Toxoplasmosis

IMPORTANT ADVICE FOR ALL PREGNANT WOMEN

Toxoplasmosis is an infection caused by a parasite. If caught during pregnancy it can seriously affect the health of your unborn baby.

HOW TOXOPLASMOSIS IS CAUGHT

Toxoplasmosis can be caught from:

  • Eating raw or undercooked meat.
  • Unpasteurised goat’s milk and unpasteurised goat’s milk products.
  • Unwashed, uncooked fruit and vegetables.
  • Dirty cat litter.
  • The soil contaminated with cat faeces.

No matter how much you love cats or enjoy certain kinds of food, a little extra care is so important if you’re pregnant.

To protect yourself and your baby from risk of infection, always follow the precautions shown in this leaflet.

THE SIMPLE FACTS ABOUT TOXOPLASMOSIS

Toxoplasmosis is an infection which is not usually dangerous to the healthy adult or child. There is a risk that if a woman catches it during pregnancy her child may become infected.

Should this happen, the baby can develop severe symptoms, including water on the brain (hydrocephalus), brain damage which can cause mental handicap and epilepsy, and eye damage which can cause partial loss of sight or even blindness.

Toxoplasmosis caught during childhood or as an adult is usually relatively harmless and is called acquired toxoplasmosis. When caught by an unborn baby from its mother, it is called congenial toxoplasmosis and this is what is dangerous.

HOW COMMON IS TOXOPLASMOSIS

By the age of 30, 3 out of 10 people will have already had the infection, probably without realising it. Once you have had toxoplasmosis you are immune for life. This means that many women will be immune before they become pregnant and their babies will not be at risk.

The symptoms of toxoplasmosis for healthy adults may be like mild flu, but it is often symptomless. Occasionally a person will suffer from a long debilitating illness like glandular fever, but this is rare.

It is not known how many women catch toxoplasmosis during pregnancy, but research suggests that it is 2 in every 1,000, which means 1,400 each year in the UK. The infection will not pass to the baby in all these cases, and most of those that do will not be severely damaged, but will go on to develop eye trouble later in life. However, 1 in 10 infected children will be born with severe symptoms which include brain damage and blindness.

TESTING FOR TOXOPLASMOSIS

Because of the lack of definite symptoms, it is not easy to diagnose toxoplasmosis. If possible it is worth knowing before you conceive your baby whether or not you have already had toxoplasmosis and are therefore immune.

A blood test can tell you this and you can ask your GP for one before you start your family. If you are already pregnant, you can ask for a test at your antenatal visit. When you request a blood test, make sure you understand what the test could show, and when you get the result ask your doctor or midwife for a full explanation of the result.

There are three possible results of a test for toxoplasmosis:

  • That you have never had the infection and must take the precautions listed.
  • That you have never had the infection and are immune.
  • That you currently have the infection and need to have further tests, expert advice and treatment.

IF YOU HAVE A CURRENT INFECTION IN PREGNANCY

If a test during pregnancy does show a current infection of toxoplasmosis, your GP or obstetrician should refer you to a Toxoplasma Reference Laboratory. Treatment with antibiotics is available which reduces the risk of the infection by 60-70% crossing to the baby.

A blood sample from the baby’s umbilical cord taken any time after 20 weeks gestation can show whether the baby has been infected. This test would only be carried out if you had a current infection, and should be discussed with your obstetrician and midwife. A scan may show whether damage has occurred.

Further antibiotics can treat the baby inside the womb to help prevent more damage. If a baby is shown to be severely damaged, the woman is offered the option of terminating the pregnancy.

HOW TO AVOID CATCHING TOXOPLASMOSIS

Only eat meat which has been cooked thoroughly right through i.e. brown with no trace of blood or pinkness to at least 70oC.
Wash your hands and all cooking utensils and surfaces after preparing raw meat.

Wash fruit and vegetables thoroughly to remove all traces of soil.

Avoid unpasteurised goat’s milk and unpasteurised goat’s milk products.

Wear rubber gloves when handling dirty cat litter. Clear out faeces daily. Ideally rinse out trays with boiling water. Always wash your hands afterwards. If possible get someone else to do the job.

Always wear gloves when gardening. Wash your hands afterwards.

Cover children’s outdoor sandboxes to prevent cats from using them as litter boxes.

Avoid feeding pets near or undercooked meat.

It is important for pregnant farmers to be aware that toxoplasmosis can be caught from sheep at lambing time.

Should you wish to discuss any of these issues in more detail, please consult your veterinary surgeon.