be transmitted through blood transfusion from an infected person or through organ transplantation from a donor infected with toxoplasmosis. Laboratory specialists who handle infected blood may also be exposed to infection through an unintended error.

Diagnosis of toxoplasmosis in pregnant women

There are some medical methods that doctors use to diagnose a pregnant woman with toxoplasmosis, including the following:

1- Blood test

A blood test is used to detect antibodies against the parasite after three weeks because this is the sufficient period the body needs to produce antibodies against the parasite.

2- Amniotic fluid analysis

The doctor performs this examination if there is any evidence that the pregnant mother has toxoplasmosis. A needle is inserted into the fluid surrounding the fetus and the sample is examined in the laboratory, but this is one of the examinations that increases the mother's risk of miscarriage.

Cat damage at home

- Fungal diseases (Ringworm) It is estimated that about 40% of cats carry this disease and it can be transmitted from them to humans. It is the most common disease that can be transmitted from cats to humans. It appears on human skin in the form of red rings or gray spots that cause itching and gradually expand.

- Conjunctivitis, which is in the form of redness in the eye with purulent secretions. It is easy to treat in cats and humans with drops and ointments. Prevention is to wash hands well after touching the cat when it is infected with the disease, and not to allow the cat to move around the house and climb on people's beds and places where they sit while it is infected with the disease.

- Sore throat and tonsils: Some cats carry the Streptococcus bacteria that cause these infections, and treatment is with antibiotics, and prevention is by not allowing the cat to put its mouth in human food or drink.

- Intestinal infections: Some cats carry Salmonella and Campylobacter bacteria that may be transmitted to humans, causing diarrhea and vomiting, and prevention is by wearing gloves when cleaning the cat and washing hands well after playing with it, and keeping the cat away from food preparation areas.

- Cat bites: More than 75% of cats carry the Pasteurella bacteria in their mouths, which may cause a type of fever, and some cats also carry staphylococcus bacteria, as well as tetanus, which can be transmitted through a cat bite, in addition to rabies, of course, so it is recommended to seek urgent medical help as soon as possible after the bite occurs, especially if the cat is from outside the home, or if the cat is domestic and the bite is deep and severe, in order to deal with the wound and prevent possible consequences.

- Cat scratch disease is a disease that is carried by small cats more than large cats, and the bacteria that causes it is called Bartonella, and this bacteria reaches the cat through the fleas that infect cats, and when the cat carries the microbe and then scratches a human, the infection is transmitted to the human, and the symptoms of the disease in humans are swollen lymph nodes and sometimes fever.

- Helicobacter pylori bacteria are the bacteria that cause stomach and duodenal ulcers in humans, and it was proven in the early nineties that it can be transmitted from cats to humans, and the disease is transmitted through food contamination with cat droppings, so prevention is to keep cats away from food preparation areas and not to put them on kitchen tables or dining tables, as well as washing hands well before preparing or eating food, especially after touching cats.

- Toxoplasma is a single-celled organism that infects cats by eating undercooked meat 

Or eating infected prey meat, or being exposed to places where other infected cats defecate, such as gardens or sand. The infected cat continues to release eggs with its feces for two or three weeks after infection and then becomes non-infectious and acquires immunity that may remain with it for life or at least for a very long time, so it does not become infected or infect anyone during this period. The eggs released by the cat are the ones that may infect humans or other cats, and they are able to remain alive on the ground for a long period that may reach a year or more, especially if they are in damp, shaded places. It has been proven that an infected cat releases about ten million eggs with its feces daily. - Viruses, including rabies, which is a fatal disease in most cases for anyone infected with it, whether human or animal, and survival from it is very rare. The animal becomes infected with the disease as a result of being bitten or scratched by another infected animal, and the human becomes infected when he is also bitten or scratched by the infected animal or when human wounds are contaminated with the saliva of the animal infected with the disease. After the infection is transmitted, the virus reaches the nervous system and affects it severely, causing severe convulsions, personality change, and many other symptoms.

Analysis of toxoplasmosis for pregnant women:

In the event of infection with toxoplasmosis before pregnancy: If it occurs two weeks before pregnancy, the risk of transmission to the fetus decreases, but there is a possibility that the risk of miscarriage increases if the child is infected.

In the event of infection with toxoplasmosis during the first trimester of pregnancy: The rate of infection of the fetus during this period is 15%, but it is more susceptible to miscarriage or birth with severe symptoms or accumulation of water in the brain.

In the event of infection with toxoplasmosis during the second trimester of pregnancy: The rate of infection of the fetus during this period is 25%, during this stage it is less susceptible to miscarriage, but it is still at risk of developing symptoms of the first trimester of pregnancy.

In the event of infection with toxoplasmosis during the last trimester of pregnancy: The symptoms are less, because the children are in good health, but in the event of infection in the last months of pregnancy, the symptoms appear in the fetus after birth, including blindness or eye damage.

2. What are the cases that require treatment for toxoplasmosis?

People with toxoplasmosis are not given any treatment except in certain cases, the most prominent of which are:

If toxoplasmosis causes severe symptoms for the patient, or if the symptoms persist for a long time.

If the parasites that cause toxoplasmosis are detected in their active phase in the body, especially in the following areas: eyes and skin.

If the patient is a pregnant woman, or if the child is born with toxoplasmosis.

If the patient has a weak immune system, and these are some factors that may weaken immunity: AIDS, cancer, and organ transplantation.

Symptoms of toxoplasmosis in pregnant women

Toxoplasmosis is transmitted to pregnant women when the cat carries a parasite. When cats eat raw meat or food that has not been cleaned well, the parasite is then transmitted through cat feces to the pregnant woman who cares for and looks after the cat.

If the pregnant woman has strong immunity, she will feel mild symptoms as a result of toxoplasmosis.

If a woman is infected with toxoplasmosis about 6-9 months before pregnancy, her body will most likely have acquired immunity to the disease and it will not cause any symptoms for her or complications for the fetus.

The pregnant woman will show several symptoms, including painless swelling of the lymph nodes around the neck.

Some other mild symptoms will generally appear that resemble flu symptoms, such as muscle aches, fatigue, headache, and fever.

The pregnant woman may suffer from a sore throat.

She may develop a rash.

A pregnant woman can be diagnosed with toxoplasmosis by blood testing to measure antibody levels.

An ultrasound of the pregnant woman may also show some abnormalities in the fetus.

If the infection with toxoplasmosis occurs before the pregnancy reaches 16 weeks, the pregnant woman may be given an appropriate antibiotic to reduce its symptoms on the fetus.

If the infection is transmitted to the fetus and this is shown by ultrasound, then the pregnant woman may be given the usual medications for toxoplasmosis that are prescribed for normal people.

Risks of toxoplasmosis on the fetus

If the pregnant woman is infected with toxoplasmosis in the first trimester of pregnancy, the risk of the fetus being infected is approximately 15 percent.

If the pregnant woman is infected with toxoplasmosis in the second trimester of pregnancy, the fetus's exposure to infection is approximately 30 percent.

The infection rate is approximately 60 percent if the pregnant woman is exposed to infection in the third trimester of pregnancy.

After birth, the fetus shows some symptoms that indicate infection with toxoplasmosis, which are eye inflammation, as well as enlargement of the liver and spleen, jaundice, and recurrent pneumonia.

After birth, the newborn is given a combination of medications for a year if it is proven that he is infected with toxoplasmosis.

How should a pregnant woman behave when there is a cat in the house?

Mouth and eye contact should not be touched

Doctors recommend getting rid of cats completely if planning to get pregnant several months in advance.

If the wife and children insist on having a cat in the house and pregnancy occurs, several preventive measures must be taken for the safety of the fetus, especially in the first three months.

The pregnant woman must stop caring for the cat and change its litter completely.

Do not play with the cat.

Place the cat away from food, drink and bedrooms.

Clean hands after touching the cat.

Do not touch the mouth and eyes before washing them if the cat is in the house.

Cook meat well before serving it to the family and the cat.

Do not serve uncooked meat to the cat.

Clean meat cutting tools with hot water.

Wear gloves when caring for garden sand in case it is contaminated with cat droppings.

Diagnosis of toxoplasmosis in pregnant women

In addition to analyzing toxoplasmosis in pregnant women, the infection can be diagnosed during pregnancy using the following methods:

Ultrasound

Used to monitor fetal growth and identify signs of congenital infection, such as: hydrocephalus

S and ventricular enlargement and intracranial calcifications.

Amniocentesis

PCR analysis of amniotic fluid is used to genetically detect the presence of the parasite.

Toxoplasmosis rate analysis in newborns

It depends on the analysis of the IgM antibody ratio in the child's blood, as its presence indicates the child's recent infection, as it is not transmitted from the mother to the infected child through the placenta.

Treatment of toxoplasmosis after miscarriage

The infected person does not need treatment, except for children under 5 years of age.

Toxoplasma medications work primarily against the active stage (Tachyzoite) only, and include:

Pyrimethamine

It is an antimalarial, and the most effective drug against Toxoplasma.

Leucovorin

It is used in conjunction with pyrimethamine to prevent bone marrow suppression.

Careful attention to the dosage regimen is essential, as it varies depending on patient variables, such as immune status and pregnancy.

Pyrimethamine can be used with sulfonamides, quinine, other antimalarials, and other antibiotics.

What is the treatment for toxoplasmosis in pregnant women?

Toxoplasmosis in pregnant women is treated based on the condition of the child and the mother, as treatment is done as follows:

In the absence of infection in the fetus, the antibiotic spiramycin is treated until the end of pregnancy to protect the child from infection.

However, in the event of infection in the child, sulfadiazine and pyrimethamine are used until the end of pregnancy.

If the pregnant mother owns a cat, she must adhere to some instructions to reduce the risk of infection with toxoplasmosis, including wearing gloves and masks when disposing of cat waste, periodically sterilizing the cat box with boiling water, keeping the cat indoors and not mixing with street animals or letting it out of the house.

Does toxoplasmosis lead to miscarriage?

One of the most common questions about the relationship between toxoplasmosis and pregnant women, but if the pregnant mother is infected with toxoplasmosis after the third month, the chance of infection in the fetus increases, but it does not clearly reach the death of the fetus, as it only causes some birth defects in 10% of infected children.

People most at risk of toxoplasmosis

Include the following:

Infants whose mothers were recently infected with toxoplasmosis during or immediately before pregnancy.

People with severely weakened immune systems, such as:

AIDS patients.

Patients receiving immunosuppressive drugs.

People who have recently undergone an organ transplant.

People receiving chemotherapy.

What are the cases that require treatment for toxoplasmosis?

People infected with toxoplasmosis are not given any treatment except in certain cases, the most important of which are:

If toxoplasmosis causes severe symptoms for the patient, or if the symptoms persist for a long time.

If the parasites that cause toxoplasmosis are detected in their active phase in the body, in: the eyes and skin.

If the patient is a pregnant woman, or if the child is born with toxoplasmosis.

If the patient has a weak immune system, due to: AIDS, cancer, and organ transplantation.

How does the treatment of toxoplasmosis differ from one case to another?

In case of infection before pregnancy: If infection with toxoplasmosis occurs a few weeks before pregnancy, the risk of transmission to the fetus may decrease, but the risk of miscarriage may increase if the child becomes infected.

In case of infection during the first trimester of pregnancy: The rate of infection of the fetus during the first trimester of pregnancy is about 10-15%. During this stage, the fetus suffers from the risk of miscarriage or birth with severe symptoms of hydrocephalus (accumulation of water in the brain), brain calcifications, or retinitis.

In case of infection in the second trimester of pregnancy: The rate of infection of the fetus during the second trimester of pregnancy is about 25%. The child infected at this stage is less likely to miscarry, but is still at risk of developing severe symptoms similar to the first trimester.

In case of infection in the third trimester of pregnancy: The rate of infection of the fetus during the last trimester of pregnancy increases from 70 to 80%, but the symptoms are less severe, as most children infected during that period are healthy at birth, but a large percentage of symptoms appear later, usually causing eye damage or blindness.

Treatment of toxoplasmosis for healthy people who have symptoms

If the infected person is healthy and has strong immunity but some symptoms of toxoplasmosis begin to appear, especially if these symptoms are severe, then the doctor may prescribe pyrimethamine and folic acid in addition to sulfadiazine.

Treatment of toxoplasmosis for people with weak immunity

If the person has weak immunity, the doctor may prescribe pyrimethamine in addition to one of the following medications:

Sulfadiazine.

Folinic acid.

Clindamycin.

People with weakened immunity may need to follow the treatment plan until symptoms improve, but if the cause of the weakened immunity is AIDS, for example, the patient may need to continue the treatment plan for an extended period, in what is called chronic maintenance therapy.

Treatment of toxoplasmosis for pregnant women and infants

For pregnant women, these are the options:

If the infection occurred before 16 weeks of pregnancy, the pregnant woman may be given the drug Spiramycin, an antibiotic that may reduce the chances of transmitting the infection to the fetus.

If the infection occurred after 16 weeks of pregnancy or if the infection was transmitted to the fetus, then the pregnant woman may be given traditional medications for toxoplasmosis to treat the mother and the fetus, such as pyrimethamine.

If the baby is born with toxoplasmosis, then he or she may be given a combination of medications, such as pyrimethamine, sulfadiazine, and folinic acid, for a full year, and steroids may be added to 

Treatment program in some cases.

Treatment of toxoplasmosis affecting the eye

If toxoplasmosis causes eye problems, then in addition to the toxoplasmosis medications mentioned above, the doctor may prescribe corticosteroids.