Toxoplasmosis

The Toxoplasmosis is a disease that is transmitted from animals to humans. This so-called Zoonosis, is relatively harmless for the host (human) as long as it does not either contract HIV or is pregnant.

What is toxoplasmosis?

Toxoplasmosis in pregnant women is problematic because the first infection of the mother with the parasites can cause serious damage to the unborn child.
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People with poorly functioning immune systems (e.g. from HIV) become seriously ill with this disease caused by small parasites and babies in the womb can be seriously damaged by the Toxoplasmosis suffer.

The causative agent of the infectious disease toxoplasmosis is the parasite Toxoplasma gondii. These small, in technical jargon called "protozoa", preferentially attack cats, whereby the animals rarely suffer serious damage. The only effect the cats have when they first become infected is diarrhea, to which the massive excretion of eggs (oocysts) is linked. In this way the parasite spreads and finds a new host - the cycle of toxoplasmosis begins again.

causes

The causes of infections with Toxoplasma gondii, i.e. the development of a Toxoplasmosis is due to different infection cycles. There are three causes in total: First, the infection from final host to final host. This means that one cat infects another cat by shedding eggs through the faeces. The protozoa are released through digestion in the intestine, pass through the intestinal wall, pass into the blood and migrate to organs and tissue.

Next, the parasites multiply in the body cells and are again excreted in the cat's stool - that can be up to a million cysts per gram of stool, which is an important route of infection for humans.

In the so-called "definitive host-intermediate host cycle", cats become infected through contaminated rodent meat (e.g. through mice or rats). Infection from eating contaminated meat or transmission through the mother's placenta to the unborn child affects the "intermediate host-intermediate host cycles" in toxoplasmosis.

Symptoms, ailments & signs

The infection causes little or no symptoms in a healthy organism, so that it often goes unnoticed. Sometimes general symptoms appear, similar to the flu. Then there is fatigue, exhaustion and a fever. Diarrhea and sore muscles are also possible. The lymph nodes in the neck can swell.

In exceptional cases, the brain and eyes are also affected in a healthy person. Inflammation of the pericardium, lungs and liver is just as rare. However, if the immune system is weakened, for example in people with transplanted organs or in HIV patients, the infection causes much stronger symptoms.

There is often an inflammation of the connective tissue layer in the lungs, which leads to tissue changes. The result is fever, shortness of breath and a dry cough. In addition, the brain is severely affected. Neurological failures and limitations arise depending on which region of the brain is affected by the infection.

It can lead to seizures and paralysis on one side. Painful eyes and visual disturbances such as visual field loss, increased light sensitivity and blurred vision are also possible. If the infection continues to spread, it can damage multiple organs. Toxoplasmosis is particularly dangerous during pregnancy, as the pathogens can pass to the child and cause severe damage or even abortion.

Diagnosis & course

For the indirect proof of an already completed Toxoplasmosis the nurse takes blood from the patient, which is examined in the laboratory for antibodies against the pathogen. Toxoplasmosis in pregnant women is problematic because the first infection of the mother with the parasites can cause serious damage to the unborn child.

The later the pregnancy stage, the more dangerous the mother's toxoplasmosis becomes for the fetus. Infected children can have severe cognitive impairments and damage to eyes and organs such as the liver or lungs. A quarter of the babies infected with toxoplasmosis in the womb are born mentally disabled and have problems with epilepsy and spasticity.

It is all the more problematic that the costs for the examination of pregnant women are not covered by the statutory health insurance. In so-called "immunosuppressed" patients (HIV-infected or patients after a stem cell transplant) a particularly serious clinical picture, the so-called "cerebral toxoplasmosis", which is characterized by neurological deficits, appears.

Complications

Toxoplasmosis can only lead to complications in pregnant women and in the case of a weakened immune system. The mostly symptom-free disease sometimes leads to symptoms requiring treatment in those affected, such as heart muscle, lung or brain inflammation.

The most serious complication in connection with toxoplasmosis, however, is infestation of the unborn child by the pathogen. This happens in about half of all cases if the mother is infected with the pathogen. It is then relevant how early or late the unborn child was infected. Infected children at an early age are always harmed when they are born. There are a variety of symptoms.

Underweight and damage to the eye tissue are particularly common. Around a quarter of infected premature babies and an eighth of children who mature in the womb die as a result of the infection. Around half of the children affected have motor and mental development disorders.

In cases in which the fetus was infected later, later damage usually only occurs in the course of development. Often, blindness occurs as a result of eye damage. But mental disabilities are also possible as a result of a damaged brain. For healthy, non-pregnant people, toxoplasmosis has practically no risk of complications.

When should you go to the doctor?

In most cases, toxoplasmosis is symptom-free. People with previous illnesses may experience flu-like symptoms such as fever, fatigue, and headaches and body aches. A doctor's visit is necessary if noticeable symptoms occur that impair well-being. Then the family doctor must be consulted. Severe symptoms such as fever and fatigue require a specialist diagnosis. Balance disorders, symptoms of paralysis and seizures must also be clarified by a doctor. Toxoplasmosis is caused by infection with a bacterial pathogen.

If the symptoms arise in connection with the consumption of raw or poorly cooked meat, medical advice is required. Contact with infected cats and forest animals can also cause the disease. In the event of a specific suspicion, the doctor should be called in. Toxoplasmosis is treated by an internist. In severe cases, hospitalization is indicated. People who have become ill should have regular medical checkups to ensure that the disease has not broken out again. A regular medical check-up is necessary, mainly due to the relatively long incubation period of several weeks.

Treatment & Therapy

In contrast to other infectious diseases such as rubella or cytomegaly, toxoplasmosis can be treated during pregnancy. The earlier it is started, the better the prognosis for the infant.

Treatment differs depending on the week of pregnancy. Spiramycin is the drug of choice up to the 16th week of pregnancy, after which time a combination of several drugs (sulfadiazine, folinic acid and pyrimethamine) is indicated over a longer period (4 weeks). In patients with a weakened immune system, the doctor also treats them with a combination of the drugs sulfadiazine, folinic acid and pyrimethamine over the same period.

There is a relationship between the occurrence of toxoplasmosis in these patients and the number of helper T cells in the blood. If the number of helper cells falls below 200 / µl, prophylaxis with co-trimoxazole three times a week is sufficient to avoid the disease caused by toxoplasmosis.

You can find your medication here

➔ Medicines to strengthen the defense and immune system

prevention

The Toxoplasmosis is a serious danger, especially for pregnant women and their babies. To avoid infection with the pathogen, precautionary measures are essential. All sausages made from raw meat such as raw ham or tea sausage can contain cysts, as can naturally raw meat.

Therefore, you should refrain from enjoying these dishes. Of course, no pregnant woman should clean the litter box. Be careful with small cats, as they are more frequently infected with primary toxoplasmosis than adult animals. Washing your hands after cuddling is a must here to prevent infection with toxoplasmosis. At the beginning of the pregnancy, it is best if the woman completely refrains from contact with and dealing with cats.

Aftercare

Follow-up care for toxoplasmosis is usually limited to a few check-ups after the infection has been overcome, provided the patient has no complicating features. In healthy people, toxoplasmosis often goes largely unnoticed after infection and heals itself again. The main complications are infections during pregnancy and in immunosuppressive patients.

Follow-up care for a complication or an unusually severe course is essential. In pregnancy, after acute treatment, it must be ensured that the unborn child has not suffered any damage from the infection. There is also a risk of miscarriage or premature birth and must be strictly controlled by the relevant specialist.

Further treatment in generally healthy patients is usually not necessary. Depending on the doctor's assessment of the need for antibiosis, follow-up care can also focus on the direct consequences of antibiotic therapy. Basically, it can be said that the general condition or aggravating treatment circumstances of the patient must be looked at in order to design the follow-up care for the patient.

Since the infection is often caused by cats, the source of the infection should be identified and it should be ensured during the follow-up period at the latest that no further infections can occur. However, once an infection is over, immunity can be assumed as a result.

You can do that yourself

Toxoplasmosis infection is usually treated therapeutically. The patient is prescribed the active ingredients spiramycin or sulfadiazine, among other things, which should quickly relieve the symptoms.

In addition, hygiene measures apply. Pregnant women in particular should pay close attention to their personal hygiene and change their diet accordingly. For example, raw or insufficiently heated animal products should be avoided. In particular, pork, poultry and lamb should be avoided. Vegetables and fruits must be washed thoroughly before consumption or further processing. Regular hand washing is indicated in any case. This is especially true after gardening or visiting a playground. It is recommended to wear gloves when gardening. Cat owners should switch from fresh meat to canned food and clean the litter box with hot water daily. Otherwise, the dangerous pathogen can be transmitted.

Proven toxoplasmosis home remedies include coconut oil, sugar, and apple cider vinegar. Apple cider vinegar in particular helps with various symptoms of the condition. Sugar and coconut oil remove the nutrient medium from the parasites. In consultation with a homeopath, medicinal herbs and medicinal plants such as wormwood or bunias orientalis can also be tried. The information brochure of the Federal Institute for Risk Assessment contains further information on the prevention, diagnosis and treatment of toxoplasmosis.