Toxoplasmosis in pregnancy

Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii that can affect the growing baby in pregnancy.

What is toxoplasmosis?

Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii. In non-pregnant women it doesn’t have many symptoms. In fact, many people will never know they have had it. Some people may have mild flu-like symptoms. A few may experience a more long-term illness similar to glandular fever and swollen lymph nodes.

Although toxoplasmosis normally causes a mild illness in people with healthy immune systems, it's risky during pregnancy because it may harm your baby. 

The parasite can be found in meat, cat faeces, the soil where cats defecate and unpasteurised goats’ milk. The toxoplasma parasite can infect most birds and warm-blooded animals, including humans. Cats are the only animals that can have infected faeces. After it catches the infection through eating birds, mice or other raw meat, a cat can shed infectious faeces for about 14 days.

Toxoplasmosis cannot be caught by stroking a cat or having a cat as a pet. The infection comes from coming into contact with the infected faeces of a cat.

How common is toxoplasmosis?

It is estimated that between a third and half of the UK population will have the infection at some point in their lives. Once you have had the infection, you are then immune for life – you cannot catch it again. Around 2,000 UK women per year contract toxoplasmosis during pregnancy.

Most pregnant women may never know they have been infected unless they experience problems during their pregnancy that mean they have tests. However the infection often has no symptoms at all.

The effects of toxoplasmosis in pregnancy

Toxoplasmosis does not usually cause any symptoms and in most cases a person does not realise they have caught the infection. It can cause symptoms similar to flu or glandular fever, sometimes including swollen lymph nodes. Once a person has had the disease they are generally thought to be protected for life, unless they suffer an impairment of their immune system.

Risks of toxoplasmosis

Toxoplasmosis is only a risk to an unborn baby if caught for the first time during pregnancy or within a few weeks before you get pregnant.

If an unborn baby catches the disease they are said to have ‘congenital toxoplasmosis’. The damage the infection may cause will depend on when in pregnancy you got the infection.

If you catch toxoplasmosis for the first time during pregnancy, it does not mean that your baby will be infected.

On average, only 4 in 10 of such infections will pass to the baby. Caught during pregnancy, toxoplasmosis can cause miscarriage, stillbirth or damage to the baby’s brain and other organs, particularly the eyes.

However, most babies born with toxoplasmosis have no obvious damage at birth but develop symptoms, usually eye damage, during childhood or even adulthood. A few will have more serious symptoms such as blindness or brain damage. 

How is toxoplasmosis caught?

Toxoplasmosis is caught by swallowing anything infected with, or contaminated by, the parasite.
This could be:

  • raw or undercooked meat (meat showing any traces of pink or blood), and raw cured meat such as Parma ham or salami
  • unwashed vegetables and fruit
  • cat faeces or soil contaminated with cat faeces
  • unpasteurised goats’ milk and dairy products made from it.

The infection can also be passed:

  • through the placenta if the mother becomes infected infection (mother to unborn baby).
  • through infected matter entering human body fluids; if, for example, during the process of lambing, material splashes into eyes or open cuts.
  • through transplanted organs or blood products from other humans that are infected toxoplasmosis
  • through inhaling the parasite eggs (possible but very unusual).

Person-to-person infection is not possible, except from mother to unborn child.

Who is at risk of toxoplasmosis?

Anyone who eats anything infected with the parasite. Pregnant women who work on the land, in catering or farming may be at higher risk as they may be more likely to come into contact with the parasite. Lambing is a particular risk for pregnant women.

Tips to avoid toxoplasmosis during pregnancy

Only eat meat that has been thoroughly cooked (ie, with no trace of blood or pinkness).

  • Avoid raw meat and cured meat, such as Parma ham.
  • Wash hands, chopping boards and utensils thoroughly after preparing raw meat.
  • Wash all fruit and vegetables thoroughly before cooking/eating to remove all traces of soil.
  • Avoid unpasteurised goats’ milk and dairy products made from it.
  • Wear gloves when gardening and wash hands and gloves afterwards – if you eat while gardening wash your hands first, and try to avoid gardening in areas that may have been soiled with cat faeces.
  • Cover children’s sandpits to prevent cats using them as litter boxes.
  • Remove faeces from cat litter tray every day wearing rubber gloves (or ask someone else do this), scald trays regularly with boiling water.
  • If you are handling litter trays, wash gloves and hands thoroughly afterwards.
  • Do not handle lambing ewes and do not bring lambs into the house.

Can I change the cat litter tray while pregnant?

Cats are the only animals that can shed this parasite in their faeces. Provided precautions are taken, cats are not a particular risk to a pregnant woman. If you are handling litter trays, wash gloves and hands thoroughly afterwards.

What should I do if I think I may have toxoplasmosis?

Toxoplasmosis is not routinely tested for during pregnancy in the UK. You may however request a blood test from your GP if you feel you may have put yourself at risk, you are concerned about symptoms.

The blood test looks for antibodies – the body’s natural defences – to the infection. It may take three weeks for these antibodies to be present following an infection, so the blood test will only pick up an infection that you’ve had for at least three weeks. Depending on the type of antibodies found and whether levels are stable, rising or falling, it’s possible to determine when the infection took place.

The results may come back in a week, or longer if they have been passed on to a Toxoplasma Reference Laboratory .

Tests for toxoplasmosis in pregnancy

Blood tests for toxoplasmosis can be done at any stage before or during pregnancy. The blood test can usually only show possible infection two to three weeks after any risk incident, as it can take this long for antibodies to be detectable.

The blood test involves taking a small amount of blood from the mother. There is no risk to the unborn baby. The blood test aims to show whether certain antibodies indicating toxoplasmosis are present or not, and, if they are present, to find out when the infection happened.

If the tests show that there is a recent or current infection, there is a risk that the baby will be infected. The obstetrician or GP will make a recommendation about any further action that might be required. It may take several weeks for the infection to pass from you to your baby. The degree of risk and severity of damage depends on when you were infected.

A positive result due to a current/recent infection

If the test shows a current or recent infection the blood must be sent on from the local laboratory to the Toxoplasma Reference Laboratory, for confirmation and further testing.

A small percentage of tests will appear positive when in reality a woman has never had the disease.

If further tests show that you have a current or recent infection, it means you are suffering from an acute toxoplasma infection. Further action needs to be taken to assess the risk of passing the infection on to your baby.

If you were infected shortly before conception

Infection caught shortly before conception (within a few weeks before) carries a one percent risk or below of transmission to the baby, but there is a risk of miscarriage if the baby does become infected.

If you were infected in the first trimester (week one to 12)

Infection caught at this stage of pregnancy carries about 10-15% risk of transmission to the baby. A baby infected at this stage has a risk of being miscarried or born with severe symptoms such as hydrocephalus (water on the brain), calcifications of the brain, or retinochoroiditis (inflammation of the retina).

If you were infected in the second trimester (week 13 to 28)

Infection caught at this stage of pregnancy brings about 25% risk of transmission. A baby infected at this stage is less likely to be miscarried, but is still at risk of developing severe symptoms as above.

If you were infected in the third trimester (week 29 to 40)

Infection caught later in pregnancy is more likely to spread to your baby, the risk of transmission may be as high as 70–80%, but if problems develop, they are less likely to be as serious. Most babies infected will be apparently healthy at birth, but a large proportion will develop symptoms later in life, usually eye damage.

Finding out if the baby has been infected

Further tests can be carried out to find out whether or not the baby is infected, although the tests will not show how severe the damage is. An obstetrician or GP can explain the risks and benefits of conducting these tests.

Amniocentesis is a technique where amniotic fluid is removed by a fine needle from the amniotic sac – the fluid-filled sac around the baby.

Cordocentesis is a technique where a sample of the baby’s blood is removed from the umbilical cord.

These procedures carry a .5-1% percent risk of causing miscarriage. They are normally carried out after 15 weeks of pregnancy. The amniotic fluid or blood from the umbilical cord is then tested at the Toxoplasma Reference Laboratory using a range of specialised tests.

If this is positive, the baby will be considered to be infected. Results typically take two to five days. A detailed ultrasound scan will show if there is major damage, such as hydrocephalus (water on the brain), but a scan that shows no damage, while reassuring, does not rule out the possibility that the baby is both infected and affected.

Treatment of toxoplasmosis in pregnancy

If you have a positive blood test result, you may be prescribed an antibiotic called spiramycin, which reduces the risk of the infection being passed from you to the baby. Spiramycin only reduces the risk of transmission from mother to baby and is not active against the parasite. It therefore cannot limit any damage if a baby has already become infected.

If the baby is found to be infected, a combination of pyrimethamine and sulphadiazine can be taken. These are both stronger antibiotics and help limit any damage to the baby, although again, they cannot undo any damage.

At 20 weeks an ultrasound scan may also highlight any obvious physical problems in the baby. Termination of pregnancy is also an option for some women, when an infected baby with severe developmental problems has been confirmed.

All babies born to women with confirmed toxoplasmosis in pregnancy will be monitored closely by paediatricians and receive blood tests during their first year.

Side effects of treatments

Spiramycin is used routinely in France for treatment of toxoplasmosis in pregnancy, with little evidence of adverse effects. Experts consider that it is safe to use in pregnancy when a baby is at risk. Women taking spiramycin sometimes experience side effects such as nausea or rashes. Pyrimethamine and sulphadiazine can have side effects for both the mother and baby related to red-blood cell production. Although not normally prescribed in pregnancy, they can be used in extreme circumstances. They are taken with folinic acid, which helps to reduce the worst side effects.

All babies born to women who have had a recent or current infection in pregnancy should be given a thorough physical examination after birth, followed by blood tests during the first year of the baby’s life.

Treatment after the baby is born

Blood sample

A blood sample should be taken from at-risk babies shortly after birth. A blood sample should also then be taken from you to compare the levels of specific antibodies between you and your baby.

Tests will be carried out to look for different types of antibodies to toxoplasmosis in the baby’s blood. Your baby carries some of your antibodies, so a positive result is expected and not necessarily alarming. If additional antibodies are present, this may indicate that your baby is infected.

Other checks/examinations

Babies who are known to be at risk of having congenital toxoplasmosis should be checked for signs of neurological damage. The eyes will be examined for signs of any problem, preferably by an ophthalmologist (eye specialist). Long-term follow-up by an ophthalmologist might be necessary if eye damage is confirmed.

Your baby’s general health will also be checked. If there is any possibility that the baby has brain damage, special head X-rays might be carried out to check for calcifications, enlarged ventricles or any other abnormalities.

Treatment for babies who have been infected with toxoplasmosis

If blood tests showed that your baby has been infected, antibiotics might be prescribed, even if your baby shows no symptoms. Treatment can sometimes be continued for as long as one year, to help prevent or limit the eye damage that can possibly occur later.

Further tests/examinations

A blood sample taken every few months, up to the age of one year, can show whether your baby’s antibody level is falling. By that age, the level should be completely negative. This means that your baby will have lost the antibodies acquired from you and is not infected. When your baby’s blood sample is completely antibody-negative, it means they are definitely not congenitally infected. A falling antibody level is a good sign, but is not conclusive and tests should continue until the antibody level is completely negative.

Breastfeeding

Breastfeeding is safe if you have toxoplasmosis, the disease cannot be transmitted this way. You are also passing on extra antibodies to your baby, making their immune system stronger. Breastfeeding is therefore recommended, unless you are being treated with pyrimethamine. This medication should be changed before breastfeeding.

UK government policy on toxoplasmosis screening

The UK National Screening Committee recently reported that screening for toxoplasmosis in pregnancy should not be offered routinely as there is not enough evidence that it would help .

The Committee suggests that getting pregnant women to avoid undercooked or cured meat and communicating the best ways of avoiding infection is a better way of controlling toxoplasmosis than antenatal screening.

Sources

  1. Ho-Yen DO, Joss AWL (eds.) Human Toxoplasmosis. Oxford Oxford Medical Publications, 1992
  2. Joynson DHM, Wreghitt TG. Toxoplasmosis: A Comprehensive Clinical Guide. Cambridge Cambridge University Press, 2001
  3. The Advisory Committee on the Microbiological Safety of Food. Risk Profile in Relation to Toxoplasma in the Food Chain. London Foods Standards Agency, 2012
  4. Hall S, Ryan M, Buxton D. The epidemiology of toxoplasma infection in Joynson DHM, Wreghitt TG, (eds.) Toxoplasmosis: A Comprehensive Clinical Guide. Cambridge, Cambridge University Press, 2001: 58-124.5
  5. Elsheikha HM. Congenital toxoplasmosis: priorities for further health promotion action. Public Health, 2008; 122(4): 335-53
  6. Krick JA and Remington JS. Toxoplasmosis in the adult overview. N England J Med 1978; 298: 550-3.7
  7. Thulliez P. Maternal and foetal infection, In Joynson DHM, Wreghitt TG, (eds). Toxoplasmosis: A Comprehensive Clinical Guide, Cambridge Cambridge University Press, 2001: 193-213.8
  8. Remington JS, McLeod R, Desmonts G. Toxoplasmosis. In Remington JS, Krupp MA, Klein JO (eds), Infectious Diseases of the Fetus and Newborn Infant, 5th Ed. Philadelphia W.B. Saunders Company, 2000: 205-346.9
  9. Public Health Wales. Results of Toxoplasma Study. Cardiff Public Health Wales, 2007 (available at: http://www.wales.nhs.uk/sitesplus/888/news/14491) (accessed December 2013)
  10. Health Protection Agency. Investigation of Toxoplasma Infection in Pregnancy. UK Standards for Microbiology Investigations 5 Issue 2.2. London HPS, 2012  (http://www.hpa.org.uk/SMI/pdf) (accessed December 2013)
  11. Toxoplasma Reference Unit, Public Health Wales, Edward Guy. Personal communication, 2012
  12. Desmonts G, Couvreur J, Thulliez P. Congenital Toxoplasmosis: Five cases with mother-to-child transmission of pre-pregnancy infection. Press Med 1990; 19: 1445-49.13
  13. Dunn D et al. Mother-to-child transmission of toxoplasmosis: risk estimates for clinical counselling. Lancet 1999; 353: 1829-33.14
  14. Hohlfeld P et al. Prenatal diagnosis of congenital toxoplasmosis with a polymerase-chain-reaction test on amniotic fluid. N Engl J Med 1994; 331: 695-9.15
  15. Gras L et al. Association between prenatal treatment and clinical manifestations of congenital toxoplasmosis in infancy: a cohort study in 13 European centres. Acta Paediatr 2005; 94: 1721-31.16
  16. McCabe R.E. Anti-Toxoplasma Chemotherapy. In Joynson DHM, Wreghitt TG (eds.) Toxoplasmosis: A Comprehensive Clinical Guide. Cambridge Cambridge University Press, 2001: 319-359
  17. Daveluy et al, for the Eurotoxo Group (panel 2). Review of data related to side effects of drugs used in congenital toxoplasmosis [unpublished report]. Bordeaux, France The Eurotoxo Group, 2005 
  18. Alex W, Joss L. Treatment. In Ho-Yen DO, Joss AWL (eds.) Human Toxoplasmosis. Oxford Oxford Medical Publications, 1992: 119-143
  19. Eaton RB et al. Newborn screening for congenital toxoplasma infection. In Joynson DHM, Wreghitt TG (eds) Toxoplasmosis: A Comprehensive Clinical Guide. Cambridge Cambridge University Press, 2001: 241-253
  20. Sanchez PJ and Ahmed A. Toxoplasmosis, Syphilis, Malaria and Tuberculosis. In Taeusch HW, Ballard RA, Gleason CA (eds.) Avery’s Diseases of the Newborn, 8th Ed. Philadelphia Elsevier Saunders, 2004: 531
  21. Bonametti AM, Passos JN. Research Letters (to the editor): Re: Probable transmission of acute toxoplasmosis through breastfeeding. Journal of Tropical Paediatrics 1997; 43: 116
  22. Goldfarb J. Breastfeeding. AIDS and other infectious diseases. Clin Perinatol 1993; 20: 225-243
  23. NSC (2015) Antenatal screening for Toxoplasmosis. External review against criterIA set by the UK Mational Screening Committee, UK National Screening Committee file:///C:/Users/user/Downloads/Review_Toxoplasmosis_2016.pdf

 

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Last reviewed on October 3rd, 2016. Next review date October 3rd, 2019.

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Comments

  • By Sarah (not verified) on 19 Sep 2018 - 17:59

    My friend made dinner the other day and added raw red onion to the dish. She did peel off the outer layer but didn’t wash the onion. Is there a toxo risk? They are onions from a supermarket, not allotment etc! Thanks

  • By Midwife @Tommys on 21 Sep 2018 - 11:39

    Hi Sarah, Raw onions are not thought to be a risk factor for toxoplasmosis. Please be reassured. Best wishes

  • By Laura (not verified) on 18 Sep 2018 - 00:03

    Hi, I have a question about gardening and toxo. I have 2 cats and last week was planting some bulbs in my garden. I wore gloves and made sure I washed my hands thoroughly afterwards, however some of the bulbs may have been planted near to an area where my cat likes to go to the toilet. I had a test before pregnancy to show I am not immune and wouldn’t really have thought about it apart from the fact a week later I have developed mild cold like symptoms, cough, sore throat and sneezing. My lymph nodes aren’t up, I am not achey and don’t have a fever and some very close members of my family have had colds recently. Do you think I should speak to my GP about doing a retest just incase those signs could be a toxo infection? Many thanks

  • By Midwife @Tommys on 20 Sep 2018 - 13:27

    Hi Laura, Thank you for your comment.
    It is highly unlikely that you have been exposed to the toxo organism as you were wearing gloves when you were in the garden and you washed your hands afterwards so you have done everything that we would recommend to keep the risk of exposure to the lowest it could be. It could be that if your family members have been suffering from colds then you may have caught it from them but if you are still worried then you can always speak to your GP again who can repeat a blood test. Hope this helps, Take Care, Tommy's Midwives x

  • By Anonymous (not verified) on 15 Sep 2018 - 23:40

    Hello, I was eating grilled chicken in a restaurant last night and when I got to the final bit I looked down and noticed there was a pinkish tinge to it. I wanted to know if undercooked chicken was a risk for toxoplasmosis? Thanks

  • By Midwife @Tommys on 17 Sep 2018 - 11:22

    Raw or undercooked chicken isn't particularly linked to toxoplasmosis but is a risk for other forms of food poisoning, particularly campylobacter or salmonella. For this reason it is important to cook chicken thoroughly. If you have not felt unwell since eating the chicken then please try not to worry. It is not likely that you have been affected. Take care

  • By LB80 (not verified) on 15 Sep 2018 - 13:58

    I am currently on holiday in Greece and i ordered a steak well done, i was in a gery dimly lit room, i was half way through and thought it tasted a bit too juicy, i shone my phone and realised the meat was a bit pink. Whilst researching online, i saw that i am also unable to eat cured meats which i was unaware of, I've eaten a few slices of salami from a vacuum package from a supermarket. Am i at an increased risk of toxoplasmosis? Really worrying :(

  • By Midwife @Tommys on 17 Sep 2018 - 11:11

    Your chances of contracting Toxoplasmosis in these situations really is very small but if you are concerned you can talk to your GP about running a test in a few weeks.

  • By Clare (not verified) on 14 Sep 2018 - 09:00

    Hi, I was in a restaurant last night and had a lovely meal. As I left I noticed a cat (who the waiter said often visited the place) and saw him stroking and playing with the cat - something he said the staff all do. I’m now worried the waiter may have played with the cat and then served me my food (I know he’s unlikely to have touched my food directly but he was handling my plate and cutlery). Is there a risk of toxoplasmosis? Thanks, very anxious.

  • By Midwife @Tommys on 14 Sep 2018 - 11:50

    Hi Clare,
    Please be reassured that there does not appear that you are at risk of contracting toxoplasmosis from what you have described. Stroking and touching a cat does not pose a risk. The risk is contact with the cat's faeces, ie cleaning out a litter tray. For general hygiene I would expect the staff to be washing their hands after touching the cat.
    Best wishes
    Tommy's midwife

  • By Clare (not verified) on 14 Sep 2018 - 12:47

    Hi, thanks for your reply - I’m pretty sure he didn’t wash his hands as the time between petting the cat and others’ food arriving was very quick! But thanks for reassurance that there’s no risk from him touching or petting a cat!! x

  • By Bobby (not verified) on 12 Sep 2018 - 18:53

    Today I cut my finger on glass as I was washing my hands after cleaning up cat poo am I now at risk of toxoplasmosis? I'm currently 34 weeks pregnant. Iv no idea how old this poo was but its more then likely weeks old.

  • By Midwife @Tommys on 13 Sep 2018 - 11:43

    Hi Bobby, Thank you for your comment.
    It is highly unlikely that you have been exposed to toxoplasmosis as you were already washing your hands at the time and you did not come in direct contact with the cat poo. If you are concerned that you have been exposed then it would be advisable that you see your GP who can do a blood test for toxo, this will tell you if you have a current infection or if you have had it in the past and if you have then your immunity will pass on to baby. Hope this helps, Take care, Tommy's Midwives x

  • By Ashley (not verified) on 12 Sep 2018 - 05:36

    I recently saved a litter of 4 kittens and their mother from under my apartment building's porch. I gave each of them a dawn dish soap bath. I then set them up in this basket for when the mother wanted to breastfeed them. I have pet them, I have even scratched them and they had scabs from fleas i'm afraid I got that under my fingernails and forgot to wash my hands. I also smoke cigarettes and bite my nails so I'm worried I did put my hands in my mouth. I cleaned out their basket today and saw tiny lumps of poop but my friend vaccuumed what fell onto the floor ( my son ran and knocked the basket over) which was only like 4 little poos. Anyways, I picked up the basket and threw the bedding into the dirty clothes and then shook it outside. I'm afraid again that I may have come in contact. I am only 4 weeks pregnant and what i've read has been haunting me ever since! I thought I was doing a good deed and saving these kittens, but I do not want anything harmful happening to my unborn child :( This was a week ago when I adopted these strays. I am trying to rehome them but may just bring them to the shelter. I feel bad but i'm terrified now. I would think it would be extremely bad luck if I went and saved the mama and babies and then my baby can't be saved :( :( :(

  • By Midwife @Tommys on 13 Sep 2018 - 10:54

    Hi Ashley,
    Thank you for your comment.
    It would be highly unlikely that you have contracted Toxoplasmosis as you have not been in direct contact with the cat or the kittens poos, your friend cleaned up the poos. However, we do recommend that good hand hygiene is maintain to avoid any exposure. If you are unsure if you have been exposed then we would recommend that you have a Toxoplasmosis blood test with your GP, this will be able to detect if you have a current infection or you have had one in the past. If you have had this in the past then you will have immunity to Toxo and this immunity will pass on to your baby. Hope this helps, Take Care, tommy's Midwives x

  • By Kitty (not verified) on 11 Sep 2018 - 10:31

    Hi, I just ate some broccoli which had some sandy dirt in it. Is there a toxo risk from this? I'm 6 wks pregnant.

  • By Midwife @Tommys on 12 Sep 2018 - 16:03

    The main risk of toxoplasmosis infection is from eating under-cooked or raw meat and unwashed raw vegetables; also from handling cat faeces. It is only a risk to an unborn baby if caught for the first time during pregnancy or within a few weeks before you get pregnant.
    However most people ( up to 50% of the UK population) have been exposed to toxoplasmosis earlier in life and are immune to it . The following link has more information for you-
    https://www.tommys.org/pregnancy-information/pregnancy-complications/infections-pregnancy/toxoplasmosis-pregnancy.

    There is no routine test for toxoplasmosis in the UK; however you can request to be tested if you think you have been exposed to it-this can be via your GP (or midwife once you have booked in for antenatal care). If the test shows you have had a recent or current infection, you should be referred for treatment and further invsetigations.

    Take care
    Tommy's Midwife

  • By Nora Elsaid (not verified) on 7 Sep 2018 - 23:21

    can the infected women be treated after abotion of the infected baby ?
    and if so , what's the strategy of treatment ?

  • By Midwife @Tommys on 10 Sep 2018 - 11:30

    Hi Nora, So sorry to understand that you have lost your baby due to toxoplasmosis. If you want to talk to a midwife please don't hesitate to call us. You shouldn't need any treatment for this infection as your immune system will develop antibodies to protect you in the future. Once you have these antibodies any future pregnancies should be protected. With best wishes form Tommy's midwives

  • By Sarah (not verified) on 3 Sep 2018 - 13:00

    Hi, I'm feeling very very anxious and have been the whole way through my pregnancy I'm currently 31 weeks pregnant and went to visit my friend and her wee one. They have a house cat, who's litter tray was in the hall and didn't look like it had been cleaned in a while, i only noticed it when I was leaving and the cat had sprayed the litter everywhere I didn't notice when I first went in cause it was behind the door. I was playing with her little girl who touches the cat all the time and the cat was also there jumping around and jumping on things that I touched, I'm so paranoid about catching toxo that I came home and went straight in the shower and cleaned my phone etc that I had obviously touched when I was leaving. I can't stop worrying about it. Any advice would be great.

  • By Midwife @Tommys on 10 Sep 2018 - 12:16

    Hi Sarah. Toxoplasmosis in pregnancy really is quite rare. If you wash your hands before eating or preparing food your risk should be very low. If you are very concerned you can ask your doctor to run a test. It may indicate that you already have immunity which would put your mind at rest. Some doctors have to make a charge for this test as it isn't clinically indicated but you could have a chat and ask. In response to your anxiety, have you tried techniques like meditation, mindfulness, yoga. All these have been shown to reduce anxiety and help you to manage. Talk to your midwife who may know where you can access these classes.

  • By Michelle Ferguson (not verified) on 30 Aug 2018 - 11:40

    Hi. Can you contract toxoplasmosis from a cat scratch and if your cart nuzzles into your face - he sometimes has a wet nose. Thanks, Michelle

  • By Midwife @Tommys on 30 Aug 2018 - 15:51

    Hi Michelle, Thank you for your comment.
    You can only be exposed to Toxoplasmosis if you have been in direct contact with infected cat faeces. You cannot contract it from stroking a cat. If the cat had infected faeces on the claws that you were scratched with then it broke the skin, there may be a possibility of transmission but if there was no faeces involved then the risk of exposure is very low. If you are worried then you can see your GP who will be able to do a blood test for toxoplasmosis to see if you have had any exposure to the organism. Hope this helps, take care, Tommy's Midwives x

  • By Sammy (not verified) on 28 Aug 2018 - 21:45

    I am wondering if you have any knowledge or advice based on this situation. I’m 37 weeks pregnant and worried about a possible exposure to toxoplasmosis during pregnancy. I managed to stand in some cat feces, when cleaning it up I only had alcohol hand sanitizer to use on my hands. Thinking this would be enough I didn’t wash my hands with soap and water, I just used hand sanitiser and have consumed food (with my hands) around 15minutes later. I am not sure how long the feces were there I know they take 1-5 days to become infectious but I wouldn’t know that. I do know that I am not immune as I have been tested in the past. Would using a alcohol based hand sanitizer multiple times have been enough to kill any oocysts on my hands?

  • By Midwife @Tommys on 30 Aug 2018 - 15:44

    Hi Sammy, Thank you for your comment.

    We do recommend that washing your hands with soap and water is the best form of hand hygiene but your did your best at the time and used hand gel. If you didn't have any cat poo directly on your hands when you cleaned it up then you should not of ingested any of it when you ate your food. However, as there is that small chance of exposure it may be worth going to your GP and having another Toxoplasmosis test to see if you have since been exposed to the organism since your last test. Please try not to be alarmed, you did the best you could to clean your hands at the time but getting your GP to do a Toxo blood test would be advisable. Hope this helps, Take Care, Tommy's Midwives x

  • By Nada (not verified) on 25 Aug 2018 - 19:45

    Hello,
    I m 17 weeks pregnant and my blood test showed a grayzone result for the toxo IgM. The doctor said it’s neither positive nor negative.
    He requested another test IgG avidity test to be sure.
    Do you think I might have catched the toxo parasite, noting that I have already done IgM test at least the 5th week and it was negative?
    Thank you

  • By Midwife @Tommys on 29 Aug 2018 - 16:25

    Hi Nada
    I am sorry that this is causing you so much anxiety. It is really difficult to know, but it is best for you to wait for your test results to come back to know for sure. And then your doctor can discuss the results fully with you. Please feel free to call us on the helpline Mon to fri 9 am to 5pm once you have your results so we can discuss what they mean. All the best
    Tommy's Midwife

  • By Shona (not verified) on 25 Aug 2018 - 06:15

    Hi there,

    I am concerned with baby toys falling on the carpet where my cats walk and then my baby putting the toys in his mouth, in winter sometimes they come inside with muddy feet. Should I be worried?

  • By Midwife @Tommys on 29 Aug 2018 - 14:51

    Hi Shona
    The concern about toxoplasmosis is most high in pregnancy for the unborn baby. Your (now born) baby, is incredibly unlikely to get toxoplasmosis from the events described above. A healthy child with toxoplasmosis may have no signs of infection or only a few swollen glands that:
    -usually appear in the neck
    -are sometimes tender to the touch
    -may become larger and smaller over several months

    Most healthy kids with these symptoms won't need medical treatment unless the infection gets worse.
    All the best
    Tommy's Midwife

  • By Mac (not verified) on 15 Aug 2018 - 23:25

    Hello,
    I have OCD contamination fears and am dealing with anxieties about toxoplasmosis and my partner, who is 39 weeks pregnant. I understand that she can be tested for this but do not want to have the test unnecessarily because of irrational fears caused by OCD. As she is this late in pregnancy, I understand that there is a greater risk of transmission to the baby.

    1. We have moved house and there is dried animal faeces in the overgrown lawn in the garden. I suspect that this is from a cat. I was walking barefooted in the garden and fear that I may have trodden in it. Since then, I have walked through the house and on the bath mat. Should I clean the carpets and wash the bath mat, in case my partner makes contact with either and then with her mouth?

    2. We ate some Spanish and Italian cured meats from a deli, as we were unaware this was a possible cause of toxoplasmosis. Does this justify the need for a test?

    3. Is there a risk of having trodden in cat faeces with shoes on and then carrying this in to the house, contaminating other objects and causing a risk of toxo to my partner?

    4. My partner picked up fresh faeces from our cat, using toilet tissue. As the faeces were fresh, I understand that the infective spores would not be released, so there is no risk of infection. Is this correct?

    Although this is causing me significant anxiety, I am reluctant to ask my partner to be tested because of my of obsessive thoughts bullying me in to it (I am committed to challenging my OCD). Please can you offer some advice.

    Thank you,
    Mac

  • By Midwife @Tommys on 20 Aug 2018 - 14:28

    Hi Mac and thank you for your query. For points 1 and 3 I think that your partner is not at any increased risk due to your potentially walking barefoot or possibly walking on some faeces. We don't easily transfer what is on our shoes or feet to someone else's mouth so the risk is no higher than for any other woman.
    When she picked up the faeces using toilet paper, I assume she washed her hands immediately so again this would not increase the risk.
    Point 2. Cured meat can potentially carry toxoplasmosis as it has not been heated through in the curing process. However, it still is only a tiny risk factor and at 39 weeks it is too late to get the test and results. Just mention to the paediatrician your concerns when the baby is checked but try to remember that the chance of transmission to the baby is really very small. Take care, Tommy's midwives

  • By Mercell (not verified) on 14 Aug 2018 - 17:01

    Hello,
    Please can you clarify whether you can inhale toxoplasmosis? I work in an animal shelter and empty the clinical waste bins daily (more often than not these contain cat faeces.) I always wear gloves and scrub my hands red raw afterwards but have never been told to wear a face mask- but have recently heard that you can contract it this way.
    Super worried now. I'm almost in my third trimester.

  • By Midwife @Tommys on 20 Aug 2018 - 13:53

    Hello Mercell
    There is a small theoretical chance that it is possible to inhale the parasite eggs. However, in view of your job it is quite probable that you already have immunity to toxoplasmosis which would mean there is no risk to your pregnancy. Why not ask your doctor for a test to put your mind at rest?

  • By Kasey Oger (not verified) on 11 Aug 2018 - 19:54

    My partner was playing with the dogs today throwing them the bone, he shouted at one of them for eating some soil, we have cats to and they do go in the garden and the dogs to eat it (as much as we try to stop them).
    Anyway he was throwing the bone for them. Hours later when we came to eat tea I realised that he hadn’t washed his hands since this, he prepared food and obviously I ate it. Is there a chance I could of caught it from this? Could it of been on the bone then to his hands then to the food and me consume it?

  • By Midwife @Tommys on 20 Aug 2018 - 14:01

    Despite everything you read, Complications in pregnancy from Toxoplasmosis is in fact rare. We do advise to wash your hands after being in the garden and before handling food and if for some reason you haven't you may be at increased risk although still small. If you think that you may have an increased risk, talk to your doctor about a blood test to put your mind at rest.

  • By Katie (not verified) on 7 Aug 2018 - 20:18

    Hi there, today my mother-in-law made us some sandwiches for our journey home from our visit with them and I ate half a sandwich made from some beef she has cooked a few days ago that has been kept in the fridge! It was only until I finished half the fairly small sandwich that I realised that the meat was quite pink! Should I be worried? And should I ask my GP about getting a toxoplasmosis blood test?

  • By Midwife @Tommys on 8 Aug 2018 - 15:16

    Hi Katie
    It is unlikely that you contracted Toxoplasmosis from this event, but if it is playing on your mind and you would prefer to have test, then yes, please do ask your GP to send you for it. You may need to pay for this as it is not always NHS funded.
    All the best
    Tommy's Midwife

  • By Anonymous (not verified) on 6 Aug 2018 - 16:16

    Hi, I have always eaten cured meats, pork and other meats "as they come" in restaurants and never given a second thought. I did this up until I missed a period (last time was around 3+5 weeks when I had medium-pork and pink lamb. I'm now 15 weeks and have avoided these foods.) I'm wondering if this warrants a toxoplasmosis blood test? My GP is not concerned but I wanted to know if it is worth paying for a private test, and, if so, you could advise on locations in London? Thanks!

  • By Midwife @Tommys on 6 Aug 2018 - 16:40

    No I don't think that you have been at increased risk in this pregnancy. If you have been previously infected with toxoplasmosis this would make you immune and your baby would not be at risk. I think your GP is right not to be concerned. Take care x

  • By Anonymous (not verified) on 6 Aug 2018 - 17:06

    Thank you so much! I was worrying that I may have contracted it before the positive pregnancy test from carrying on as normal up to that point. Thanks!

  • By Jen (not verified) on 7 Aug 2018 - 13:47

    Hi, I’m a bit confused at this answer as in answer to the lady below asking re eating chorizo and rare steak at 7 weeks she was advised to get a blood test - is the above concern different as this person was less than 4 weeks’ pregnant? Thanks

  • By Midwife @Tommys on 8 Aug 2018 - 15:11

    Hi Jen
    If you have eaten rare or dry cured meats in pregnancy, or are concerned that you have come into contact with toxoplasmossi via another means then it is best to get a blood test if you do not know if you are immune to Toxoplasmosis or not. Most people will have a historical infection (likely from childhood) but if you are unsure and this is worrying you extensively, then go to your GP and ask for the test.
    All the best
    Tommy's Midwife

  • By Margaret (not verified) on 6 Aug 2018 - 11:57

    Hi,

    I've had the test for toxo based on exposure to wild cats and homegrown veg, still waiting for results.

    I've noticed that I've become a bit fastidious about washing my hands after putting on and taking off my shoes. I never did this before pregnancy and want to avoid developing unnecessary worries/habits. Is there a risk of catching toxoplasmosis from having stepped in something and then transferring it to the laces and then on to the hands? Or of catching other infections from having stepped on dried dog or bird faeces?

    I'm also wondering if toxoplasmosis is dangerous if a baby contracts it after he's born, as an infant or toddler?

    Thanks

  • By Midwife @Tommys on 6 Aug 2018 - 13:52

    Hi Margaret,
    There is a small theoretical risk of contracting these infections at any time but you must get this into proportion. We advise to wash your hands before preparing or eating uncooked meat and to wash vegetables before preparing them. We also advise to lower your risk of touching cat faeces by wearing gloves in the garden or when changing litter trays. And we suggest that you avoid goats milk and some raw meats.
    If you take these precautions while you are pregnant your risk of contracting toxoplasmosis is extremely small. If you do think that you have put yourself at increased risk we advise that you have a test. When your test result comes back you will be informed whether you have ever contracted toxoplasmosis. If you have then you are immune and will not catch it again.
    Babies and toddlers can catch the infection but there is no reason to believe that this will be dangerous.
    I hope this helps.

  • By Alex (not verified) on 1 Aug 2018 - 10:33

    Hi
    I am 6 weeks pregnant and before i knew i eat some mint from my garden, i did wash it before hand. Today i have realised my neighbours cats has pooped in the veg patch (where the mint was) a few times some seem like old faeces. Im worried now incase i touched my mouth or eat after gardening without washing my hands and about eating the mint from my garden. Am i at risk?
    Thankyou

  • By Midwife @Tommys on 1 Aug 2018 - 11:28

    Dear Alex
    It sounds like you are very anxious about this encounter, so it is probably best that you go to your GP and tell him/her that you are worried that you have come into contact with toxoplasmosis and you'd like to be sent for the blood test. Often, this test cannot be covered by the NHS and may incur a charge. It does sound unlikely that you'd contract toxoplasmosis from this event in the garden, but i feel that not having the test may cause you more concern in not knowing. Information about the blood test in more detail is above in the body of this article.
    All the best
    Sophie Tommy's Midwife

  • By Emma (not verified) on 1 Aug 2018 - 07:15

    I'm currently 4 weeks pregnant through IVF and I bent down and kissed my dog on the side of his mouth this morning then realising from the smell he had eaten cat poo. I'm worried about this pregnancy already and now I'm worried I've made a silly mistake. I washed my hands and face and lips with antibacterial soap straight away.

  • By Midwife @Tommys on 1 Aug 2018 - 10:57

    Hi Emma
    It sounds like you are very anxious about this encounter, so it is probably best that you go to your GP and tell him/her that you are worried that you have come into contact with toxoplasmosis and you'd like to be sent for the blood test. Often, this test cannot be covered by the NHS and may incur a charge. It is impossible to know if the cat faces that the dog ate, contained Toxoplasmosis or not and so by not having the simple blood test, this may cause you more concern in not knowing. Information about the blood test in more detail is above in the body of this article. I am sure that washing your hands and face thoroughly has been effective in destroying any toxoplasmosis if it was present. But most women who are concerned that they have been in possible contact, go onto have the test to put their mind at ease.
    All the best, Sophie Tommy's Midwife

  • By Silvia (not verified) on 31 Jul 2018 - 15:47

    Good Afternoon,

    Yesterday I was cutting some pork meat I bought at the supermarket, without realizing that I had a cut/abrasion on one of my fingers, the ones you get when you torture your cuticles all the times. It wasn’t bleeding but I felt pain like burning when the meat liquid got into the cut (same with water).
    I quickly washed my hands and sprayed some wound disinfectant, I also made the cut bleed after that (in the attempt to make sure it wasn’t before). I am not sure whether this is classified as an open cut or not, however I am panicking that this might pose a problem with regard to a possible toxoplasmosis infection.
    Thank you for your attention

  • By Midwife @Tommys on 1 Aug 2018 - 10:53

    Hi Silvia
    It sounds like you are very anxious about this encounter, so it is probably best that you go to your GP and tell him/her that you are worried that you have come into contact with toxoplasmosis and you'd like to be sent for the blood test. Often, this test cannot be covered by the NHS and may incur a charge. It does sound unlikely that you'd contract toxoplasmosis from this event, but i feel that not having the test may cause you more concern in not knowing. Information about the blood test in more detail is above in the body of this article.
    All the best
    Sophie,Tommy's Midwife

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