Toxoplasmosis: A Guide for Patients

Toxoplasmosis is a disease that can severely affect your unborn baby during pregnancy with tragic consequences ranging from stillbirth to physical and neurological defects.

The only way your baby can get toxoplasmosis is from you, if you catch it while you're pregnant. The best way to protect your unborn baby from toxoplasmosis is by taking responsibility for protecting yourself.

What Is Toxoplasmosis?

Toxoplasmosis is spread by a tiny parasite called Toxoplasma gondii that can be found almost everywhere. It can infect many animals; for example, it can be in the meat we eat, the birds and mice cats eat, and it can infect cats themselves.

It can also infect humans. We get the parasite by mouth from eating undercooked meat, from touching our mouth or eyes with our hands if they are contaminated from handling raw meat, from changing litter from a cat that has recently been infected, or from handling vegetables from the garden where soil has been contaminated by a newly infected cat. (Cats often choose gardens as their litter boxes.)

If you get infected during pregnancy, your case will probably be mild — so mild that you may never even realize you have toxoplasmosis. But while you continue to feel fine, your unborn baby could get your infection and have serious problems.

What Are The Effects?

Stillbirth, premature delivery, and physical and neurological damage are some of the devastating effects seen with babies at birth. Sometimes an infected baby appears perfectly normal at birth, only to develop severe disabilities later in life, such as eye disorders, learning disabilities or mental retardation.

First The Good News

Just like German measles (rubella), most people can have an active toxoplasmosis infection just once in their lives. One toxoplasmosis infection before you are pregnant protects your unborn baby during any subsequent pregnancy (unless your immune system has been weakened, for example, by cancer drugs or transplant anti-rejection drugs).

The Bad News

If you've never been infected before, you must take steps throughout your pregnancy to protect your baby. If you don't, and you get the parasite while you're pregnant, there is a risk your unborn baby can acquire the infection from you — with serious consequences — while you continue to feel just fine.

Chances Are, You're At Risk

Only about 10 to 20% of American women of child-bearing age have had toxoplasmosis at some time in their lives. They are immune, so their unborn babies are not at risk.

That leaves nearly nine out of 10 expectant mothers at risk of getting toxoplasmosis during pregnancy. The tragedy is that thousands of infants are born with this preventable disease every year in the United States!

Am I Immune?

There are blood tests that can help your doctor find out if you have ever had toxoplasmosis, or if you are currently infected. Your doctor can tell you about them and have you tested, if appropriate. Until your doctor says otherwise, presume you are susceptible to the disease and take every precaution to avoid infection during your pregnancy.

How Can I Keep From Catching It?

Unless your doctor tells you that you are not at risk, assume that you are, and do all you can to avoid infection throughout your pregnancy. Here are several ways you can keep from getting toxoplasmosis. They make sense if you just keep in mind how toxoplasmosis is spread: through your mouth and eyes.

• Don't eat any meat unless it's cooked well-done. Thorough cooking kills the parasite.
• Keep your hands away from your mouth and eyes when handling uncooked meats and raw fruits and vegetables. And wash your hands as soon as you're finished.
• Ask someone else to handle the cat litter for nine months. If you must do it yourself, wear disposable gloves and wash your hands afterward. Make sure the litter is changed daily and the pan is soaked in water that has just been brought to a boil.
• Be careful working in the garden. A stray cat may be using it for a litter box. Wear gloves when you garden and keep your hands away from your mouth and eyes. Wash garden fruits and vegetables — and your hands — thoroughly when finished.
• Steer clear of children's sand boxes. Cats think of them as great litter boxes!

What If I Get The Infection While I'm Pregnant?

Doctors have several ways to treat the infection during pregnancy either to prevent you from passing it on to your unborn baby or to treat your baby before and after it's born.

If your doctor suspects an active toxoplasmosis infection, testing may be done to help find out if and when during pregnancy you were infected. By knowing when, your doctor can then advise which course of therapy is best for you and your expected child.

Published by permission of Abbott Diagnostics ©1991, reviewed 2011.

Scientific Advisor: Jack S. Remington, M.D., from the Department of Immunology and Infectious Diseases, Research Institute of the Palo Alto Medical Foundation.