Toxoplasmosis

Associated Risks: Long term Sequelae (3)

1. Chorioretinal disease (85% of infected children) 2. major neurological abnormalities 3. phycomotor and mental impairment 85-90% infants that do not have symptoms at birth can have long term sequelae.

Associated Risks: Newborn (3)

1. Chorioretinitis (blindness, retinal impairments) 2. hydrocephalus 3. intracranial calcification and convulsions

Signs and Symptoms: Maternal (3)

1. Fever 2. Night Sweats 3. Unwellness

U/S results suggestive of T. gondii infection (2)

1. Hydrocephalus 2. Hyperdensity/thickened placenta

Serologic Testing (IgG and IgM antibodies)

1. IgG -/IgM-: absence of infection or in very rare cases, very recent acute infection. 2. IgG+/IgM-: past infection 3. IgG+/IgM+: recent infection or false positive If you suspect acute infection, repeat the test in 2-3 weeks. If there is a 4-fold increase in the titres, this represents a recent infection.

Prevention (8)

1. Wear gloves and thoroughly clean hands and nails when handling materials potentially contaminated by cat faeces 2. Change litter q 24 hours 3. Eat only well-cooked meat (>67C/153F) 4. Freeze meat 5. Prevent cross-contamination: clean hands and utensils after handling raw meat or vegetables 6. Wash all uncooked fruits and vegetables 7. Do not drink water that is potentially contaminated 8. Avoid raw milk/eggs/cheese.

CMO CTCS

Consultation with MFM/OB recommended due to medical condition arising in pregnancy

Life cycle

Humans become infected during the OOCYST stage The protozoan can spread disease during its TACHYZOITES stage

Associated Risk: Maternal (4)

If immunocompromised, can lead to: 1. severe encephalitis 2. myocarditis 3. pneumonitis 4. hepatitis via acute infection or reactivation of latent infection

Congenital Toxoplasmosis

Incidence: 20-50% infants without treatment The later the pregnancy when maternal infection occurs, the more likely to pass onto the fetus. Severity of disease increases with gestational age

Amniocentesis

Investigation for T. gondii in AFV via PCR Sensitivity: 81-90% Specificity: 96=100% Diagnostic testing only performed/recommended when maternal primary infection is diagnosed, or when there are abnormal U/S results suggestive of toxoplasmosis.

Length of infection

Once human is infected, it is believed that they remain infected for life but remain asymptomatic unless immunocompromised.

Northern Canada Specific Guidelines

Screening program established due to high incidence of toxoplasmosis: 59.8% prevalence Higher incidence of eating raw/undercooked meat and contaminated water

Antibiotic Treatment/Prophylaxis

Spiramycin - reduces incidence of vertical transmission and severity of infection of fetus Spiramycin 1 g PO q 8 hours for duration of pregnancy

Infection can be acquired via: (4)

consumption or contact 1. Eating raw or undercooked meat, milk, eggs 2. Contaminated water 3. Soil, Sandbox, Litter (Warm, humid conditions) 4. Uncooked fruits and vegetables 3rd leading cause of food-born death via infectious disease.

Toxoplasmosis is a...

intracellular protozoan parasite Toxoplasma gondii