Toxoplasmosis symptoms during pregnancy

Toxoplasmosis | March of Dimes

Toxoplasmosis is an infection you can get from eating undercooked meat or touching cat poop.

Most times, there are no symptoms so you may not know that you have toxoplasmosis.

If you get toxoplasmosis just before or during pregnancy, you may pass it to your baby.

Toxoplasmosis can cause problems during pregnancy, including miscarriage, preterm birth or stillbirth.

Most babies born with toxoplasmosis have no symptoms. Symptoms can include eye infections, swollen glands, liver or spleen, or jaundice.

Toxoplasmosis is an infection you can get from eating undercooked meat or touching cat poop or a litter box. It’s caused by a very common parasite called Toxoplasma gondii. The parasite is so tiny you can’t see it.

More than 40 million people in the United States may have the parasite. Very few people have symptoms because a healthy immune system usually keeps the parasite from causing an infection. However, toxoplasmosis can cause health problems for you and your baby during pregnancy.

How do you get infected with toxoplasmosis?

You can come in contact with the parasite that causes the infection through:

Eating raw or undercooked meat or shellfish
Eating unwashed fruits and vegetables
Touching cat litter or poop
Touching kitchen utensils and cutting boards used to prepare raw or undercooked meat and fruits and vegetables
Touching dirt or sand
Touching stray cats

What are the signs and symptoms of toxoplasmosis?

You may not know if you have the infection. Many times there are no symptoms. For some people, it feels like the flu. Symptoms can include:

Achy muscles
Headache
Fatigue (tiredness)
Fever
Swollen glands
Blurry vision
Eye redness

These symptoms can last for a month or longer. If you think you have toxoplasmosis, talk to your health care provider. Your provider can give you a blood test to find out if you have the infection. Even though blood tests are a regular part of prenatal care, you don’t usually get tested for toxoplasmosis. So be sure to talk to your provider if you think you have the infection.

Can toxoplasmosis cause problems before pregnancy?

If you have toxoplasmosis within 6 months of getting pregnant, you may be able to pass it to your baby during pregnancy. Talk to your health care provider about being tested. Wait 6 months after a toxoplasmosis infection before trying to get pregnant.

Can toxoplasmosis cause problems during pregnancy?

Yes. Pregnancy complications caused by toxoplasmosis include:

Preterm birth – Birth that happens before 37 weeks of pregnancy
Stillbirth – When a baby dies after 20 weeks of pregnancy
Miscarriage -- When a baby dies before 20 weeks of pregnancy

If you get toxoplasmosis just before or during pregnancy, you may pass the infection to your baby even if you don’t have any symptoms. The risk of passing the infection to your baby depends on how far along in your pregnancy you were when you were infected. The later in your pregnancy that you get infected (third trimester), the more likely it is that your baby will also get infected. But the earlier in pregnancy you get infected, the more serious the baby’s problems may be after birth. For example, your baby could have damage to the liver, brain and eyes. Up to 1 in 2 babies (50 percent) who are infected with toxoplasmosis during the pregnancy are born early (preterm). Some infected babies may die.

If you have toxoplasmosis during pregnancy, there are several ways your health care provider can check to see if your baby is infected:

Amniocentesis. An amniocentesis (also called amnio) can test the fluid around your baby for infection. You can get this test at 15 to 20 weeks of pregnancy. It also can be tested for other problems with the baby, like birth defects or genetic problems.

Ultrasound. About 1 in 3 babies infected with toxoplasmosis have a problem that can be seen on an ultrasound. Ultrasound (also called sonogram) is a prenatal test that uses sound waves to show a picture of your baby before they are born. Ultrasound helps your provider check on your baby’s health and development. Most pregnant people get an ultrasound in their second trimester at 18 to 20 weeks of pregnancy.

Blood test. Your baby’s blood can be tested for toxoplasmosis after birth.

How can toxoplasmosis during pregnancy harm your baby?

Most babies born with toxoplasmosis have no symptoms. But about 1 in 10 babies (10 percent) with the infection are born with problems, including:

Eye infections or eye inflammation
Swollen liver and spleen
Jaundice (when a baby's eyes and skin look yellow.)
Seizures or convulsions
Fluid on the brain (hydrocephalus)
Swollen lymph nodes
Large head size (macrocephaly) or smaller-than-normal head size (microcephaly)
Feeding problems
Low birthweight
Skin rash or bruising

Without treatment, newborns may develop problems later in life, even if they show no symptoms earlier. This can happen even 20 or 30 years later. These problems include:

Intellectual and developmental disabilities (problems with how the brain works that can cause your baby trouble or delays in physical development, learning, communicating, taking care of themselves or getting along with others).
Eye infections and vision problems
Pneumonia
Cerebral palsy (a group of conditions that affects the parts of the brain that control the muscles. It can cause problems with movement, posture,standing up straight and balance).
Seizures or convulsions
Hearing loss

Each year, between 800 and 4,400 babies in the United States are born with toxoplasmosis. If you think you had toxoplasmosis during pregnancy, be sure your baby is tested.

How is toxoplasmosis treated during pregnancy?

If you are infected during pregnancy, both you and your baby should be closely monitored during your pregnancy and after the baby is born. Getting treated with certain antibiotics helps reduce the chance of your baby getting toxoplasmosis. Antibiotics are medicines that treat certain types of infections. This treatment also helps reduce the seriousness of any symptoms your baby may have.

If you’re infected before 18 weeks of pregnancy, your provider may give you an antibiotic called spiramycin. This medicine helps reduce the chance of your baby getting the infection.

If you’re infected after 18 weeks of pregnancy, your provider may give you different antibiotics called pyrimethamine, sulfadiazine or leucovorin. These medicines are recommended for use after 18 weeks of pregnancy. If you take them before 18 weeks of pregnancy, they may cause birth defects in your baby.

How is toxoplasmosis treated in your baby after birth?

If your baby shows symptoms of toxoplasmosis, the provider may treat your baby with antibiotics. Your baby may continue these antibiotic treatments until their first birthday, sometimes even longer.

Should you nurse your baby if you had toxoplasmosis during pregnancy?

Yes. Your provider can give you a blood test to find out if you are still infected. If you are healthy and no longer infected, the chances of giving your baby toxoplasmosis while nursing is very small. Don’t nurse your baby if you have cracked and bleeding nipples or breast inflammation if you were infected recently.

How can you prevent toxoplasmosis?

Here’s how to protect yourself from toxoplasmosis:

Don’t eat raw, undercooked or contaminated meat, especially lamb, pork or venison. Cooked meat should not look pink, and the juices should be clear. Use a meat thermometer to check the temperature of the meat before you eat it.
Don’t eat raw, undercooked or contaminated shellfish, such as oysters, clams or mussels.
Do not drink raw milk, especially goat’s milk.
Wash your hands with soap and water after handling fruits, vegetables or raw meat, poultry (such as chicken or turkey) or shellfish.
Don’t touch your eyes, nose or mouth when handling raw meat.
Clean cutting boards, work surfaces and utensils with hot, soapy water after using them with fruits, vegetables or raw meat.
Peel or thoroughly wash all raw fruits and vegetables before eating.
Use work gloves when you’re gardening. Wash your hands afterward.

If you have a cat:

Don’t let your cat go outside your home, where it may eat spoiled food or come in contact with the parasite.
Change your cat’s litter box daily. Ask someone else to clean the litter box. If you have to do it yourself, wear gloves. Wash your hands thoroughly when you’re done emptying the litter.
Only feed your cat canned or dried cat food from the store or well-cooked table food. Don’t feed your cat raw or uncooked meat.
Stay away from children’s sandboxes. Cats like to use them as litter boxes.
Don’t touch stray cats or kittens.

Last updated August 2021

Toxoplasmosis - Symptoms and causes

Overview

Toxoplasmosis (tok-so-plaz-MOE-sis) is an infection with a parasite called Toxoplasma gondii. People often get the infection from eating undercooked meat. You can also get it from contact with cat feces. The parasite can pass to a baby during pregnancy.

Most people infected with the parasite do not have symptoms. Some people get flu-like symptoms. Serious disease most often affects infants and people with weakened immune systems. Toxoplasmosis during pregnancy may cause miscarriage and birth defects.

Most infections don't need treatment. Drug treatment is used for people with more-serious cases, pregnant people, newborns and people with weakened immune systems. Several steps to prevent toxoplasmosis can lower the risk of infection.

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Symptoms

Most people infected with toxoplasmosis do not have any symptoms. They often don't know they're infected. Some people have flu-like symptoms, including:

Fever.
Swollen lymph nodes that may last for weeks.
Headache.
Muscle aches.
Skin rash.

Symptoms of eye disease

The toxoplasma parasites may infect tissues of the inner eye. This can occur in people with healthy immune systems. But the disease is more serious in people with weakened immunity. An infection in the eye is called ocular toxoplasmosis. Symptoms may include:

Eye pain.
Poor vision.
Floaters, which are specks that seem to swim in your vision.

Untreated eye disease can cause blindness.

Effect on people with weakened immune systems

People with weakened immune systems are likely to have more-serious disease from toxoplasmosis. A toxoplasmosis infection from earlier in life may become active again. People at risk include those living with HIV/AIDS, people receiving cancer treatment and people with a transplanted organ.

In addition to serious eye disease, toxoplasmosis can cause severe lung or brain disease for a person with weakened immunity. Rarely, the infection can show up in other tissues throughout the body.

Lung infection may cause:

Breathing problems.
Fever.
Cough.

Toxoplasmosis may cause inflammation of the brain, also called encephalitis. Symptoms may include:

Confusion.
Poor coordination.
Muscle weakness.
Seizures.
Changes in alertness.

Effect on fetus or infant

Toxoplasmosis can pass from the mother to the fetus during a pregnancy. This is called congenital toxoplasmosis.

Infection during the first trimester often causes more-severe disease. It also may result in miscarriage. For some babies with toxoplasmosis, serious disease may be present at birth or appear early in infancy. Medical problems may include:

Too much fluid in or around the brain, also called hydrocephalus.
Severe eye infection.
Irregularities in brain tissues.
An enlarged liver or spleen.

Symptoms of severe disease vary. They may include:

Problems with mental or motor skills.
Blindness or other vision problems.
Hearing problems.
Seizures.
Heart disorders.
Yellowing of the skin and whites of the eyes, also called jaundice.
Rash.

Most babies with toxoplasmosis do not show symptoms. But problems may show up later in childhood or teenage years. These include:

Return of eye infections.
Problems with motor skill development.
Problems with thinking and learning.
Hearing loss.
Slowed growth.
Early puberty.

When to see a doctor

Talk to your health care provider about a test if you are worried about exposure to the parasite. If you are planning a pregnancy or are pregnant, see your provider if you suspect exposure.

The symptoms of severe toxoplasmosis include blurred vision, confusion and loss of coordination. These need immediate medical care, particularly if you have a weakened immune system.

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Causes

Toxoplasma gondii is a parasite that can infect most animals and birds. It can only go through the entire cycle of reproduction in domestic and wild cats. These are the main hosts for the parasite.

Immature eggs, a middle stage of reproduction, can be in the feces of cats. This immature egg allows for the parasite to make its way through the food chain. It can pass from soil and water to plants, animals and humans. Once the parasite has a new host, the reproduction cycle goes on and causes an infection.

If you're in typical health, your immune system keeps the parasites in check. They stay in your body but are not active. This often gives you lifelong immunity. If you're exposed to the parasite again, your immune system would clear it out.

If your immune system is weakened later in life, parasite reproduction can start again. This causes a new active infection that can lead to serious disease and complications.

People often get a toxoplasma infection one of the following ways:

Cat feces with the parasite. Cats that hunt or who are fed raw meat are more likely to carry toxoplasma parasites. You may get infected if you touch your mouth after touching anything that has been in contact with cat feces. This may be gardening or cleaning a litter box.
Contaminated food or water. Undercooked beef, lamb, pork, venison, chicken and shellfish are all known carriers of the parasite. Unpasteurized goat milk and untreated drinking water also may be carriers.
Unwashed fruits and vegetables. The surface of fruits and vegetables may have the parasite on them.
Contaminated kitchen tool. Parasites may be on cutting boards, knives and other utensils that come into contact with raw meat or unwashed fruits and vegetables.
Infected organ transplant or transfused blood. Rarely, toxoplasma parasites are passed through an organ transplant or blood transfusion.

Risk factors

The parasite is found throughout the world. Anyone can become infected.

Risks of serious disease from toxoplasmosis include things that prevent the immune system from fighting infections, such as:

Infection with HIV/AIDS.
Chemotherapy treatment for cancer.
High-dose steroids.
Drugs that prevent the rejection of transplanted organs.

Prevention

Certain precautions can help prevent toxoplasmosis:

Wear gloves when you garden or handle soil. Wear gloves when you work outdoors. Wash your hands with soap and water afterward.
Don't eat raw or undercooked meat. Use a meat thermometer to make sure meat is cooked enough. Cook whole meats and fish to at least 145 F (63 C) and let rest for at least three minutes. Cook ground meat to at least 160 F (71 C). Cook whole and ground poultry to at least 165 F (74 C).
Don't eat raw shellfish. Do not eat raw clams, mussels or oysters, particularly during pregnancy.
Wash kitchen utensils thoroughly. Wash cutting boards, knives and other utensils with soapy water after contact with raw meats or unwashed fruits and vegetables. Wash your hands thoroughly before and after preparing foods.
Wash all fruits and vegetables. Wash fresh fruits and vegetables before eating, peeling or cooking.
Don't drink unpasteurized goat milk. Avoid unpasteurized goat milk or products made from the milk.
Don't drink untreated water. During pregnancy, do not drink untreated water.
Cover children's sandboxes. Cover sandboxes to prevent outdoor cats from using them as litter boxes.

For cat lovers

If you're pregnant or otherwise at risk of toxoplasmosis, take these steps to protect yourself:

Help your cat stay healthy. Keep your cat indoors. Feed it dry or canned cat food, not raw or undercooked meat.
Avoid stray cats or kittens. Avoid stray cats, especially kittens. Do not get a new cat when you're pregnant.
Have someone else clean the litter box. Clean the box daily, if possible. If someone else can't clean it, wear gloves and a face mask to change the litter. Then wash your hands well.

By Mayo Clinic Staff

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Toxoplasmosis during pregnancy

Toxoplasmosis during pregnancy is dangerous. Its pathogen belongs to the group TORCH infections that can penetrate the fetus through the placenta and cause Problems. From the article you will learn more about toxoplasmosis - how to identify and when to treat.

Contents of the article

How you can get toxoplasmosis

The causative agent is Toxoplasma (the simplest intracellular parasite). Its carriers are mostly domestic animals. Toxoplasma finally settles in the body of cats, but can choose birds and mammals as an intermediate place of residence. Sick animals infect the soil, grass, vegetable gardens.

The main ways of infection with toxoplasmosis during pregnancy:

eating undercooked or raw meat, as well as unwashed vegetables, herbs;
work with the earth, for example in a vegetable garden;
interaction with cat waste products;
organ transplant, blood transfusion;
in utero - from mother to fetus.

The causative agent is not transmitted from a sick person through sexual or airborne droplets. During pregnancy, 1% of women become infected with toxoplasmosis, while 20% pass the infection to the fetus.

Causes of toxoplasmosis during pregnancy

If a woman had an infection long before pregnancy - in childhood or adolescence, then the disease is not dangerous for her. After suffering toxoplasmosis, antibodies are formed that protect the mother and baby.

However, if the infection occurred within six months before conception, the health of the mother and child may be at risk. It takes time for the formation of antibodies - at least 6 months after the disease. Accordingly, when they are not there yet, the pathogen can re-penetrate and harm the fetus.

There are also cases of chronic toxoplasmosis - when the infection proceeds in a latent form and is activated when immunity is reduced in pregnant women.

During pregnancy, contact with animals should be avoided, and, if possible, visiting regions with a high prevalence of toxoplasma: Africa, the Middle East and Latin America should be excluded.

Symptoms of toxoplasmosis in pregnant women

The infection has no pronounced manifestations. The most severe signs of toxoplasmosis in pregnant women appear in case of reduced immunity. In the acute course of the disease, the symptoms are similar to a viral disease (flu, SARS): the temperature rises to 38‒39degrees, the lymph nodes are enlarged, the woman feels weak and weak. Headaches and muscle pain may also join.

In most cases, the entry of the pathogen into the body does not cause the development of the disease. Toxoplasmosis manifests itself in a mild form, sometimes goes unnoticed, and a person learns about the disease from tests.

The likelihood of a more severe course increases if the body is weakened. Therefore, with toxoplasmosis in pregnant women, the likelihood of clinical complications is higher.

Fetal effects

In the first trimester, the greatest risk of severe consequences is when the fetus is infected, since the laying of organs and systems in the baby occurs. However, the risk of infection is lower. And at a later date, toxoplasmosis is less dangerous for the fetus, but it is easier for a woman to get infected with it.

The severity of the consequences depends on the gestational age:

Up to 8-9 weeks, the risk is no more than 20%, but leads to severe malformations and even intrauterine death. Among the frequent consequences: stillbirth, absence of a brain in a child, hydrocephalus, liver enlargement, severe organic pathologies.
At 9-18 weeks, the risk of infection is approximately 25%. The danger is in severe damage to the brain, liver, eyes, as well as the appearance of convulsive syndrome and fever in an infant.
At 18‒25 weeks, the risk is approximately 65%. Infection leads to dysfunction of organs in a child. Jaundice, anemia, enlargement of the liver, spleen are possible.
At 26-40 weeks, the risk of infection of the fetus from the mother is high - up to 80%. Subsequently, the child may develop deafness, epileptic seizures, mental retardation.

If a child had an acute infection in the 2nd trimester, then more often at birth, chronic or overt (with severe clinical symptoms) toxoplasmosis is diagnosed. In the first case, complications may appear a few months after birth or already in adolescence.

If infected in the last weeks of pregnancy, a child is likely to be born with signs of acute congenital toxoplasmosis, accompanied by fever, rash, jaundice, pneumonia, and gastrointestinal upset.

Diagnosis of toxoplasmosis during pregnancy

To reliably determine the infection, it is necessary to take tests. Laboratory diagnosis of toxoplasmosis is carried out by the methods of RNIF and ELISA. In the blood of a pregnant woman, the presence or absence of antibodies of class M and G is determined:

If no antibodies are found, then the woman was not infected at all. This means that there is a risk of infection entering the body during pregnancy.
If antibodies of class G less than 40 U/ml are detected, it is possible to speak about the carriage of Toxoplasma without the risk of infection of the fetus.
With G values over 200 U/ml and absence of M antibodies, the diagnosis is chronic acquired toxoplasmosis. In this case, specific treatment is not required.
If both types of antibodies increase, the situation indicates an acute infection.

If there is no suspicion of pathology, the examination is carried out 1-2 times during pregnancy. If there are warning signs, the doctor may prescribe to donate blood regularly. To detect intrauterine toxoplasmosis in children, amniocentesis (analysis of amniotic fluid), as well as cordocentesis (examination of umbilical cord blood), assess the likely signs of pathology on ultrasound. If an infection is detected in the fetus in combination with signs of damage on ultrasound, it is recommended to terminate the pregnancy.

Treatment of toxoplasmosis in pregnant women

Treatment of pregnant women for the prevention of congenital toxoplasmosis in the fetus is not carried out. With proven infection of the expectant mother in the first trimester, it is recommended to terminate the pregnancy, and if there is a threat of miscarriage, preservation therapy is not carried out.

Starting from the second trimester, the question is whether to treat the pregnant woman:

After 12 weeks, with a reliably accurate test result, an additional examination is carried out. In this case, interruption according to indications is also possible. But at such times, if a woman refuses to interrupt, the disease can be treated with specific drugs against Toxoplasma.
Treatment is provided by a gynecologist and an infectious disease specialist. Therapy involves taking strong antibacterial drugs, in some cases, antimalarial and antiparasitic drugs are used. You can start drinking such medicines no earlier than 12-16 weeks.
The treatment has side effects, so the doctor individually determines the dosage, correlates the risk and benefit, and makes important recommendations. Therapy has been shown to reduce the risk of infant mortality and neurological damage from congenital toxoplasmosis.
Chronic toxoplasmosis is treated before or after pregnancy. In the absence of complaints and clinical manifestations in the mother and fetus, the woman is observed, but specific therapy is not prescribed.

Toxoplasmosis in pregnant women is not an indication for caesarean section. A woman can give birth naturally.

Prophylaxis

Tips to help reduce the chance of infection during pregnancy:

Maintain good personal hygiene. Wash your hands before and after eating, and especially after interacting with any pets and visiting public places.
Eat only well-done or long-cooked meat, wash vegetables and fruits thoroughly with boiled water.
Avoid close contact with cats, especially outdoor cats, do not litter box.
Regularly undergo examinations: screenings, tests, ultrasound.
Wear gloves when working on the ground or in sand.

The danger of infection is not so great, but if you are planning a pregnancy or are already in happy expectation, keep your finger on the pulse. It is much easier to take the proper steps to avoid contracting a dangerous infection than to try to treat it during pregnancy. Take care of yourself and your future baby!