Toxoplasmosis; It is an infection of the parasite called “toxoplasma gondii“. Contagion takes place by oral contraption of uncooked raw meat, feces of the cat, and any contaminant that has come into contact with the cat feces. There is no direct interest in this disease with dogs. If the pregnant person gets the infection by these means, the infection can also pass to the baby through the placenta.
The cat is the main host and carrier of this parasite.
In cat stomach, parasitic forms called sporozoites multiply by dividing and they are thrown out with feces in oocysts. These oocysts are quite resistant to external environment. They can contaminate everything on the outside and then pass to the person by mouth. Contagion is caused by oral ingestion of oocysts on tissue cysts or parasitic on uncooked raw meat, or oocysts on unwashed fruits and vegetables. Oocysts in the soil or in the feces of the cat can also be parasitized by oral contaminants.
After 5 to 18 days of incubation this infection is often unnoticed without treatment and does not require treatment. It can cause problems in people with a disease that break the immune system, such as AIDS, or baby during pregnancy. In fact, almost half of the people are infected with toxoplasma at any time of their life, but most people do not give any symptoms.
What are the toxoplasma symptoms?
It usually heals spontaneously with mild symptoms such as flu-like fever, fatigue, weakness, muscle and joint aches.
On average, 1-2 out of every 1000 pregnancies are infected with acute toxoplasmosis during pregnancy. Toxoplasma infection in pregnancy is often unrecognizable as it is in other people and does not cause complaints to the mother.
How can toxoplasma damage the baby?
Infection can be affect the baby %15 in the first 3 months. Transition rate to baby is 30% in the second trimester and 60% in the third trimester. However, infection in the first trimester infects more serious problems on baby. Infection in the following months will cause fewer problems.
Infection before pregnancy does not a risk for pregnancy.
Infection in the baby can cause problems such as miscarriage, death in the womb, brain damage, hydrocephalus, cerebral calcification, vision problems (chorioretinitis), mental retardation, hearing problems, growth retardation, liver and spleen growth, pneumonia, myocarditis, rash .
The classic triad of the disease is hydrocephaly, intracranial calcifications, and chorioretinitis (eye damage).
In some infants during pregnancy or after birth, no damage or anomaly has been observed when the infection is proved to have passed to the baby.
Although some babies do not have an abnormality in their birth, vision and hearing problems and neurological injuries have been observed many years after their long term follow-up.
Findings and symptoms in toxoplasmosis infection:
– Chorioretinitis, uveitis
– Periventricular calcification
– Ventriculomegaly
– Microcephaly
– Hepatosplenomegaly, calcifications in liver at ultrasound
– Hyperechogenic bowel
– Acid
– Jaundice
– Anemia
– Mental retardation
– Common purpuric rach
– IUGR
Toxoplasma diagnosis in pregnancy:
There are several methods for detecting the parasite itself or the antibodies against toxoplasma. These are tests such as mouse inoculation test, cell culture, determination of parasite antigens, determination of parasite DNA by PCR. There are various tests such as Sabin-Feldman test, HAI, EIA, ISAGA, ELISA for the detection of antibodies against parasite in the pregnant woman.
Antibodies detected by these methods indicate that the infection has been newly infected with IgM. The IgG antibody shows the infected before or immunized infection. However, these antibodies may not always give very clear information. IgM antibody can sometimes remain positive for 1-2 years after infection. In this case, toxoplasma IgG avidity test is used to obtain information about how long the infection has been passed. The high avidity test indicates that the infection was passed at least 3 months ago. A low avidity test indicates that the infection has passed within the last 3 months.
If IgM is positive, IgG is negative, this is probably a recent infection. In cases where both IgM and IgG are positive, the test is repeated after 3 weeks and a 4-fold increase in antibody titre indicates that this is a new infection.
People with both IgM and IgG antibody negative were never infected. If they meet with toxoplasmosis, they are at risk of becoming infected, so they should stay away from raw and uncooked meats and cat feces.
The diagnosis of fetus toxoplasma infection:
Determination of whether the infection passes the fetus is possible with some tests. These are methods such as detection of parasite or IgM antibody in blood of fetus or detection of parasite in amnion fluid by PCR.
In addition, some of the anomalies described above in infected fetuses can also be observed with ultrasonography.
What should be done when a toxoplasma infection occurs in pregnancy?
The toxoplasmosis infection in pregnancy can not be said to cause any harm to the baby, the risk is as described above. Risks of toxoplasma infection are explained to the family. If the family wishes to terminate their pregnancy, the pregnancy is terminated. If the family does not want to terminate the pregnancy, the antibiotic treatment should be started immediately and antibiotics should be given to the baby after birth. Antibiotic therapy can not prevent the baby from being affected, but it reduces the severity of the effects of the baby. Spiramycin, primetamin and sulfadiazine antibiotics are used for toxoplasma infection in the pregnancy.
To protect against toxoplasma infection:
In pregnancy, cat feeders at home should pay particular attention to:
Pregnant women not contact with the feces of the cat. Those who are not pregnant at home should clean the feces of cat and the cat litter at home. You should wash your hands with soap after you touch the cat. There is no direct interest in this disease with dogs, but infection can also be acquired from a dog that has been contacted with cat or cat feces.You should not eat raw meat or undercooked meat, salami or sausage.You should thoroughly wash your hands after touching raw meat with bare hands. You should also wash the knives thoroughly which you chopped raw meat. You should eat fruits and vegetables washed with plenty of water and wash your hands after you touch them.