Understanding Toxoplasmosis: Symptoms, Causes and Diagnosis and Treatment Options

Toxoplasmosis is an infection caused by a parasite called Toxoplasma gondii. It is one of the world’s most common parasites and is primarily caused by ingesting undercooked meat (such as venison, lamb, and pork) and being exposed to infected cat feces. It can also be spread from an infected mother to her child during pregnancy.

What is Toxoplasmosis?

The incidence of this infection is most common in Central America and Central Africa, mainly due to the humid weather conditions. Local cuisine customs also play a role here. Most adults have toxoplasmosis without even being aware of it.

Toxoplasmosis is caused by a single-celled parasite which can persist for long periods in human bodies. When an individual get infected with T. gondii, the parasite forms cysts which may affect almost any part of your body — often your brain and muscle tissue of different organs, including your heart.

If you’re generally healthy, your immune system keeps the parasites in check.

The people most at risk from toxoplasmosis have compromised immune systems (including people with HIV/AIDS and cancer) or infants whose mothers have an active infection during pregnancy.

What are the Symptoms Associated with Toxoplasmosis?

Most people who catch this infection exhibit little to no symptoms, as their healthy immune system prevents the parasite from doing much damage. Some flu-like symptoms, if any, include:

• Fever.
• Headaches.
• Fatigue.
• Body pain.
• Swollen lymph nodes (neck glands).

These symptoms generally resolve on their own.

People with weakened immune systems mean those who have had an organ transplant, have HIV/AIDS or cancer, and are receiving chemotherapy or taking medications that suppress their immune system. They are at the risk of developing:

• An eye infection that can cause blurry vision and eye pain.
• A lung infection that can cause fever, cough, shortness of breath, and tuberculosis.
• Brain inflammation that can cause seizures, headaches, poor coordination, and confusion.

An expecting mother can contract toxoplasmosis before or during her pregnancy and pass this on to her child, even without exhibiting symptoms herself. Some early infections can lead to stillbirth or a miscarriage. Babies who survive are likely to be born with serious problems like:

• An enlarged spleen and liver
• Seizures
• Jaundice – yellowing of skin & whites of eyes
• Severe eye infections

A few develop symptoms after a long time, even when they are in their teens.

If you are generally healthy, they remain in your body in an inactive state. But, if your immune system is weakened, the infection can be reactivated, leading to serious consequences.

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What Causes Toxoplasmosis?

While you will not catch this infection from someone else who might be infected, the following scenarios may lead to it:

• Eating or drinking contaminated food (meat) and water (most common).
• Eating unwashed fruits and vegetables (most common).
• Using contaminated knives, cutting boards, and other utensils that might be harboring the parasite.
• Coming in contact with cat feces that carry the parasite (rare).
• Receiving blood transfusion or an organ transplant from an infected donor (rare).

How is this Infection Diagnosed?

Typically, doctors run a blood test to look for antibodies for this parasite. Antibodies are types of proteins our immune system produces when it is threatened by a harmful substance. If your test comes back positive, it simply means you have had this infection at some point in your life. It does not indicate the presence of an active infection.

Some additional imaging tests such as a CT or MRI can be done to detect changes in the brain, eyes, and ears.

If you are pregnant, the doctor will test your amniotic fluid. An ultrasound can additionally help determine if the unborn child is infected.  While a detailed ultrasound cannot diagnose toxoplasmosis, it can, nonetheless, show whether the baby has certain signs like hydrocephalus (fluid buildup in the brain). But, a negative ultrasound does not rule out the possibility of this infection. For that reason, the newborn may need an examination as well as follow-up blood tests during the first year of life.

What are the Treatment Options for Toxoplasmosis?

The doctor may recommend not treating your infection if you are healthy and exhibiting mild symptoms. However, if the disease persists and starts to affect your brain, eyes, and other internal organs, your doctor will prescribe pyrimethamine and sulfadiazine.

You may be adviced an antibiotic spiramycin, If you are pregnant and got infected with toxoplasmosis before the 16th week of pregnancy. Use of this medication may reduce the risk of neurological problems in your baby from congenital toxoplasmosis.

If the infection happened after the 16th week of pregnancy, or if test results show that the unborn child has toxoplasmosis, you may be given pyrimethamine and sulfadiazine and folinic acid (leucovorin).

If you have HIV/AIDS, you may need to take medications lifelong.

There are currently no vaccines or medications that can prevent the infection, but its symptoms can be managed.

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How can Toxoplasmosis be prevented?

The following steps can be kept in mind to protect your family and you from catching this infection. These are:

• Wash all fruits and vegetables before consumption. Ideally, also peel them.
• Wash your hands properly after spending time outdoors, especially before you prepare or eat food.
• Make sure your meat is cooked properly.
• Do not drink unprocessed water or unpasteurized milk.
• Wear gloves while gardening or working outside.
• Avoid touching your face, mouth, or eyes while preparing meals.
• Use soap and warm water to wash all utensils, especially those that come in contact with raw meat.
• Thoroughly clean the counter post food prep.

What to do if you’re a Cat Owner?

While it is rare to get infected from cat feces, you can take the following preventative measures:

• Try to keep your cat indoors so that it cannot catch the parasite.
• Avoid petting stray cats or kittens.
• Do not feed your cat raw or uncooked meat either.
• Change its litter box every day as T.Gondii eggs aren’t infectious until at least 24 hours have passed since the cat has defecated . If you are pregnant, have someone else handle this task. Wash your hands well once done.

Living with Toxoplasmosis

Pregnant women who have this condition should constantly work with their doctor to determine a customized treatment plan. Babies born with toxoplasmosis often receive treatments for up to a year.

People and children with weak immune systems may require hospitalization to prevent any serious complications that might occur from the infection.

While medical management can help treat toxoplasmosis, the best solution is prevention.

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Frequently Asked Questions (FAQs):

Q: Why is vitamin B recommended along with toxoplasmosis medication?

If a person has HIV or AIDS, drugs such as pyrimethamine can decrease the levels of folic acid in the body, which is a type of vitamin B. Hence, your doctor may additionally recommend vitamin B as well.

Q: How is uncooked meat a carrier for toxoplasmosis?

There may be toxoplasma cysts present in undercooked meat or fruits and vegetables that have come in contact with contaminated manure or cat feces.

Q: When should I see my doctor if I’m planning my pregnancy?

It is ideal to visit your doctor at least 3 months before becoming pregnant and discuss the risk factors. Your doctor may run a blood test to check if you have had toxoplasmosis before.

Q: Why should pregnant women take special precautions to avoid this infection?

This is because toxoplasmosis can be very serious, in some cases even fatal for a child infected in the uterus. They are likely to have lasting consequences that can affect their eyes, brain, heart, and lungs.