Toxoplasmosis, not only from cats: what it is, symptoms, therapy


“Don’t touch the cat”. This warning is often addressed to pregnant women, who – together with their belly – see their phobia towards domestic felines grow, considered the main “infectors” for the toxoplasmosis. “In fact, the parasite responsible for this disease can infect many animals, not just cats, including reptiles, molluscs and birds,” says Dr. Nicholas Castaldinispecialist in internal medicine at the San Pier Damiano Hospital in Faenza, Ravenna.

«Moreover, usually, the problem does not concern apartment cats, which feed on controlled foods and which hardly come into contact with other animals, grasses or contaminated soil. Furthermore, their litter box is cleaned regularly, while the parasite oocysts hatch after three days at room temperature and high humidity conditions. This means that the real feline reservoir of this infection are the Stray catsalthough according to the most recent data, the main source of transmission is the consumption of inadequately cooked meatwhich causes 65 percent of infections.

What is toxoplasmosis

Toxoplasmosis is a parasitic infection caused by a microorganism (the Toxoplasma gondii) which can be transmitted from animals to humans. «It is therefore part of the great chapter of zoonosisa natural phenomenon with which man has lived for thousands of years, because the “jump of species” is not a novelty of our times», explains Dr. Castaldini.

«Contagion can occur through ingestion of the meat of an infected animalparticularly if consumed raw or inadequately cooked, or more frequently through fecal-oral transmission, possible in several ways: for example, by eating contaminated fruit or vegetablestouching the eyes or mouth after cleaning the litter box of an infected cat, gardening in soil contaminated by the faeces of an animal with toxoplasmosis.

Because toxoplasmosis can reactivate itself

Usually, after having contracted the first infection (primary toxoplasmosis), specific antibodies and lymphocytes are produced in the body which protect for life from subsequent infections: there is, however, a secondary form (post-primary toxoplasmosis) characterized by the absence of signs clinical and laboratory tests of the acute infection, but with the persistence of the parasite in the body, “settled” in the muscles and in the brain.

When the immune system fails, the microorganism can reactivate, become aggressive again and induce new damagesi with a mechanism very similar to that of herpes simplex, which occasionally surfaces on the lips or face, perhaps when we are sick or particularly tired or stressed.

What are the symptoms of toxoplasmosis

In healthy adults, the Toxoplasma gondii it results in an asymptomatic or at least mild infection, which resolves on its own within a few days. “Sometimes they can develop flu-like symptomssuch as low-grade fever, body aches, headache, tiredness, general malaise and swollen lymph nodes, like any other infection,” describes Dr. Castaldini.

«The case of immunosuppressed subjects is different, such as people affected by HIV, cancer patients, transplant recipients and in general those taking immunosuppressant therapies: in this case, the acute infection can be very severe and generate, for example, encephalitis or serious eye problems, such as chorioretinitisan inflammation that affects the back area of ​​the eye and can cause irreversible damage to vision».

Toxoplasmosis, what are the risks in pregnancy

A particularly delicate period is pregnancy, when the infection contracted by the expectant mother can be transmitted to the fetus through the placenta. «Depending on the quarter in which this happens, they can arise malformations in the unborn child or even miscarriage or death in utero», warns Dr. Castaldini.

«That’s why among the tests of the first trimester of pregnancy the execution of the Toxo test, a simple blood test aimed at discovering the immunization status against toxoplasmosis. If specific antibodies are detected, the so-called “memory antibodies”means that the woman has already been infected and can rest assured; if you don’t have antibodies, you need to repeat the test every month and follow some hygiene rules to avoid contagion; if, on the other hand, you have IgM type antibodies, which indicate an acute or subacute infection, you need to think about the need to proceed with a specific antibiotic therapy ».

How is toxoplasmosis treated?

Once the infection has been ascertained, it is possible to administer to the future mother or to the subject with severe symptoms specific drugs (antibiotics) which can eradicate Toxoplasma gondii and avoid major repercussions.

«In pregnancy, the most used therapy is the one with spiramycin, well tolerated by both the mother and the fetus, but there are even more effective antibiotic combinations, such as pyrimethamine and sulfadiazine, which are mandatory when the presence of the parasite is confirmed in the amniotic fluid. Thanks to the current treatment possibilities, around 90 percent of children are born without obvious symptoms and test negative,” assures the expert.

How to prevent toxoplasmosis

At the moment, there is no vaccine against toxoplasmosisfor which prevention passes through a series of behaviors and practices that can reduce the risk: often replace the cat litter box (in case of pregnancy, it is better to delegate this task) and avoid contact with their feces, do not consume raw meat (including the cold cuts) or undercooked, carefully wash fruit and vegetables under running water (always to be cooked during pregnancy), carefully clean utensils and kitchen surfaces that have come into contact with raw ingredients, use rubber gloves for activities involving contact with potentially contaminated materials (such as gardening), avoid consuming raw seafood (especially mussels, scallops and oysters).

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