Monday, June 29, 2009

TOXOPLASMOSIS and PREGNANCY

Toxoplasmosis and Pregnancy

clip_image002

Reviewed by the Bambang Widjanarko

Last updated: Juni 2009

Highlights

What is toxoplasmosis?

Toxoplasmosis is an infection you can get from a microscopic parasite called Toxoplasma gondii. Although the infection is generally a mild, symptomless illness for people with healthy immune systems, it's risky to get during pregnancy because the parasite can sometimes infect the placenta and your baby.
The number of babies born in the United States with toxoplasmosis (known as "congenital toxoplasmosis") is relatively small, but the infection can be devastating, causing stillbirth or long-term damage. Fortunately, there's a lot you can do to avoid becoming infected in the first place.

What are my chances of getting toxoplasmosis and infecting my baby?

The Centers for Disease Control (CDC) estimates that only about 15 percent of women of childbearing age are immune to toxoplasmosis. So unless you know for sure that you're immune, you should take steps to avoid becoming infected. Fortunately, the number of women who contract the disease during pregnancy is still relatively small and not all of them transmit the infection to their babies.
If you get infected with toxoplasmosis in the first trimester, the risk that your baby will also be infected is about 15 percent. The risk rises to about 30 percent if you get infected in the second trimester and to 60 percent in the third trimester. Somewhere between 1 and 10 in 10,000 babies in the United States contract the infection in utero each year.
There's also a very small risk of infecting your baby if you contract the infection within three months before you conceive. To be on the safe side, some experts recommend that infected women wait six months before trying to conceive.

How is toxoplasmosis spread?

Some experts believe that about half of toxoplasmosis infections are caused by eating raw or undercooked infected meat, but you can also get the parasite in other ways, such as eating unwashed contaminated produce, drinking contaminated water, or handling contaminated soil, cat litter, or meat and then touching your mouth, nose, or eyes. Toxoplasmosis can't be transmitted from person to person, with the exception of transmission from mother to baby during pregnancy or from an infected blood transfusion or organ transplant.

Do I have to get rid of my cat?

No. You've probably heard that cat feces and litter are a major source of toxoplasmosis, but that doesn't mean you need to get rid of your beloved pet. It just means you'll need to take some extra precautions. Here's the scoop on how cats can transmit the infection.
Felines are a natural host for the parasite and it reproduces in their intestines. A cat may become infected with toxoplasmosis from eating infected prey or undercooked meat, or anything contaminated by the feces of another infected cat. The parasites then form "oocysts" in the cat's gut, and the cat excretes up to 10 million oocysts daily for about a week to ten days. (Oocysts can't be seen with the naked eye, and in most cases you'll have no idea that your cat is sick.)
The oocysts first become infectious 24 hours or so after they're excreted. Under the right conditions, they can live in the soil, sand, or litter and remain infectious for up to 18 months. During this time, they spread, contaminating water, fruits, and vegetables, and infecting warm-blooded species, including humans, that ingest them.
So while it's possible to get infected with toxoplasma oocytes from direct contact with cat feces (such as handling the litter of a newly infected cat), you can also be exposed to oocytes elsewhere (for example, while gardening, eating unwashed vegetables, or drinking contaminated water).
Although only cats pass the parasite in their feces, other infected species harbor the parasite in their tissue forever, in so-called "tissue cysts." Heat will kill the parasites, but if you eat raw or undercooked meat (or touch it and then touch your mouth, nose, or eyes), you can be infected by these tissue cysts. Pork, lamb, and game meat (like venison) are major culprits, but any type of meat may be infected, so all meat should be handled and cooked appropriately.

So how do I avoid getting infected?

Here are some guidelines, whether you have a cat or not:

  1. Cook meat well. Use a food thermometer to test the internal temperature of meat. Most meat should be cooked to a temperature of 160 degrees Fahrenheit, or 180 degrees F in the thigh for whole poultry. If you're not actually measuring the temperature of the meat, cook it until it's no longer pink in the middle. Be sure not to sample meat you're cooking before it's done.
  2. Avoid salt-cured or smoked meats such as Genoa salami, Parma ham, and prosciutto unless you first heat them until they're steaming. For example, they're fine if cooked on a pizza. But if not cooked, they're risky because they might have been processed without thorough heating or with no heat at all. Also, don't eat dried meats like jerky, which may have not gotten sufficiently hot during the drying process.
  3. Don't drink unpasteurized milk or products made from unpasteurized milk, and avoid raw eggs.
  4. Wash or peel fruits and vegetables before eating.
  5. Wash counters, cutting boards, dishes, utensils, and your hands with hot, soapy water after preparing unwashed produce or uncooked meat, poultry, or seafood.
  6. Don't touch your mouth, nose, or eyes while preparing food, and always wash your hands before eating. Also make sure open sores aren't in contact with potential sources of exposure to the parasite. Wear disposable gloves if you have cuts on your hands.
  7. Keep flies and cockroaches away from your food.
  8. Avoid contaminated water. Use bottled water when camping or traveling to developing countries.
  9. Wear gloves while gardening, and don't touch your hands to your mouth, nose, or eyes until they've been washed thoroughly afterward.
  10. Avoid public sandboxes and cover your child's sandbox when it's not in use. If that's not always possible, then stay out of it as well. (Toxoplasmosis isn't likely to be harmful for your child and you can't catch it from him if he does get it, but you do need to stay away from sand that might contain infected cat feces.)
  11. Don't get a new kitten or cat while you're pregnant, and don't play with stray cats or kittens.
  12. If you have a cat, have other people empty the litter box, and have them do it daily. This reduces the risk of infection because the oocysts aren't infectious for the first 24 hours after they're excreted. If you must do the job, wear disposable gloves and wash your hands well afterward. Some even suggest wearing a mask in case any particles become airborne when the litter is stirred up, and disinfecting the box by pouring near-boiling water into it five minutes before you handle it.
  13. To keep your cat from becoming infected while you're pregnant, feed him only commercial cat food or well-cooked table scraps, never raw or undercooked meat. Keep him indoors so he won't hunt down potentially infected prey like mice or birds. (Remember, though, that even an indoor cat might catch a mouse.)
  14. Keep Kitty off of the kitchen counter and dining table.
  15. Though it's unlikely your cat has any parasites in his fur, it's a good idea to wash your hands after playing with him, especially before eating or otherwise putting your hands to your mouth.

How will I know if I get toxoplasmosis?

Without testing, you probably won't know you've been infected because the vast majority of people with healthy immune systems don't have any symptoms at all. If you do, you may have painless swollen lymph glands and other generally mild symptoms like muscle aches, fatigue, headache, fever, and possibly a sore throat or a rash. Only rarely do more serious symptoms arise in otherwise healthy people. Sometimes toxoplasmosis is suspected when certain fetal abnormalities are picked up during a prenatal ultrasound, though most infected babies look normal.
Blood tests that can detect toxoplasmosis antibodies that indicate immunity or recent infection, but experts disagree over whether pregnant women need to be screened routinely. In the United States, where the disease isn't very common, some worry that screening all pregnant women would result in too many false positive results, leading to undue anxiety and costly follow-up testing. Others argue that even though congenital toxoplasmosis is relatively rare, the consequences can be devastating, so they advocate prenatal testing for all women or universal newborn testing or both.
The American College of Obstetricians and Gynecologists (ACOG) doesn't recommend screening pregnant women, with the exception of those who are HIV-positive or when infection is suspected. In contrast, in France, where the disease is more common, , all women are tested, and those who aren't immune are tested monthly during pregnancy.
Talk about the pros and cons of testing with your doctor or midwife and together you can make a decision that's right for you. And be sure to call your caregiver if you have swollen glands or other reasons to suspect you've been infected.
If it seems as though you might be infected, your blood will tested to measure your levels of two antibodies (IgG and IgM). Depending on the results, you may need to be tested again in two to three weeks and have your blood sent to a toxoplasmosis "reference lab." This is done both to confirm the initial results and to help pinpoint when you might have become infected.

What will happen if I do get toxoplasmosis?

If test results suggest that you got toxoplasmosis while pregnant, your practitioner will begin treating you with an antibiotic that may lower your risk of transmitting the disease to your baby. And since not all maternal infections are transmitted to the baby, you'll have an amniocentesis to determine whether your baby also has the infection. (The lab will do a special DNA test on your amniotic fluid to check for the presence of the toxoplasmosis parasite.) You'll also have a series of ultrasounds throughout your pregnancy to look for abnormalities in your developing baby.
If your amniotic fluid shows that your baby has been infected or an ultrasound shows a problem, you'll probably be referred to a specialist for care, and you may also want to talk to a genetic counselor about the risks to your baby. Depending on your baby's gestational age, you'll be given the option to end the pregnancy. If you continue the pregnancy, you'll be given other antibiotics to take beginning some time in the second trimester to reduce the risk of problems for your baby.

What could happen if my baby gets toxoplasmosis and how will he be treated?

The consequences for your baby can range from mild to severe.

It's unclear whether toxoplasmosis can cause miscarriage, though in some cases it can result in stillbirth or death shortly after birth.

Congenital toxoplasmosis can affect your baby's brain, causing structural and neurological problems, such as mental or motor developmental delays, cerebral palsy, and epilepsy.
It can affect other organs too, most commonly the eyes, leading to visual impairment and sometimes blindness. Other signs of toxoplasmosis may include an enlarged liver and jaundice, an enlarged spleen, a low platelet count, a rash, a heart or lung infection, and enlarged lymph nodes.
The vast majority of babies with congenital toxoplasmosis, particularly those infected later in pregnancy, look normal at birth but may develop serious problems such as vision impairment (and possibly blindness) and developmental delays months or even many years later. For this reason and because treating babies effectively reduces the progression of the disease, some experts say that all babies in the United States should be tested for toxoplasmosis. Currently only Massachusetts and New Hampshire routinely do so.
If your baby tests positive for toxoplasmosis at birth, he'll be treated with antibiotics for about a year, even if he has no symptoms. Special hearing and eye exams will be done, as well as a sonogram or CAT scan of his head and other tests as needed. Studies show that although treatment after birth may not reverse all the damage that occurred before birth, it will greatly reduce a baby's risk of developing new problems during infancy and beyond.

3 comments:

  1. There is a safe & effective Natural Herbal Medicine. For Total Cure Call    +2349010754824,  or email him   drrealakhigbe@gmail.com       For an Appointment with (Dr.) AKHIGBE contact him. Treatment with Natural Herbal Cure. For:Dengue Fever, Malaria. Painful or Irregular Menstruation. HIV/Aids. Diabetics. Vaginal Infections. Vaginal Discharge. Itching Of the Private Part. Breast Infection. Discharge from Breast. Breast Pain & Itching. Lower Abdominal Pain. No Periods or Periods Suddenly Stop. Women Sexual Problems. High Blood Pressure Chronic Disease. Pain during Sex inside the Pelvis. Pain during Urination. Pelvic Inflammatory Disease, (PID). Dripping Of Sperm from the Vagina As Well As for Low sperm count. Parkinson disease. Obesity, Lupus.  Cancer.  Tuberculosis.  Zero sperm count. Bacteria, Toxoplasmosis, Diarrhea.Herpatitis A&B, Rabies. Asthma.  Quick Ejaculation. Gallstone, Cystic Fibrosis, Esquizofrenia, Cirrhosis,  Premature Ejaculation. Herpes. Joint Pain. Stroke. Coeliac Disease, Weak Erection.  Erysipelas, Thyroid, Discharge from Penis. HPV.  Hepatitis A and B. STD. Staphylococcus + Gonorrhea + Syphilis. Heart Disease.  Pile-Hemorrhoid.rheumatism, thyroid, Autism, Penis enlargement,  Waist & Back Pain.  Male Infertility and Female Infertility. Etc. Take Action Now. contact him & Order for your Natural Herbal Medicine:  +2349010754824  and email him    drrealakhigbe@gmail.com    Note For an Appointment with (Dr.) AKHIGBE.I suffered in Cancer for a year and three months dieing in pain and full of heart break. One day I was searching through the internet and I came across a testimony herpes cure by doctor Akhigbe. So I contact him to try my luck, we talk and he send me the medicine through courier service and with instructions on how to be drinking it.To my greatest surprise drinking the herbal medicine within three weeks I got the changes and I was cure totally. I don't really know how it happen but there is power in Dr Akhigbe herbal medicine. He is a good herbalist doctor.

    ReplyDelete
  2. Once again I want to appreciate Dr Ubarlo for helping me with his herbal medicine to cure my herpes. virus completely, I really suffered from this virus for the past 2 yrs, Right now I'm herpes negative after using the herbal medicine Dr Ubarlo sent to me .l give all thanks to God for leading me to Dr Ubarlo was able to cure me completely from herpes virus, Dr Ubarlo you are the best traditional doctor in the world God bless you sir, contact Dr Ubarlo for cure if you have been passing through similar diseases or virus like. herpes. HIV .gastritis. fibroid. etc via Email drubarlohome@gmail.com or Whats App contact +2348119508814 God bless you all

    ReplyDelete
  3. Once again I want to appreciate Dr Ubarlo for helping me with his herbal medicine to cure my herpes. virus completely, I really suffered from this virus for the past 2 yrs, Right now I'm herpes negative after using the herbal medicine Dr Ubarlo sent to me .l give all thanks to God for leading me to Dr Ubarlo was able to cure me completely from herpes virus, Dr Ubarlo you are the best traditional doctor in the world God bless you sir, contact Dr Ubarlo for cure if you have been passing through similar diseases or virus like. herpes. HIV .gastritis. fibroid. etc via Email drubarlohome@gmail.com or Whats App contact +2348119508814 God bless you all

    ReplyDelete