I’m pregnant – what do I need to know about toxoplasmosis | Dr. Justine Lee, DACVECC, DABT, Board-certified Veterinary Specialist

Posted by justinelee in Animal Safety, Blog, Pet Health

Toxoplasmosis: I’m pregnant. Do I have to worry about toxoplasmosis?

In today’s blog, Dr. Justine Lee reviews toxoplasma. As a veterinarian, this freaked me out as a pregnant mother too! Toxoplasma – often called “toxo” – is a type of parasite that cats can carry within their body. While some cats can become sick from toxoplasmosis, some cats are never affected from toxoplasma; that said, they can become carriers of the infection (e.g., carry it within their body without being affected by it). This can be of concern, as toxoplasma is considered a zoonotic disease – this means that the disease can spread to humans too. Cats can shed toxoplasma in their feces, which poses a potential risk to you.

Cats are typically exposed to toxoplasmosis when they go outside and hunt; that’s because wildlife may also carry toxoplasma, and if your cat potentially eats dead carrion (e.g., mice, rats, voles, etc.), your cat can be exposed. Likewise, outdoor exposure to fecal material from an infected cat (e.g., in the soil) can result in contamination of the environment – potentially exposing you and your cat. (This is one of the reasons why veterinarians often advocate that cats stay indoors.) When your cat defecates – even inside in the litter box, it can potentially spread toxoplasma to you.

The three most common sources of toxoplasmosis exposure to humans include:

• Cleaning litter boxes
• Gardening outside (where other cats may be defecating in the garden and exposing the soil to toxoplasma)
• Inappropriate hygiene while handling raw meat or ingestion of rare or raw meat

In affected cats, toxoplasmosis can cause fever, inflammation of the eye, inflammation of the pancreas, pneumonia-like changes, or even neurologic signs. In humans, toxoplasmosis can result in spontaneous abortion (e.g., miscarriage). Also, exposure to the unborn human fetus can result in mental impairment and birth defects.

That’s why it’s so important for women who are pregnant to use caution to avoid toxoplasma exposure. Decades ago, medical doctors used to tell you to get rid of your cat if you were pregnant. Thankfully, this myth has been debunked and it’s no longer necessary to get rid of your cat(s). That said, women who are pregnant still need to take avoid exposure to toxoplasmosis by avoiding contact with cat feces. (See Prevention below)

Breeds predisposed
Cats that are outdoors, hunters, eat raw meat (e.g., raw food diet), immunosuppressed (e.g., feline immunodeficiency virus, feline leukemia, on chemotherapy, on chronic steroids, etc.) or are very young are more at risk of being exposed to toxoplasma.

Diagnosis
There is a blood test that your veterinarian can perform to test your cat (and you) for toxoplasma exposure. If your cat tests positive, it means exposure to toxoplasma has occurred in the past, and that your cat may be a carrier. A positive test does not necessarily mean that your cat needs to be treated with antibiotics; it means that your cat – at some point – was exposed and may carry the infection. However, even if the test is negative, caution should still be observed to prevent toxoplasma exposure to you.

As for humans, there is also a similar blood test. Ask your medical doctor about getting tested for toxoplasma yourself. If you test positive for toxoplasmosis while pregnant, this is actually good; it means that in the past, you have been exposed and that your immune system can likely fight it off. A negative toxoplasma titer in you means that your immune system has not been exposed, and if you are currently pregnant, you want to make sure to avoid any exposure to toxoplasma at all to protect your unborn baby.

Treatment
Certain antibiotics (e.g., clindamycin) can treat active toxoplasmosis infections in cats. Unless your cat has active infection or signs consistent with toxoplasmosis, treatment is typically unnecessary.

Prevention
The best way to prevent toxoplasma exposure to you and your cat is to do the following:

• Keep your cat indoors to avoid exposure through hunting.
• If you do let your cat outdoors, do so supervised on a leash.
• Avoid feeding a raw diet to your cat to prevent exposure to toxoplasmosis and other types of bacteria.
• Use gloves while gardening (or handling soil) outside.
• If you have a sandbox in your backyard, make sure to cover it when not in use. It looks like a gigantic kitty litter box to other outdoor cats or stray cats. If they defecate within the box, it can result in accidental exposure to you.
• Fence off your garden (e.g., chicken wire fencing and netting) to prevent outdoor cats from defecating in your garden and exposing your vegetables to toxoplasma.
• Use caution when handling raw meat and make sure to implement appropriate hygiene (e.g., washing hands thoroughly with warm water and soap, etc.).
• Avoid the ingestion of raw or rare meat while pregnant.
• Avoid cleaning the litter box and have another family member do so while pregnant. If you must, make sure to dispose of feces within 24 hours to prevent toxoplasma from “hatching” into its infectious, dangerous form. Use appropriate hygiene after handling a litter box (e.g., wearing gloves, washing hands thoroughly with warm water and soap, avoiding touching your face immediately after handling, etc.).
• Avoid contact with stray, unknown, or outdoor cats while you are pregnant. That means no volunteering at shelters to clean cages while pregnant!

Prognosis
The prognosis for cats infected by toxoplasma varies, and depends on how severe the infection may be. While there is an antibiotic to treat toxoplasmosis, it can result in significant inflammation in your cat’s body if he or she does develop it.

The best way to keep you and your unborn child safe is to avoid exposure to toxoplasma while pregnant. When in doubt, consult your veterinarian or medical doctor for additional information.