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 Anonymous (not verified) on 13 Oct 2018 - 17:06

    Hi,

    I am 32 weeks pregnant and toxoplasmosis is something I have had extreme anxiety about my whole pregnancy (I own a cat). I was previously tested for this at around 24 weeks pregnant and tested negative therefore I am not immune to it, however, have still been very anxious about toxoplasmosis since the test in case I catch it. What worried me even more was the fact that my Mam fed my cat some meat from a saveloy the other day (a cold one from a shop/counter, NO IDEA WHY!) and now I am panicking that this could contain toxoplasmosis which could then be passed on to my cat? I am freaking out and have severe anxiety when it comes to toxoplasmosis as it is.

    Thanks

  • By Midwife @Tommys on 22 Oct 2018 - 12:28

    I can understand your concerns but I wonder whether you should focus on relieving your anxiety by techniques such as meditation, mindfulness, exercise, yoga etc. If you have already had a toxoplasmosis screen at 24 weeks, this means that in the x number of years you have been alive , you have never caught this infection. despite the numerous times you must have been exposed to a risk factor. You can't catch the infection from stroking or owning a cat and as long as you wash your hands after cleaning litter trays or when gardening your risk is not increased.

  • By Hannah (not verified) on 10 Oct 2018 - 21:42

    Hi there, my husband and I have been on the waiting list for a kitten for some time now and a couple of weeks ago one came up for us which will be ready in a couple of weeks. However I found out a week ago that I'm pregnant and so have been reading a lot about toxoplasmosis. I don't want to do anything at all that puts risk to our baby but the kitten has been raised indoors, is a pedigree, will be an indoor cat with us (my husband will do the litter box) and will not be fed raw meat so I'm wondering how risky it is in that instance? The only thing was I read an American government site called CDC which said not to get a new cat in pregnancy. It feels like the right time for us to have a cat and I feel she will help a lot with minimising feelings of anxiety and loneliness in pregnancy (I'm living far away from my family and friends at the moment) but I really think we'll have to say no to her if she will actually pose a risk to my pregnancy. I should also say we had two family cats while I was growing up that I used to kiss and cuddle all the time (much to the annoyance of my parents!) so I wonder if I may already have had toxo. Any advice would be so welcome as it's stressing me out a lot! Thanks so much in advance.

  • By Midwife @Tommys on 11 Oct 2018 - 12:51

    Hi Hannah, Thank you for your comment.

    Toxoplasmosis can be contracted through contact with cat faeces, not from stroking a cat or having it as a pet. Cats can contract Toxo from eating birds then it is transferred to the gut of the cat and comes out in the faeces.
    This kitten has been bread very well from what you explain and as long as your husband cleans the litter tray and the kitten is up to date with an immunisation injections from the vet then you should be fine to get your kitten. Just maintain good hand hygiene at all times. If you feel that getting the kitten would cause anxiety about toxo then delay getting the kitten until after the baby is born, just have a think about it before making your decision.

    Hope this helps, take care, Tommy's Midwives x

  • By Anonymous (not verified) on 8 Oct 2018 - 12:09

    Would someone be able to advise me whether I’d be considered at risk of toxoplasmosis from simply moving my cat’s litter box outside for my husband to clean? I washed my hands throughly with soap and water afterwards but didn’t wear a mask. Is there any chance I could have inhaled toxoplasmosis just by putting the box outside?

  • By Midwife @Tommys on 8 Oct 2018 - 14:01

    No , I think this is not increasing your risk. Please don't worry. x

  • By Chelsea (not verified) on 8 Oct 2018 - 03:07

    Hello. My cat is mainly indoor. But for the summer we put him outside during the night. From like 3-7am. He has eaten several mice. I cuddle and kiss him (not directly on the mouth) but on his kitty cheeks .. I scoop his litterbox but I’m not as worried about that as I wear gloves AND a mask. What I do worry about is how close I’ve come to his face and the couple of time he’s brushed his paw across my face/mouth since he walks thru his litter box.. when he touches my face or lips (quickly and always gently he is also declawed) I always wash the area with soap and water because clearly I’m a worry wart. You don’t think I could get a it from those two things do you?
    THANKS

  • By Midwife @Tommys on 8 Oct 2018 - 13:57

    The risks are very low, but if you want to be 100% sure, the only way is to do a test. Take care

  • By Anonymous (not verified) on 2 Oct 2018 - 23:12

    I’m in my second trimester and one of my cats yesterday walked mud and dirt over a towel in our bathroom which I have been using for drying my face after cleansing. I dried my face on the towel without realising the cat had left muddy paw prints on it and I’m now concerned about having ingested soil and put myself at risk for toxoplasmosis (I’m not sure whether the mud had fully dried). Should I be concerned?

  • By Midwife @Tommys on 8 Oct 2018 - 12:56

    It doesn't sound as if you have put yourself at increased risk. Although you can never be completely sure, cats are in fact very clean animals and mud in itself isn't a risk. Also you are unlikely to have got the soil into your mouth or ingested it in any way. If you think that the cat may have had faeces on it's paws and you could have swallowed this, you could get a test in a few weeks time.

  • By Anonymous (not verified) on 8 Oct 2018 - 22:25

    Hi, thank you for your response. I’m fairly sure that it was mud and dirt rather than actual faeces on the cat’s paws. I was more worried that the cat could have walked soil containing toxoplasmosis onto the towel rather than directly walking in faeces. Should I still be concerned?

  • By Midwife @Tommys on 10 Oct 2018 - 12:34

    Hi there
    Soil does not contain toxoplasmosis - this can only be found in cat faeces. So if you are sure that it was soil and not faeces, then you are not at risk of contracting toxoplasmosis. If you are still worried and wish to have the blood test done privately anyway, then you should wait at least 2-3 weeks from possible contamination event until the test for the results to be accurate.
    All the best
    Tommy's Midwife

  • By Anonymous (not verified) on 1 Oct 2018 - 10:07

    Hi, I was cleaning my house and there was definitely mud and soil that got on my hands a few times as I was cleaning the floor. I washed my hands twice with soap and hot water and didn't notice any left on me. I still suck my thumb (I know...) and carried on doing this, made myself a sandwich too and ate - is there any risk or was washing my hands after soil contact enough to not need to worry?

  • By Midwife @Tommys on 1 Oct 2018 - 14:22

    Yes, there is no need to be concerned. Washing hands with soap and water is the best way to reduce the risks. Take care.

  • By Helen (not verified) on 28 Sep 2018 - 12:27

    Hi there. I’m probably over-reacting, but this morning I was at a friend’s house and quickly pet the head of her (mixed indoor and outdoor) cat. After the visit, I had a sweet from a wrapper and drank from a bottle of water but forgot to wash my hands first. I honestly didn’t think of the potential risks until afterwards. I wasn’t in contact with cat faeces and only scratched her head for a few seconds. Is there a risk of transmission?? Many thanks.

  • By Midwife @Tommys on 28 Sep 2018 - 16:33

    Hi - the risk of infection from petting your friends cat is low, however, if you are concerned please get in touch with your GP for advice and testing if they feel it necessary.

  • By anna (not verified) on 25 Sep 2018 - 21:28

    Hi,

    I am in Italy and have just eaten pork meat, steak. I noticed that the middle of he steak was not cooked good and took a peace from the outer part. I also only eat around the middle of my slice since I thought the midle looked a bit pink. But now I am so scared, I am thinking that the chef must have used a knife to slice the steak and that the knife was in contact with all the slices. Can toxoplasmosis transfer from raw meat to a knife to another peace of meat ?

  • By Midwife @Tommys on 26 Sep 2018 - 11:32

    Hi Anna
    It appears that you may have potentially had contact with under cooked meat.
    To be on the safe side and to put your mind at ease one way or another , it would be best to go to your GP to inform them that this has occurred and a midwife has suggested that you are tested for toxoplasmosis. This is best tested for 2-3 weeks after the possible contact for the toxoplasmosis to be detected if it is present.
    Please try not to worry, but it is certainly worth getting the blood test done.
    All the best
    Tommy's Midwife

  • By Helen (not verified) on 23 Sep 2018 - 20:17

    Hi I am currently abroad in France and 7 weeks and didn’t realise you were not supposed to eat salad from restaurants here. I have only eaten a small amount of lettuce in a burger and will obviously be avoiding now. Should I be concerned?

  • By Midwife @Tommys on 24 Sep 2018 - 12:41

    Hi Helen,
    There should be no risk as long as your salads are washed.

  • By Faye (not verified) on 23 Sep 2018 - 19:10

    Hi,
    I was at my husband's grandparents and as I had covered the meat in gravy, horseradish and mustard I didn't realise the steak was pink. There was no blood and would describe it medium. Does this pit me at risk? After reading the internet I have completely freaked myself out. We have gone through such a long journey to get pregnant and now I'm worried I've put our baby at risk stupidly for not checking.
    Thanks.

  • By Midwife @Tommys on 25 Sep 2018 - 16:05

    For your own peace of mind I would advise seeing your GP for a toxoplasmosis test to assess if there is any risk to your pregnancy-you can request this if you think you may have put yourself at risk. You may already been exposed to the infection before you became pregnant-the test will also show this.
    The following link has more information -

    https://www.tommys.org/pregnancy-information/pregnancy-complications/infections-pregnancy/toxoplasmosis-pregnancy

    Take care
    Tommy's Midwife

  • 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?

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