Pregnancy

Toxoplasmosis in pregnancy, how to prevent it

Catching toxoplasmosis in pregnancy, especially in the first few weeks, is a serious problem and that is why one of the most important tests carried out in early pregnancy is that relating to toxoplasmosis, called the “toxo-test”.

If we have never come into contact with this parasite before pregnancy (therefore negative to the toxo-test) you will have to  repeat this exam monthly and take some precautions to avoid contracting the dangerous disease during pregnancy.

Meaning of toxoplasmosis

Toxoplasmosis is a disease caused by the parasite Toxoplasma gondii . This parasite lives in cats and other warm-blooded animals and causes toxoplasmosis in humans.

The disease does not present particular symptoms and often we do not realize that we have caught it. In a healthy person the effects are similar to those of a mild flu . As a result, many people do not know they have had it and are already immune to it (and are for life).

How do you get infected

Toxoplasmosis infections in most cases are due to infected meat that has not been cooked enough to eliminate the parasite.

In other cases it is taken from contaminated raw vegetables (from the feces of an infected animal, typically the cat) or by direct contact with the infected feces without using gloves and/or washing your hands adequately before putting them in your mouth or touching food.

Food is the first cause of toxoplasmosis infection.

In summary, you can get toxoplasmosis:

  • eating raw or undercooked meat (especially pork and sheep)
  • eating contaminated raw vegetables
  • touching feces of infected animals without washing hands thoroughly

Effects of toxoplasmosis in pregnancy

Toxoplasmosis gives mild symptoms in adult human beings who do not realize they have caught it, but it can cause irreversible damage to the fetus .

Toxoplasma can cross the placenta without problems and, depending on the week of pregnancy in which the infection occurs, cause various problems including malformations and miscarriages .

Infected fetuses between 16 and 24 weeks are usually normal at birth. If the infection occurs in the first trimester, the consequences are very different.

The toxo-test before and during pregnancy

For this reason it is of fundamental importance that the woman knows even before pregnancy (thanks to preconception tests ) whether or not she is immune to toxoplasmosis. In this way she can take the right precautions by herself already starting from when she decides to have a baby.

The toxo-test is performed with a simple blood sample and allows you to understand, before pregnancy, if you are immune and therefore if there will be no risk of contracting the disease and having problems.

If you are not immune and therefore there is the possibility of contracting toxoplasmosis, in addition to the precautions regarding food and risky behavior, it is important to do the toxo-test every month (it is part of the checks to be done every month during pregnancy ).

The toxo-test measures two values, IgM and IgG . IgM is high at the onset of the disease, while IgG remains in the blood when you are already immune.

If you discover the disease in pregnancy

If toxoplasmosis is diagnosed, especially in the first trimester of pregnancy, antibiotic therapy with spiramycin or other drugs will be started later in the pregnancy (obviously always under strict medical supervision).

This therapy seeks to minimize the possibility of the infection spreading to the fetus by crossing the placental barrier.

Toxoplasmosis and cats (domestic and stray)

The cat is the first carrier of toxoplasmosis because toxoplasma gondii develops right in its intestine and the feces of the infected animal may contain cysts which will in turn infect other animals (including humans).

The cat becomes a carrier by eating infected animals, such as mice.

Rarely , therefore, can a domestic cat that eats canned foods be a carrier of toxoplasmosis.

Different for stray cats that are much more likely to be carriers of the disease or domestic cats that live in environments such as the countryside where they can be in contact with other infected animals.

The feces of the infected animal can come into contact with the vegetable through the soil or with the food through dirty hands and thus the toxoplasma cysts ingested by the human just by eating .

The sources of risk and good behavior

The main source of risk  is represented by the consumption of raw or undercooked meat .

For this reason, the main recommendations concern the cooking of the meat: temperatures above 62° C kill the microorganism.

As far as freezing meat is concerned, this practice decreases its infectivity but does not completely eliminate the risk. So better not to trust.

No raw sausages and wash the work surface and everything that comes into contact with raw meat (hands included) very well.

Even raw vegetables can be infected (and not only by toxoplasma) because they are in contact with the ground and must be washed carefully.

If we really want to be picky, flies can carry toxoplasmas by leaning first on the feces of infected cats and then on your food. So beware!

Another important vehicle of contagion is the practice of gardening and therefore contact with the earth where there may be feces of infected animals: always use gloves and always wash your hands after work and never bring them to your mouth.

Even stray cats (and therefore not domestic cats that can be managed without problems during pregnancy by adopting some precautions) can be a source of infection because they could feed on infected mice and birds and defecate in the ground where the toxoplasma survives for weeks .

Rules for preventing toxoplasmosis infection

  • The meats must always be well cooked : do not taste, do not touch your mouth and eyes while preparing it and your hands must always be washed thoroughly after handling the meat while it is cooking.
  • Avoid fresh or unseasoned sausages (aged for less than a month) or home-made products
  • Do not drink unpasteurized milk purchased in bulk from the farm
  • Fruit and vegetables must be washed well with Amuchina even if they have been purchased in ready-made packages
  • Always wear gloves while gardening
  • Wash hands well after any contact with soil , raw meat or unwashed vegetables
  • Always perform the toxo-test every 30-40 days
  • Take hygiene precautions in the presence of a cat

Table of foods that can transmit toxoplasmosis

Raw meats   RISK
Non-seasoned sausages (less than 30 days) (fresh sausage or salami) and/or family products   RISK
Smoked meat   RISK
Fresh vegetables/salads even if purchased pre-washed packaged   RISK
Bulk raw goat’s milk coming directly from the milking   RISK
Pasteurized milk   SAFE
Meat, even raw, consumed after freezing for at least 24 hours UNCERTAIN
Meat cooked at at least 60° C for a few minutes (dark color on the cut surface)   SAFE
Cured products for at least one month (raw ham, cured salami)   SAFE
Cooked ham, mortadella, cooked salami   SAFE

 

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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