Congenital toxoplasmosis

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How common is toxoplasmosis and congenital toxoplasmosis?

About 1.1 million people per year are infected with toxoplasmosis in the United States. It is estimated that there are about 400 to 4,000 babies born with congenital toxoplasmosis every year in the United States. Surveys have shown that about 15% of women of child-bearing age are infected with the parasite that causes toxoplasmosis.

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Is toxoplasmosis dangerous to the mother, too?

If I was infected with toxoplasmosis before getting pregnant, is my baby in danger of getting congenital toxoplasmosis?

When is infection with toxoplasmosis most dangerous to a pregnancy?

If I catch toxoplasmosis when I am pregnant, what are the chances that the baby will catch congenital toxoplasmosis?

Other than eating raw/undercooked meat and coming in contact with infected cat feces, can anything else raise the chance of a baby catching congenital toxoplasmosis?

Are all cats infected with the parasite that causes toxoplasmosis?

Is it dangerous to pet a cat when I am pregnant?

Should I give my cat away while I am pregnant?

Is termination of the pregnancy, or abortion, an option if my baby has congenital toxoplasmosis?

How can I prevent getting toxoplasmosis from the food I eat?

Are certain groups of people at a higher risk of getting toxoplasmosis?

Can toxoplasmosis infection cause a miscarriage?

Is toxoplasmosis dangerous to the mother, too?

Most adults exposed to the parasite that causes toxoplasmosis will not have any symptoms. If they do, they are generally mild, like a fever, feeling tired and unwell, and swollen/sore lymph nodes. Toxoplasmosis is mainly dangerous to an unborn baby because it can interrupt normal development.

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If I was infected with toxoplasmosis before getting pregnant, is my baby in danger of getting congenital toxoplasmosis?

If a woman is infected with the parasite that causes toxoplasmosis before she is pregnant, it rarely infects her fetus. Once a woman has had toxoplasmosis, she is generally immune from a second infection. However, after becoming infected, the parasite can become "dormant", which is like going to sleep, inside the woman's body. It can stay dormant inside her body for a long time. If a woman gets pregnant and has dormant toxoplasmosis, there is a chance that the parasites could "wake up" during her pregnancy and infect the baby. The chances of the parasite "waking up" are much higher if the woman's immune system does not work as well as it should. This can happen if the woman has HIV, is being treated for cancer, has had an organ transplant, or other diseases that affect the immune system.

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When is infection with toxoplasmosis most dangerous to a pregnancy?

Congenital toxoplasmosis is most dangerous to the baby in the first trimester of pregnancy. This is because the baby still has to go through a lot of development before they are born, so there is more of a chance that the parasite will cause problems with development. Later in pregnancy, like in the third trimester, the baby is mostly developed and is just growing bigger. Getting toxoplasmosis at this point can still cause symptoms after birth, but they are likely to be less severe.

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If I catch toxoplasmosis when I am pregnant, what are the chances that the baby will catch congenital toxoplasmosis?

The good news is that not all women who get infected with the parasite that causes toxoplasmosis will pass it on to their baby. Overall, if a mother is infected during pregnancy, there is about a 30% chance that the baby will be infected. The risk is lowest in early pregnancy (10-25%) but the effects to the baby are usually more severe. In later pregnancy (third trimester), there is a higher risk of infection in the baby (60-90%), but the effects on the baby are usually milder.

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Other than eating raw/undercooked meat and coming in contact with infected cat feces, can anything else raise the chance of a baby catching congenital toxoplasmosis?

Eating raw/undercooked meat and coming in contact with infected cat feces are the main ways a woman would become infected with the parasite that causes toxoplasmosis. However, after becoming infected, the parasite can become "dormant", which is like going to sleep, inside the woman's body. It can stay dormant inside her body for a long time. If a woman gets pregnant and has dormant toxoplasmosis, there is a chance that the parasites could "wake up" during her pregnancy and infect the baby. The chances of the parasite "waking up" are much higher if the woman's immune system does not work as well as it should. This can happen if the woman has HIV, is being treated for cancer, has had an organ transplant, or other diseases that affect the immune system.

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Are all cats infected with the parasite that causes toxoplasmosis?

Not all cats are infected with the parasite that causes toxoplasmosis. Cats that are not fed raw meat and do not hunt (like indoor cats) are very unlikely to be infected with the parasite.

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Is it dangerous to pet a cat when I am pregnant?

Petting a cat while pregnant does not put you at risk of catching toxoplasmosis. Studies have shown that cats infected with the parasite that causes toxoplasmosis do not have any of the parasite in their fur. The parasite is only found in the cat's feces (poop). Therefore, the risk of catching toxoplasmosis from touching a cat is very small, and maybe even nonexistent.

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Should I give my cat away while I am pregnant?

It is not necessary for you to give your cat away while you are pregnant, as long as you take the necessary steps to prevent contacting its feces (poop). You should have someone else clean the cat's litter box while you are pregnant. If no one else is available, wear gloves when cleaning the litter box and wash your hands thoroughly afterwards. Only feed your cat canned or dried food, or well-cooked table food. Do not feed your cat raw or undercooked meat.

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Is termination of the pregnancy, or abortion, an option if my baby has congenital toxoplasmosis?

If congenital toxoplasmosis in the baby has been confirmed in the baby through an amniocentesis, some families will consider termination. This is very personal choice and it is important to make an informed decision by talking with your doctors and possibly a genetic counselor.

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How can I prevent getting toxoplasmosis from the food I eat?

There are many steps you can take to lower the chance of becoming infected with toxoplasmosis from the food you eat, including:

  • Cook meat to a safe temperature (71.1ºC or 160ºF) before eating. Use a meat thermometer to make sure meat is fully cooked.
  • Thoroughly wash fruits and vegetables before eating.
  • Wash cutting boards, dishes, counters, utensils, and hands thoroughly with hot, soapy water after they have touched uncooked meat, poultry, seafood, and unwashed fruits/vegetables
  • When travelling outside of the United States, Canada, or Europe, avoid eating undercooked meat and unwashed vegetables, and avoid drinking untreated water
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Are certain groups of people at a higher risk of getting toxoplasmosis?

Population-based studies have shown that certain groups of people are at a higher risk for toxoplasmosis infection. Black and Hispanic people are more frequently infected than Caucasian people. Also, people who are born outside of the United States, Canada, or Europe are at a higher risk. People with low educational levels or who have low income are also at a higher risk. Finally, people who have jobs that require working in the dirt have a higher risk of infection.

The environment plays a critical role in the life cycle of the parasite that causes toxoplasmosis, T. gondii, and warm, humid climates are ideal for continuing the life cycle of the parasite. In parts of Central America, testing positive for toxoplasmosis starts around one year of age, when children begin playing in contaminated soil, and it reaches 50 to 75 percent by adolescence.

References
  • Berger F, Goulet V, Le Strat Y, Desenclos JC. Toxoplasmosis among pregnant women in France: risk factors and change of prevalence between 1995 and 2003. Rev Epidemiol Sante Publique 2009; 57:241.
  • Jones, J.L., Parise, M.E. and Fiore, A. E. (2014) Neglected parasitic infections in the United States: Toxoplasmosis. Am J Trop Med Hyg 90(5): 794-799. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4015566/
Can toxoplasmosis infection cause a miscarriage?

Toxoplasmosis infection during pregnancy can cause a miscarriage in some cases.

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