Toxoplasmosis

Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii which is harbored commonly by cats, birds and domesticated animals like pigs, sheep, lamb and chicken. Humans commonly contract the infection by direct ingestion of the parasite from sandboxes or soil contaminated by cat feces or undercooked pork, chicken, venison, lamb and mutton.

Symptoms range from none to swollen lymph glands, prolonged flu like illness, to severe infections involving the lungs, brain and eyes in immunocompromised individuals.

This infection if acquired in pregnancy can be passed to the fetus across the placenta and lead to fetal loss or severe congenital defects.

Where does it occur?

I t occurs worldwide.

How is it transmitted?

It is transmitted through ingestion of soil contaminated by cat feces, eating without washing hands after handling cat litter, eating under cooked meats like pork, lamb, mutton and chicken, through blood transfusion and organ transplantation. Maternal to fetal transmission occurs across the placenta.

Is it contagious from person to person?

It is not commonly contagious from person to person, except from mother to fetus across the placenta.

What is the risk for travelers?

Risk for travelers is generally low.

How soon after exposure will one develop symptoms?

Symptoms usually develop 1 to 4 weeks after ingestion.

What are the signs and symptoms?

Most immunocompetent adults and children have no symptoms and are able to ward of the infection.

If symptomatic infections do develop (10-20% of the time) adults present with flu like illness with fever, sore throat, body aches, muscle pains and swollen lymph glands. Symptoms may last for months before resolving by itself.

Immunodeficient individuals (HIV) will have more severe symptoms of lung involvement with fever, chills, cough, chest pain and shortness of breath; eye involvement with pain, tearing and blurred vision; brain involvement with headache, stiff neck, nausea, vomiting, seizures, paralysis and coma.

Maternal infection during pregnancy can result in infection of the fetus with fetal death or severe congenital manifestations of jaundice, neurologic defects etc.

Are there any lab tests to diagnose the illness?

Blood and spinal fluid antibody tests, PCR tests or biopsy demonstrating the parasite are available to diagnose the illness.

Is there any treatment?

Combination treatments with Sulfadiazine, Pyrimethamine and folate (to avoid toxicity) or clindamycin are effective treatments.

What preventive measures can be taken?

Wash hands after playing in soil contaminated by cat feces, handling cat litter or raw meats. Pay attention that children do not eat soil and wash vegetables well prior to eating.

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