HealthLink BC File #43,  September 2011

Toxoplasmosis

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• What is toxoplasmosis?
• What are the symptoms of toxoplasmosis?
• How is toxoplasmosis spread?
• Pregnancy and toxoplasmosis
• How can I avoid getting toxoplasmosis?
• Cats and you
• Is there a treatment for toxoplasmosis?

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What is toxoplasmosis?

Toxoplasmosis is a common disease found in birds and mammals across North America. The infection is caused by a parasite called toxoplasma gondii. It affects about 20 out of every 100 people in North America by the time they are adults.

What are the symptoms of toxoplasmosis?

Most people who are infected do not show any symptoms. A healthy person's immune system usually prevents the parasite from causing disease.

Those who do get sick with a mild form of the illness usually have flu-like symptoms such as fever, sore throat, sore muscles and tiredness. Glands in the neck, armpits or groin can become swollen but they are usually not sore. In some cases the infection can also cause blurred vision or temporary loss of vision.

People undergoing therapy such as chemotherapy or radiation or with HIV/AIDS can develop further complications.

How is toxoplasmosis spread?

All animals and birds can become infected with the toxoplasmosis parasite. The parasite enters the muscles of a bird or animal when it eats raw meat, or drinks the milk, of an infected animal. Cats can also spread the parasite in their feces. The infection cannot be spread from person to person.

Common ways for people to become infected with toxoplasmosis include:

• Touching your hands to your mouth after cleaning a cat's litter box, or touching anything that has come into contact with cat feces
• Eating raw or undercooked meats
• Drinking unpasteurized milk
• Working in gardens or playing in sandboxes that contain cat feces
• Accidentally swallowing contaminated dirt in the playground.

Other ways for people to become infected with toxoplasmosis include:

• Drinking water contaminated with toxoplasma.
• Receiving an infected organ transplant or blood transfusion - this is very rare

Pregnancy and toxoplasmosis

If you are pregnant or thinking of becoming pregnant, be sure to follow the advice in this HealthLink BC File on how to avoid infection.

Your health care provider may test you for toxoplasma. A growing fetus can become infected with the toxoplasmosis parasite. This can happen if the mother is infected with the parasite while pregnant or before she becomes pregnant.

The disease may be most severe when the fetus is infected during the second to sixth month of a pregnancy. Infection in the fetus early in pregnancy can result in miscarriage, poor growth, early delivery or stillbirth. If a child is born with toxoplasmosis, he/she can experience eye problems, hydrocephalus (water on the brain), convulsions or mental disabilities.

Treatment of an infected, pregnant woman may prevent or lessen the disease in her unborn child. Treatment of an infected infant also helps reduce the severity of the disease as the child grows.

How can I avoid getting toxoplasmosis?

• Be careful not to accidentally swallow dust when cleaning the cat litter box.
• Avoid cleaning cat litter boxes if you are pregnant or trying to become pregnant.
• Wear gloves when cleaning the cat litter box, and then wash your hands.
• Place a secure lid on your sandbox to prevent cats from using it as a litter box.
• Do not eat raw or undercooked meat.
• Wash your hands, utensils and cutting boards after handling raw meat to prevent contaminating other foods.
• Do not drink unpasteurized milk from any animal.
• Wear gloves when gardening, and wash your hands afterwards.
• People who are pregnant or have a weak immune system, and are concerned about the quality of the water in their community should consult with their doctor about whether they should be treating their drinking water or using bottled water.

Cats and you

Just like other family members, your pet cat can pass disease on to you. Most infected cats do not appear sick. The cat's feces contain the parasite for only two weeks after the cat is infected. However, the feces themselves may remain infectious for over a year.

Cats are not likely to be infected if they have been raised indoors, never caught and eaten mice or birds, and never been fed raw meat. A stray or unfamiliar cat that appears sick should not be handled. Report the cat to the SPCA or to the humane society.

Here are some tips if you have a pet cat:

• Wash your hands after patting, brushing or being licked by your cat.
• Clean out the litter box every day.
• Dispose of cat feces in a plastic bag and put in the garbage.
• Do not compost the cat litter, or dispose of the litter near your garden.
• See a veterinarian if there are any signs of illness in your cat.
• Do not feed raw meat to your cat.

Is there a treatment for toxoplasmosis?

Most people will recover from toxoplasmosis without treatment. However, medication is available from your family doctor to treat the infection. Treatment may be required if the eyes or heart are affected or if the infection occurs in people who are pregnant, have a weak immune system or illnesses such as AIDS or cancer.

For more HealthLinkBC File topics, visit www.HealthLinkBC.ca/healthfiles/ or your local public health unit. Click on www.HealthLinkBC.ca or call 8-1-1 for non-emergency health information and services in B.C. For deaf and hearing-impaired assistance, call 7-1-1 in B.C. Translation services are available in more than 130 languages on request.