Do you have a cat at home? Then be aware of this: Everything about Toxoplasmosis!

Have you ever heard of a disease called 'Toxoplasmosis'? Probably not. But if you have a cat in your home for love, or if you are a pregnant mother, it is very important to know a little about it. It is an infection caused by a very small, invisible parasite. In this article, we will look at what it is, how it is caused, who is most affected, and how to protect yourself from it.

What is Toxoplasmosis? In simple terms…

Toxoplasmosis is an infection caused by a small parasite called Toxoplasma gondii (T. gondii). This parasite reproduces, or makes its offspring, in the intestines of cats. These parasites are shed in cat feces. We can get this disease either by coming into direct contact with cat feces (for example, when cleaning the litter box), or by eating meat that contains this parasite (if eaten undercooked).

Most of the time, we don't have any symptoms when we get this infection . But when our immune system (like the soldiers that fight to protect our bodies from diseases) attacks these parasites, they form small growths called ` cysts` inside the body. Inside these `cysts`, the parasite can remain silent and cause no problems. However, if the parasites inside these `cysts` become active again later, then the disease will appear.

Who is most affected by this disease called toxoplasmosis?

In fact, anyone can be infected with the T. gondii parasite. But, as mentioned earlier, most people don't show any symptoms . Your immune system is secretly controlling this parasite.

However, toxoplasmosis can be especially dangerous for pregnant women and people with weakened immune systems , such as those infected with HIV and cancer patients. It has not been found that having a cat in the home significantly increases the risk of developing this disease, but it is important to be careful.

What happens if you get toxoplasmosis during pregnancy?

If you become infected with toxoplasmosis while you are pregnant or about to become pregnant, you can pass the parasite to your baby through the placenta. This can increase the risk of miscarriage or stillbirth . Or, the baby may have serious health problems. For example, vision problems , blindness, developmental delays, and learning disabilities. Therefore, you need to be very careful during pregnancy.

Are you immunocompromised?

If you are living with HIV, have cancer, or are taking immune-suppressing medications, your immune system is not working properly. This means your body is less able to fight off disease. We call these people immunocompromised .

While a normal person can fight off toxoplasmosis without symptoms, for someone with a weakened immune system, a new infection or a reoccurrence of an old infection can be life-threatening .

If you have ever had toxoplasmosis, the T. gondii parasite lives in cysts in your body. When your immune system is weakened, these dormant parasites can become active again and make you sick. If left untreated, it can damage organs and even cause death in a person with a weakened immune system.

How common is this disease called toxoplasmosis?

Worldwide, it is estimated that about one in three people is infected with the T. gondii parasite. But surprisingly, many infected people do not show any symptoms.

What causes toxoplasmosis? How does it get into our bodies?

The main cause of this is the parasite called `T. gondii`. We get this from unknowingly ingesting something that contains this parasite.

Because of the way this parasite hides inside the body, you can have symptoms either right away when you're first infected or later. When the parasite first enters the body, some people experience symptoms like a fever or a cold. But most of the time, our immune system controls this initial infection without any symptoms.

When our immune cells fight this parasite, T. gondii forms small sacs (cysts) inside the body. Inside these cysts, it can remain dormant for a long time, without any activity. Research suggests that although these cysts occasionally rupture and the parasites are released, our immune system fights them off and keeps them under control. As with the initial infection, there are usually no symptoms at this time.

However, if your immune system is weakened, the parasites that come out of those ruptured cysts can cause a new case of toxoplasmosis (reactivation).

So how does this parasite get into our bodies?

This often happens by unknowingly eating something that contains the `T. gondii` parasite.

The parasite `T. gondii` lives in the intestines of cats and is excreted in their feces. This cat feces can contaminate soil, water, plants, and even the food we eat.

You can unknowingly get this parasite through things like:

• Cleaning the cat's litter box.
• Gardening in areas where cats roam.
• Drinking unfiltered or untreated water.
• Eating unwashed fruits or vegetables.
• Eating undercooked or improperly refrigerated meats.

Toxoplasmosis is not a disease that can be transmitted from person to person (although it can be transmitted from a pregnant mother to her baby). It can also, very rarely, be transmitted through an infected organ transplant or blood transfusion.

What are the symptoms of toxoplasmosis?

These symptoms depend on where in the body the parasite is active. They also vary depending on whether it is a new (acute) infection, a reactivation, or a congenital infection.

Symptoms of Ocular Toxoplasmosis

This is when the T. gondii parasite infects one or both eyes. This condition is most often seen in young children or young adults who are infected with T. gondii at birth . Rarely, the eye can be affected even when the T. gondii is first introduced. Symptoms include:

• Eye pain.
• Blurred vision.
• Blindness.

Symptoms of acute toxoplasmosis

This is the body's response to the initial exposure to the T. gondii parasite. Most people do not experience any symptoms . However, some may experience symptoms such as fever and chills. These include:

• Fever.
• Tiredness, fatigue.
• Muscle pain.
• Painless, swollen lymph nodes in the neck or armpits.
• Sore throat.
• Enlargement of the liver and spleen (hepatosplenomegaly).
• Ocular toxoplasmosis (this is very rare).

Symptoms of reactivated toxoplasmosis

If you are immunocompromised, you may have a previous T. gondii infection that is no longer able to fight off the infection. This includes people with AIDS or cancer, or people taking medications that suppress the immune system. Reactivation of toxoplasmosis often causes symptoms that affect the brain and spinal cord (central nervous system or CNS) . These symptoms include:

• Headache.
• Confusion.
• Epileptic seizures.
• Fever.
• Loss of power on one side of the face (facial paralysis).
• Changes in vision.
• Numbness.
• Weakness or decreased mobility.
• Brain infection (`Toxoplasmic encephalitis`).
• Coma.

Symptoms of Congenital Toxoplasmosis

This occurs when the parasite is passed from mother to baby through the placenta. Some babies may not have any symptoms at birth, but are at high risk of developing symptoms later in life . These symptoms include:

• Yellowing of the skin and eyes (jaundice).
• Skin rash.
• Enlargement of the liver and spleen (hepatosplenomegaly).
• Vision loss, eye pain, or sensitivity to light (retinochoroiditis).
• Calcium deposits in the brain.
• Hydrocephalus (fluid in the brain).
• Small head (microcephaly).
• Epileptic seizures.
• Delays in the development of motor skills.
• Learning delays or changes.
• Ocular toxoplasmosis.

How is toxoplasmosis diagnosed? How does a doctor detect it?

To diagnose toxoplasmosis, your doctor will examine you and ask about your symptoms. Then, they may order tests such as:

• Blood tests: This is what is most often done. A small amount of blood is taken from your vein and sent to a lab to check for antibodies to the T. gondii parasite. Sometimes, they also check for parts of the parasite (DNA).
• Biopsy: This is done very rarely. A piece of tissue is taken from the body and checked for signs of T. gondii.
• Imaging: If your doctor suspects that you have toxoplasmosis in your brain, they may order a CT scan or MRI. This involves having you lie down on a machine and taking pictures of your brain.
• Lumbar puncture: This test may be done if you suspect you have toxoplasmosis in your brain or spinal cord . In this test, a doctor uses a needle to remove a small amount of cerebrospinal fluid (CSF) from your lower back. It is sent to a lab to be tested for T. gondii.
• Amniocentesis: If you are pregnant and have been diagnosed with toxoplasmosis, your doctor may order this test. This involves taking a sample of cells from the fluid (amniotic fluid) surrounding your baby to look for signs of T. gondii.
• Ultrasound scan: If you are pregnant and have been diagnosed with toxoplasmosis, your doctor may order an ultrasound scan. While this alone cannot diagnose toxoplasmosis, it can look for changes in the baby's brain that could indicate an infection.

What are the treatments for toxoplasmosis?

Toxoplasmosis is treated with a combination of anti-parasitic medicines and antibiotics. These medicines stop the T. gondii parasite from growing and spreading inside the body.

A medicine called ``Folinic acid`` is also given to reduce the side effects of anti-parasitic medications.

Usually, people with good immunity and no symptoms are not treated for toxoplasmosis. This is because treatments only work when the parasites are active. These medications cannot kill the dormant cysts that have formed in the body.

The medications commonly given for toxoplasmosis are:

• `Pyrimethamine`
• `Sulfadiazine`
• `Atovaquone`
• `Spiramycin` (before 18 weeks of pregnancy)
• ``Trimethoprim-sulfamethoxazole''
• `Clindamycin`
• `Leucovorin`

How quickly will I feel better after treatment?

Most treatment plans take two to six weeks, but you may start to feel better in just a few days. It can take three weeks to six months for the brain damage caused by the parasite to fully heal.

The most important thing is to continue taking the medication for as long as your doctor tells you, even if you feel better. Only then can you be sure that all active parasites have been killed.

If you are pregnant and are diagnosed with toxoplasmosis, you will need to take medication throughout your pregnancy. A baby born with toxoplasmosis will need treatment for about a year. Treatment for immunocompromised individuals may need to be continued for the rest of their lives.

If I have toxoplasmosis, how can I take care of myself?

If you are pregnant and have been diagnosed with toxoplasmosis, follow your doctor's instructions carefully to prevent passing it on to your baby.

If you are immunocompromised and have toxoplasmosis, work with your doctor to develop a plan to treat toxoplasmosis while managing your other medical conditions.

What is the outlook for toxoplasmosis? Can the disease be cured?

This varies from person to person. People with healthy immune systems rarely develop serious complications from toxoplasmosis.

More than 70% of children with toxoplasmosis at birth reach expected developmental milestones if treatment is started early.

In immunocompromised patients, toxoplasmosis is often seen in the brain. With treatment, there is a 70% chance of survival. However, if left untreated, toxoplasmosis of the brain is fatal.

Is toxoplasmosis completely curable?

Toxoplasmosis may never be completely cured because the cysts produced by the T. gondii parasite remain in the body. Medications can control the active infection, but they cannot destroy the cysts.

If your immune system is healthy, the cyst should not reactivate. But if your immune system is weak, or you had toxoplasmosis at birth, the parasite can reactivate in the future and make you sick.

How to protect yourself from toxoplasmosis? (Prevention)

The most important things you can do to stay safe are food safety and good hand washing. Doing these things correctly can greatly reduce your risk.

• Freeze and cook meat thoroughly before eating.
• Peel fruits and vegetables, or wash them thoroughly before eating.
• Wash cutting boards, counters, knives, cutlery, and dishes thoroughly with soap after using them.
• Do not drink unpasteurized milk.
• Do not eat raw or undercooked oysters, mussels, or shellfish.
• Do not drink untreated water.
• Wear gloves when working in the garden or with soil. Wash your hands thoroughly with soap afterward.
• Keep sandpits outdoors (where children play) covered.
• Do not feed raw or undercooked meat to cats.
• Clean your cat's litter box every day. Wear gloves, then wash your hands thoroughly with soap.
• Try to keep the cat indoors.

If you are pregnant or have a weakened immune system, think about these things in particular:

• If possible, avoid cleaning your cat's litter box yourself. Ask someone else to do it. If you absolutely have to do it yourself, wear disposable gloves and wash your hands thoroughly afterward.
• Avoid adopting a new cat or bringing home a stray cat.

How do I know if my cat has toxoplasmosis?

Like humans, cats often don't show any symptoms when they contract toxoplasmosis. If you have any questions about your pet cat, ask your veterinarian.

Do I need to get rid of my cat if I'm pregnant/have a weak immune system?

No, you don't necessarily need to get rid of your cat just because you're pregnant or have a weakened immune system. Cat lovers can take steps to reduce their risk of toxoplasmosis.

• Keep your cat indoors.
• Always have someone else clean the litter box.
• Do not feed your cat raw or undercooked meat.
• If you have to clean the litter box yourself, wear gloves and a mask, and wash your hands immediately afterward.
• Finally, do not bring a stray cat home or adopt a new cat while you are pregnant or have a weakened immune system.

When should you see a doctor?

If you are pregnant, planning to become pregnant, or have a weakened immune system, talk to your doctor about steps you can take to protect yourself and your unborn baby from toxoplasmosis.

If you have symptoms of toxoplasmosis, especially if you have a weakened immune system, see a doctor immediately.

Finally, things to remember (Take-Home Message)

Toxoplasmosis is usually not a serious disease. However, it is a particular threat during pregnancy and for people with weakened immune systems. Fortunately, there are many things you can do to protect yourself from this infection. Talk to your doctor about how to reduce your risk of toxoplasmosis based on your situation. It's best to be safe!

` Toxoplasmosis, cats, pregnancy, infection, parasite, symptoms, prevention