toxoplasmosis during pregnancy

Symptoms
You probably won't know if you've contracted toxoplasmosis, although some people may develop toxoplasmosis symptoms similar to those of the flu or mononucleosis, such as:

Body aches Swollen lymph nodes Headache Fever Fatigue Occasionally, a sore throat

In people with weakened immune systems If you have HIV/AIDS, are receiving chemotherapy or have recently had an organ transplant, a previous toxoplasma infection may reactivate and you're more likely to develop signs and symptoms of severe infection, including:

Headache Confusion Poor coordination Seizures Lung problems that may resemble tuberculosis or Pneumocystis jiroveci pneumonia, a common opportunistic infection that occurs in people with AIDS Blurred vision caused by severe inflammation of your retina (ocular toxoplasmosis)

Risk of miscarriage and health problems

If you get toxoplasmosis in the early stages of pregnancy, the risk of miscarriage is increased. Its rare for the infection to pass to the baby during early pregnancy but, if it does, it can cause serious health problems.

In babies If you become infected for the first time just before or during your pregnancy, you have about a 30 percent chance of passing the infection to your baby (congenital toxoplasmosis), even if you don't have signs and symptoms yourself.

Your baby is most at risk of contracting toxoplasmosis if you become infected in the third trimester and least at risk if you become infected during the first trimester. On the other hand, the earlier in your pregnancy the infection occurs, the more serious the outcome for your baby. Many early infections end in stillbirth or miscarriage, and children who do survive are likely to be born with serious problems, such as:

Seizures An enlarged liver and spleen Yellowing of the skin and whites of the eyes (jaundice) Severe eye infections

Only a small number of babies who have toxoplasmosis show signs of the disease at birth. Often, infected children don't develop signs and symptoms including hearing loss, mental disability or serious eye infections until their teens or later.

Treating toxoplasmosis
Most cases of toxoplasmosis are mild and do not require treatment. Either no symptoms develop or a full recovery is made without complications. If you are diagnosed with toxoplasmosis, your GP will recommend the most appropriate treatment plan for you. This will depend on your health and what symptoms you have. If you have severe symptoms you may be prescribed a combination of pyrimethamine and sulfadiazine, or a medication called azithromycin which is given on its own. Folic acid supplements may also be recommended. This treatment is usually given for three to six weeks. If further courses of treatment are required, there will be a rest period of two weeks in between. .
Pregnant women

If you are pregnant and become infected with toxoplasmosis for Most cases of toxoplasmosis are mild and do not require treatment. Either no symptoms develop or a full recovery is made without complications. If you are diagnosed with toxoplasmosis, your GP will recommend the most appropriate treatment plan for you. This will depend on your health and what symptoms you have. If you have severe symptoms you may be prescribed a combination of pyrimethamine and sulfadiazine, or a medication called azithromycin which is given on its own. Folic acid supplements may also be recommended.

This treatment is usually given for three to six weeks. If further courses of treatment are required, there will be a rest period of two weeks in between. .
Pregnant women

If you are pregnant and become infected with toxoplasmosis for the first time, you may be treated with an antibiotic called spiramycin. Spiramycin may reduce the risk of your unborn baby becoming infected and limit the severity of congenital toxoplasmosis if your baby does become infected. There is some evidence to suggest that the earlier treatment starts, the lower the risk of congenital toxoplasmosis. However, in most cases, whether or not your baby becomes infected will depend on when you were infected. Overall, about 30-40% of mothers who are infected with toxoplasmosis give birth to a baby with congenital toxoplasmosis. Antibiotic treatments are not always effective at preventing the damage caused by congenital toxoplasmosis in the unborn baby. Sulfadiazine plus pyrimethamine are usually prescribed in cases where tests show that the baby has become infected in the womb (congenital infection). However, until more research has been carried out, these antibiotics remain the most effective form of treatment for toxoplasmosis.
Congenital toxoplasmosis

If your baby is born with congenital toxoplasmosis, he or she will be examined to see whether the infection has caused any damage. They will have the following tests:

Bloodtest...blood will be taken either from a vein in your babys arm or by pricking the skin of their heel, and the sample will then be tested for toxoplasmosis antibodies

eye examination - an ophthalmologist (a specialist in diagnosing and treating eye conditions) will examine your babys eyes to check for any lesions at the back of the eye (affecting the retina choroid) an x-ray or scan - may be taken of your babys head to check for any brain damage

Congenital toxoplasmosis is usually treated with antibiotics. These will probably be a combination of pyrimethamine plus sulfadiazine. Pyrimethamine and sulfadiazine have been found to be effective for moderately and severely affected babies. One study found that 72% of babies with moderate or severe congenital toxoplasmosis had normal intelligence and motor function by their early teenage years. Treatment with these medications may continue for up to a year. Unfortunately, some babies with congenital toxoplasmosis develop long-term disabilities because it is not possible for antibiotics to undo any damage that has already been done. It is also possible for eye infections to reoccur at a later stage of childhood.

Preventing toxoplasmosis
The advice outlined below may help to reduce your risk of developing a toxoplasmosis infection.

Wear gloves when gardening, particularly when handling soil - also, wash your hands thoroughly afterwards with soap and hot water. Do not eat raw or undercooked meat - particularly lamb, pork and venison, including any ready-prepared chilled meals. Cook all red meat until no trace of pinkness remains and the juices run clear. Do not taste meat before it is fully cooked. Wash your hands thoroughly after handling raw meat.

Wash all kitchenware thoroughly after preparing raw meat. Always wash fruit and vegetables before cooking and eating - this includes readyprepared salads. Avoid drinking unpasteurised goats' milk or eating products that are made from it. Do not handle or adopt stray cats. Avoid cat faeces in cat litter or soil - wear gloves if you are changing a cats litter tray and wash your hands thoroughly afterwards. If you are pregnant or immune deficient, ask someone else to change it for you. Feed your cat dried or canned cat food rather than raw meat.

It is important that pregnant women and those with a weakened immune system follow this advice to avoid becoming infected. Pregnant women should avoid contact with sheep and newborn lambs during the lambing season because there is a small risk that an infected sheep or lamb could pass the infection on at this time.