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 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

  • By Tracey (not verified) on 30 Jul 2018 - 18:08

    Hi, I have recently been on holiday in Spain and eaten chirizo and a very rare steak.
    Since I returned home last week I found out I am pregnant, approx 7 weeks.
    I have been eating rare steaks and salami/cured meats all my adult life.
    Do you think it is possibly I may have passed toxoplasmosis onto the baby?
    Thanks

  • By Midwife @Tommys on 31 Jul 2018 - 16:21

    Hi Tracy
    For your peace of mind, i feel that you should go to your GP and inform them that you are pregnant and have eaten these meats and very rare steak before realizing you were pregnant and that you would like a blood test to find out if you have been exposed. You may need to pay for this blood test as not all GP surgeries can run the test via NHS funding. Please feel free to get in touch again if you need any further advice.
    Sophie,Tommy's Midwife

  • By JC (not verified) on 26 Jul 2018 - 23:13

    Hi - so I am currently 20 weeks pregnant. I have three lovely indoor cats that I take care of. They have always been indoor cats, they were given vaccinations and spayed when young and have never been outside or eaten table food. Throughout my pregnancy I have been cleaning their litter box. I usually do it every 3-5 days. I have taken precautions such as covering my mouth, avoiding touching any of the feces, and vigorously washing my hands after cleaning the boxes. I haven't felt sick. But it still makes me nervous for my baby. Would I still be at risk? Is my baby? I'm quite paranoid about the situation.

  • By Midwife @Tommys on 27 Jul 2018 - 12:56

    Hi JC,
    It does not sound like you are at risk, they are indoor cats and you are taking pre-cautions. If you are worried then do see if someone else change the litter tray for you. It is possible to do a blood test via your GP however I must stress it does not sound like there is a risk and this test would unlikely be necessary.
    Best wishes
    Tommy's midwife

  • By Worried mum to be (not verified) on 24 Jul 2018 - 20:46

    I've just been out for dinner in a nearby pub where I've eaten several times before. It was only as I was approaching the end of my meal that I realised one of the spinach leaves was coated in soil. I'm worried I may have eaten some of the soil. How much at risk am I of toxoplasmosis?

  • By Midwife @Tommys on 26 Jul 2018 - 11:56

    Hi Worried Mum
    It is very unlikely that you have been in contact with toxoplasmosis from this event - but if you would feel better having a blood test to check that you have not been exposed, then please see the article above for information on how to go about asking for the test.
    All the best
    Sophie,Tommy's Midwife

  • By JC (not verified) on 24 Jul 2018 - 15:42

    Hi - so I am currently 20 weeks pregnant. I have three lovely indoor cats that I take care of. They have always been indoor cats, they were given vaccinations and spayed when young and have never been outside or eaten table food. Throughout my pregnancy I have been cleaning their litter box. I usually do it every 3-5 days. I have taken precautions such as covering my mouth, avoiding touching any of the feces, and vigorously washing my hands after cleaning the boxes. I haven't felt sick. But it still makes me nervous for my baby. Would I still be at risk? Is my baby? I'm quite paranoid about the situation.

  • By Midwife @Tommys on 26 Jul 2018 - 11:49

    Hi JC, with all of the precautions you take, you are not at high risk of contracting toxoplasmosis.
    If you are very worried, then please get someone else to empty your litter tray for you.
    But unless you are consuming cat faeces (which may or may not contain toxoplasmosis anyway) then you are not at high risk.
    If you are feeling that anxious about it, then you can go to your GP and request a blood test (see information in article above) if you believe that you have been exposed.
    All the best
    Sophie,Tommy's Midwife

  • By Anon (not verified) on 23 Jul 2018 - 21:34

    Hello

    I’m 13 weeks pregnant and I recently gave my cat a kiss and cuddle without realising that he had some flecks of dirt/soil attached to his coat. I don’t think that I ingested any of the dirt/soil on his coat but I can’t be completely sure and I’m now worrying about having contracted toxoplasmosis. Do you have any advice?

    Many thanks

  • By Midwife @Tommys on 26 Jul 2018 - 11:42

    Hi
    Toxoplasmosis is ONLY caught by swallowing anything infected with, or contaminated by, the parasite. You would not have swallowed anything from this encounter. So please do not worry. This is not a high risk toxoplasmosis event. So please put it out of your mind .
    Sophie,Tommy's Midwife

  • By saim (not verified) on 23 Jul 2018 - 16:59

    Hi, I work as a reception in a vets. Yesterday, my colleague cleaned out a cat litter tray with bare hands, I think he washed his hands (but I'm not sure how thoroughly) from a cat that was staying in with us, and then touched my computer keypad. I sterilized it with wipes and washed my hands but I'm still freaking out just incase he didn't wash his hands enough and has spread the parasites onto the computer which I used. I'm 25 weeks. Thanks

  • By Midwife @Tommys on 24 Jul 2018 - 13:51

    Hi,
    thanks for posting I'm really sorry to hear that you have been so freaked out by your colleague's actions at the veterinary surgery where you work.
    As long as you take appropriate precautions in pregnancy, the likelihood of you being infected, or affected, by this parasitic infection Toxoplasma gondii is extremely small.
    Half the UK population has been exposed to this parasite and so have natural immunity to it. You may also have been in contact with cats as you grew up so you are also likely to have had exposure; and therefore immunity to Toxoplasmosis. Cats do not cause risk - because the toxoplasma parasite completes its lifecycle in the gut of a cat – it is the faeces of an infected cat that presents the risk. However, these faeces only become infective from at least 24 hours after being passed – when spores are released.
    Toxoplasmosis only presents a problem if you are exposed to it and infected for the first time in pregnancy and since oocysts (eggs) are transmitted by ingestion, in order to contract toxoplasmosis, a pregnant woman would have to make contact with contaminated faeces and then, without washing her hands, touch her mouth or otherwise transmit the contaminated faecal matter to her digestive system. If you take necessary precautions – such as regular hand washing - the risk is minimal.
    Your colleague washed his hands and you also washed your hands and sterilized your keypad so please continue to take these precautions in your workplace and when preparing fruit and vegetables wash them thoroughly. Make sure that you also cook meat thoroughly avoiding pink or undercooked meat.
    I hope this reassures you
    Warmest wishes
    Anna-Tommy's Midwife

  • By Anonymous (not verified) on 11 Jul 2018 - 16:08

    Hi, I've just moved into a new house and there was soil on the carpet - it is obviously quite old as the house has been empty for a month, but was dusty when I scraped it up. I'm 10-11 weeks pregnant and I ate a sandwich (and may have put my hand in my mouth) before I remember to wash them - I don't know if the soil is from outside, the garden etc but the previous owners had a cat. Is there a toxoplasma risk? Thank you very much

  • By Midwife @Tommys on 12 Jul 2018 - 16:02

    Hi,
    It does not sound like there has been any risk to you contracting toxoplasmosis, the virus needs warm moist soil to stay alive, the fact that the soil was dried out means that it would be stay alive. It also sounds like you are unsure if you even ingested any of the soil in the first place therefore would not be at risk of toxoplasmosis. If you are worried you can get a blood test however it is an expensive test which GPs will only do for a good reason so I cannot guarantee they will do this for you.
    I hope this reassures you
    Best wishes
    Tommy's midwife

  • By Anonymous (not verified) on 12 Jul 2018 - 16:35

    Thanks so much - sounds like the stress of worrying is worse than anything in this situation :) just checking you meant "not" instead of "be" in this though - "the fact that the soil was dried out means that it would be stay alive."?

  • By Midwife @Tommys on 12 Jul 2018 - 16:41

    Yes, sorry! I meant would not stay alive in dry soil

  • By Anonymous (not verified) on 10 Jul 2018 - 13:50

    Hello

    This is my first pregnancy (11 weeks) and I have accidentally touched some potting soil/compost in the pot of my indoor Aloe Vera plant at work before touching my face and mouth. I’m extremely anxious about having contracted toxoplasmosis. Please can you advise?

  • By Midwife @Tommys on 11 Jul 2018 - 16:01

    There is no risk of Toxoplasmosis from touching indoor plants and you can continue to do your indoor gardening without any concerns. Take care

  • By Soph (not verified) on 6 Jul 2018 - 19:44

    Hi, a friend of mine was wearing a jacket that had dried mud on it from a garden centre visit three months ago, and she touched her jacket and then touched food I may then have eaten. Is there a toxoplasmosis risk in this case? Have severe pregnancy anxiety. I am 10 weeks pregnant. Thanks

  • By Midwife @Tommys on 9 Jul 2018 - 12:19

    Hi Soph, There is no risk from this jacket. The parasite would not live this long in this environment. Please be reassured that you have not put your pregnancy at risk.

  • By Soph (not verified) on 9 Jul 2018 - 14:16

    Also, she's now saying it was maybe two months ago...still the same outcome?? Thanks!

  • By Midwife @Tommys on 9 Jul 2018 - 14:44

    The parasite lives in the infected faeces of cats. Mud in itself is not a risk. The risk comes if you handle cat poo that has been recently infected by the parasite. Please be reassured that the mud on your friend's jacket is not a risk for toxoplasmosis

  • By Sophhigh1 (not verified) on 6 Jul 2018 - 15:49

    Hi I’m 30 weeks pregnant currently on holiday in Spain I’ve eatwn 3 slices of olive roll which is similar to a luncheon meat in a Spanish restaraunt I am now panicking about toxiplasmosis I avoided chorizo and salami and thought I would be safe with the olive roll but can’t help but panic what are the chances of toxiplasmosis should I be worried ? Thanks

  • By Midwife @Tommys on 9 Jul 2018 - 12:27

    I don't know what olive roll is and whether the meat is cooked or uncooked. Remember that the risk of contracting toxoplasmosis when eating uncooked or cured meats is low but if you are concerned just ask your GP to do a blood test when you get back from your holiday. Take care

  • By Ruby (not verified) on 4 Jul 2018 - 12:30

    Hi I was living in South Africa for 2 years and I can only be sure I contracted toxo from there. When I was 5 weeks pregnant my blood test showed 1.50 positive toxo. At 8 weeks I had a missed miscarriage is it possible I infected the baby with toxo what should I do to cure myself as we do want to try for another baby?

  • By Midwife @Tommys on 5 Jul 2018 - 14:06

    Hi Ruby, Thank you for your comment, we are so sorry to hear about your miscarriage.
    With regards to your question, if you have already been exposed to toxoplasmosis, then you will be immune to the organism already, this means that in a future pregnancy, this immunity will also be passed on to baby so that they are protected. It may be advisable to get your bloods checked again to see if you do have this immunity from your previous exposure. Your GP should be able to do this for you. Hope this helps, Take Care, Tommy's Midwives x

  • By What should I do? (not verified) on 3 Jul 2018 - 20:11

    Last night I went to dinner with my family and on the way out of the restaurant I dropped something on the ground and I picked it up on their flower landscaping. It was some flowers surrounded by wood chips. I didn’t think anything of it. We got home and had some ice cream for dessert when all of a sudden I thought about maybe I should’ve washed my hands before I ate anything else! I don’t remember getting any type of wood chips or dirt on me so figure everything should be ok? I’m still worried tho. Since I ate ice cream and didn’t specifically use my fingers to eat could that help eliminate any type of exposure? I washed my hands when I thought about all this, but still worried. I’m 31 weeks pregnant and feel so dumb for being in the homestretch and then this happens. How long does the infection take to pass through the placenta? If it’s several can I just be induced eventually? Do people ever do that to avoid possible exposure ? Thank you for your response

  • By Midwife @Tommys on 5 Jul 2018 - 12:45

    Hi, Thank you for your comment.

    Please feel reassured that it is highly unlikely that you have been exposed the toxoplasmosis. There was no cat faeces on the wood chip and if you were picking something up then you wouldn't of touched anything that surrounded the area. You didn't put your fingers in your mouth and you ate using a spoon and you washed your hands when you felt like you needed too. Exposure to Toxo is around 2 to 3 weeks after the event before he antibody can be detected on a blood test. Please go to the following link for more information about Toxoplasmosis exposure on the Tommy's website https://www.tommys.org/pregnancy-information/pregnancy-complications/infections-pregnancy/toxoplasmosis-pregnancy
    If you think that you have been exposed to Toxo then the GP will be able to offer you a blood test from this. Hope this helps, take care, Tommy's Midwives x

  • By Rachel (not verified) on 1 Jul 2018 - 00:29

    Hello! I am 11 weeks pregnant with my first, and have been experiencing flu-like symptoms, such as aches, chills, constantly cold and goosebumpy, just overall feeling sick towards night time for over a month now on and off. I got my doctor to check my immune status through blood work a couple weeks ago because I feared listeriosis. But she said the results were normal but didn’t go into much depth other than that I’m fine and the symptoms must just be a part of pregnancy. But then I read about toxoplasmosis and saw that it said that symptoms are flu-like and can last over a month. I had an ultrasound at 8 weeks and the heartbeat was 164, a good sign. And that everything looked normal. But I am now very worried that I may have toxoplasmosis. My question is, if I was infected would that have shown on an immunity blood test because of white blood cells or something? Or do they have to do a specific screening to determine toxoplasmosis infection? Thank you for your response.

  • By Midwife @Tommys on 2 Jul 2018 - 13:35

    You would need to have a specific blood test looking for antibodies to the toxoplasmosis infection. Just ask your GP to arrange the testing if it has been at least 3 weeks since you may have been infected.

  • By Roni (not verified) on 25 Jun 2018 - 22:15

    I’m 30 weeks pregnant and my son played near an open large sandbox at the pool. I wasn’t there with him, but he said he didn’t go in it. Just by the area. Anyways, he wore pool shoes after that, but I didn’t notice anything on the shoes. I touched them tho to pick them up and now I’m worried I possibly exposed myself to toxo. Should I be worried or am I over thinking this? I’m just worried he stepped near sand then put his shoes on and then I touched them the day after near the bottom of the shoe. Can toxo live on shoes? I washed my hands, but not for a little while after because I didn’t think of it until after.

  • By Midwife @Tommys on 27 Jun 2018 - 11:10

    Hi,
    Toxoplasmosis only presents a problem if you are exposed to it and infected for the first time in pregnancy and since oocysts (eggs) are transmitted by ingestion, in order to contract toxoplasmosis, a pregnant woman would have to make contact with contaminated faeces and then, without washing her hands, touch her mouth or otherwise transmit the contaminated faecal matter to her digestive system. If you take necessary precautions – such as regular hand washing - the risk is minimal. You are right that the sandpit could be contaminated but the cat that in theory defecated in the sandpit would have had to have been infected at the time.

    We also advise women to thoroughly wash any fruit or vegetables that may have been grown in potentially infected soil – due to the risk of infective spores which can survive in the soil for long periods. This does not usually present a risk if you buy commercially grown produce – but may be more of a risk if you grow your own fresh produce in a garden or allotment, or at your farm cats may defecate in the soil.

    If you think that you would like to have a blood test for peace of mind, you can either ask your GP if your local hospital provides private blood screening tests; alternatively you can search online – as there are many private clinics and labs offering this test. You should expect to pay at least £100 or more in most cases. I would advise you to ask for both Toxoplasma IgG & IgM blood tests. The risk is minimal to contract toxoplasmosis from the sand but if it is going to cause you great anxiety you might want to find out more about the blood test.

    Warm regards
    Anna-Tommy's Midwife


  • By Rebecca (not verified) on 24 Jun 2018 - 14:53

    Hi,
    I’ve had such anxiety during my pregnancy. I ate a foot long subway sandwich containing salami and pepperoni. I’m 29 weeks and absolutely terrified that I could have harmed my baby. I went to see a GP who did not take me seriously at all and made comments like ‘how has the human race survived’ etc. I see my midwife again in a few weeks which would be the right time to check for an infection (3 weeks from eating the sandwich). I’m terrified she also will not take my concerns seriously about a toxoplasmosis infection. Do you have any advice? Becky

  • By Midwife @Tommys on 27 Jun 2018 - 11:28

    Hi Becky,
    Toxoplasmosis is an infection caused by a parasite. While many of us will be infected at some time in our lives it rarely has any implications and we only really take extra precautions when we are pregnant. We advise against eating uncooked meat including cured meats like salami but in reality the risk is extremely small. If you have caught the infection for the first time in this pregnancy, there is still only a small risk that you would pass this on to your baby.
    It is thought that up to half the UK population has been exposed to this parasite and so have natural immunity to it. You may also have been in contact with cats as you grew up so you are also likely to have had exposure; and therefore immunity to Toxoplasmosis.
    If you are still really worried you could have a private blood test. I would advise you to ask for both Toxoplasma IgG & IgM blood tests. The IgG test measures your immunity – a positive IgG antibody test would indicate you are already immune to this infection. IgM positive would indicate that you may have had had a recent or active infection and further tests would then be required. Please don't worry on your own though! You can always call us for anything 9-5 weekdays on 0800 0147 800
    Warmest wishes
    Anna-Tommy's midwife

  • By Jo (not verified) on 16 Jun 2018 - 18:41

    I drank some water from a glass at my friend’s house and my son has since told me their cat drank from that glass prior to me drinking from it. Is there any risk of toxoplasmosis? I am 35 weeks pregnant.

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