Toxoplasmosis symptoms in humans
Toxoplasmosis is an infectious disease caused by parasites which is widespread throughout the world. For the pathogens, man is only an intermediate host, the main host is cats.
The toxoplasmosis transmission is mainly carried out by raw and insufficiently heated meat products as well as by contact with contaminated food or soil. Usually the infection does not cause any discomfort. However, the toxoplasmosis can be severe, especially in the case of immune-weakened and pregnant women. Read here all the important information about toxoplasmosis and how you can protect yourself against the disease.
Toxoplasmosis is an infectious disease caused by the parasite Toxoplasma gondii. It is actually an animal disease (zoonoses), which the human being “captures” only as an intermediate host of the parasite.
Infection with toxoplasmosis often occurs and can affect people of all ages. It usually goes unnoticed, but can also cause discomfort. In people with a weakened immune system, toxoplasmosis can have serious consequences. The same is true for a first infection in pregnancy.
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It is estimated that about half of the population in World has a toxoplasmosis infection. However, this rate is probably lower for women of childbearing age. However, it increases with age as in other population groups. Almost 70% of the over 50-year-olds are able to detect antibodies as a sign of a toxoplasmosis infection.
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If a pregnant woman already has antibodies to the parasitic disease toxoplasmosis as a result of a previous infection, these also protect the unborn from infection. It looks different when a woman is infected with toxoplasmosis for the first time during pregnancy: The unborn person can also infect herself. In this case, serious damage to the child or even a miscarriage is imminent.
The risk of a becoming mother transmitting the parasite to the unborn (transmission risk), increases with the duration of pregnancy: In the 1st trimester of pregnancy, It is about 15 percent and then increases to about 60 percent until the last trimester.
At the same time, however, the risk of severe complications decreases. At the same time, however, there is a risk of serious complications. Therefore, the danger to the unborn child depends among other things as on the time of the infection.
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A toxoplasmosis infection in the first trimester is rare. It either leads to a miscarriage or stillbirth or causes serious damage to the unborn:
- Enlargement of liver and spleen
- Cardiac muscle inflammation (myocarditis)
- Pneumonia in the connective tissue layer between the lung bubbles and the blood vessels (interstitial pneumonia)
- Water accumulation in the cranial cavity
- Inflammation of the network and choroid in the Eye (Chorioretinitis)
- Calcifications within the skull (intracranial calcifications)
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Toxoplasmosis infections in the later pregnancy initially proceed in most cases without symptoms. However, many of the affected children develop congenital defects such as squint (strabismus), numbness or epilepsy over the next twenty years. A psychomotor developmental delay is also one of the possible late effects of toxoplasmosis acquired in the mother’s body.
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A toxoplasmosis examination is only provided with a reasonable suspicion of an infection. However, a blood test for toxoplasmosis is advisable in all women with children or at the latest in the early pregnancy. If you suspect an intermittent infection, it is advisable to repeat the toxoplasmosis test several times during pregnancy.
If toxoplasmosis is detected as an initial infection during pregnancy, a amniotic water examination (amniocentesis) can be used to determine whether the unborn child is also infected. In exceptional cases, a blood test from the umbilical cord (ultrasonically controlled umbilical cord puncture) can provide evidence of a childish toxoplasmosis infection.
In addition, the doctor may recognize any organ changes in the unborn child in ultrasound. Newborn babies can be tested on congenital toxoplasmosis: The doctor searches for antibodies against toxoplasmosis in a blood sample of the child.
An initial infection with toxoplasmosis in pregnancy must be treated immediately. Pregnant women up to the 16th week of pregnancy receive the antibiotic spiramycin; Later a combination of pyrimethamine (antiparasitic) and sulfadiazine (antibiotic) is recommended as a rule. In addition, folic acid is added to prevent severe bone marrow damage.
During the treatment the blood count and liver function values are closely monitored.
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Newborns born with toxoplasmosis also receive the three preparations pyrimethamine, sulfadiazine and folinic acid. The duration of the treatment depends on the severity of the disease.
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The consistent treatment of toxoplasmosis in pregnancy means that babies often come to the world without any special symptoms. However, some have scars on the eye retina. Since some children can show symptoms such as attention disorders even after years, it is sometimes necessary to have an early and sufficiently long medical treatment of toxoplasmosis (up to one year).
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Pregnant women who have not yet experienced toxoplasmosis infection and therefore do not have antibodies to the parasite should absolutely take the following preventive measures. These are mainly related to the handling of cats (end-hosts of toxoplasmosis agents):
- Pregnant women should leave the daily cleaning of the cat’s toilets with hot water (more than 70 ° C) to other family members.
- Cats should not be fed with raw meat but only with cans and / or dry food. If this is not possible, pregnant women should stay away from the cat.
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The time between infection with toxoplasmosis and the onset of the first symptoms (incubation period) is several days to three weeks.
In humans with a healthy immune system, the toxoplasmosis runs approximately nine out of ten cases without complaints. Rarely, the infection causes flu-like symptoms such as mild fever, headache, limb pain, and fatigue. Lymph node swellings (especially in the neck and neck area) are also possible. Doctors then speak of lymph node toxoplasmosis.
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Toxoplasmosis affects very rarely eyes or other organs. Inflammation of the middle eye (uveitis), inflammation of the heart (pericarditis), inflammation of the lung (pneumonitis) or hepatic inflammation (hepatitis) may occur. Toxoplasmosis infection can also be chronic, although in most cases it is not noticed.
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In humans with an immune deficiency – for example, HIV and AIDS patients as well as transplant patients – the toxoplasmosis can take a severe course. In most cases, brain involvement (cerebral toxoplasmosis) is associated with the formation of numerous brain abscesses. They may lead to headaches, fever, changes in the nature, paralysis and epileptic seizures. Toxoplasmosis can affect mainly AIDS patients but also many other organs such as heart, lung or liver.
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Toxoplasmosis is caused by the single-cell parasite Toxoplasma gondii. Humans serve the parasite only as an intermediary (as well as pigs and cattle); The principal animals are cats and feline predators.
In the intestine of the cat, the parasite increases and develops egg-like pre-stages (oocysts), which are excreted in large numbers through feces. After one to four days of ripening in the air, the oocysts become infectious and remain for several months.
Mammals, birds and humans are usually infected with contaminated food with the toxoplasmosis pathogen: the eggs of the parasite are mainly ingested with insufficiently heated or raw meat or sausages, especially with pork, sheep and goat meat, but also with poultry.
Also foods that grow in the soil or near the ground (vegetables, fruit) can be contaminated with the toxoplasms eggs (for example by cat) and thus be infectious. In addition, direct transmission of the toxoplasms, for example, when you reach the mouth after direct contact with cats or their excrement with unwashed hands.
One of the very rare infectious pathways is the parasite transmission in transplants – that is, when a patient is transferred to the organs of a toxoplasmosis-sick donor.
How is Toxoplasmosis diagnosed?
The mentioned symptoms can give a doctor first indications of a possible infection with toxoplasm. Various diagnostic methods are available to clarify the suspicion:
Toxoplasmosis test for antibodies
Patients with healthy immune systems are usually taken a blood sample to examine them for body-specific antibodies (antibodies) against toxoplasm. Depending on the type and quantity of the antibodies, it can be determined whether the affected person was already infected with toxoplasmosis or whether it is a current infection and if so, at what stage is the disease.
Toxoplasmosis direct detection of the pathogen or its genome
In order to determine an active infection without doubt, the pathogen itself or its genome (DNA) must be detected. This diagnostic pathway is also of paramount importance in patients with a weakened immune system, since the toxoplasmosis test for antibodies can be negative.
Direct pathogen detection can be carried out by cultivation in cell culture or animal experiments. In order to detect the genetic material of the parasite, tissue samples or body fluids of the patient are examined.
It is not necessary to treat a toxoplasmosis that runs without symptoms or only with mild lymph node swelling.
However, a treatment of the toxoplasmosis is absolutely necessary for:
- Significant clinical symptoms
- Immune-weakened patients Initial infection in pregnancy
- Newborn who have been infected with the parasite in the womb (Natal toxoplasmosis)
Toxoplasmosis therapy is usually done with special antibiotics or antiparasitics such as Sulfadiazine and pyrimethamine
How to prevent Toxoplasmosis?
There are a number of behaviors that reduce the risk of toxoplasmosis contagion:
- Wash hands with soap if you have touched raw meat or vegetables
- Clean also used kitchen equipment (cutting board, knife etc.) thoroughly after the processing of meat or vegetables
- Do not eat raw meat or sausage
- Also avoid inadequately heated meat and sausage products (especially from pork, lamb or goat). To kill the eggs of the parasite, meat must be heated to a core temperature of at least 50 ° C (frying, cooking)
- Keep foodstuffs (potatoes, carrots, etc.) separate from other foodstuffs so that they can not be contaminated as well
- Wash, peel or cook vegetables, salads and fruits before eating
- Wear gloves during gardening and wash your hands thoroughly afterwards
- Do not feed cats with raw meat
- Do not kiss a cat and wash hands after contact with the animals
- Clean the litter box daily with hot water. Particularly vulnerable persons such as pregnant women should leave this task to others
- Cover sandboxes when not in use, so they can not be used by cats as a litter box
- Do not drink unfiltered water from lakes, streams, etc. In the wild. It can be contaminated with oocysts from the toxoplasmosis pathogen