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We have taken so many aspects in our modern daily lives for granted, especially water sanitation as well as our improved knowledge about food hygiene. As a result, parasitic diseases such as toxoplasmosis have since grown “quaint”, or at least we thought so. Little did we know that more than 40 million people in the United States may be infected with the Toxoplasma parasite. Meanwhile, as many as 49% of pregnant women in Malaysia were found to have Toxoplasma antibodies in their blood, suggesting a previous infection. It’s hard not to learn more about this parasitic disease, when in reality there are so many people affected by it.
Toxoplasmosis is an infection caused by a parasite called Toxoplasma gondii. Here’s how the little guy looks like under microscope:
The Toxoplasma parasite can stay for long periods of time in the bodies of humans and other animals, possibly even for a lifetime. Of those who are infected however, very few go on to develop symptoms. This is because a healthy person’s immune system usually keeps the parasite from causing illness.
However, pregnant women and individuals who have compromised/weakened immune systems (e.g. those with HIV/AIDS or receiving chemotherapy) should be cautious; for them, a Toxoplasma infection could be a serious health concern.
For individuals with weakened immune systems who do have symptoms after being infected by the Toxoplasma parasite, the symptoms may arise within 5 to 23 days after exposure to the parasite. The symptoms of the infection may vary, but it generally has the following hallmarks:
General flu-like symptoms, such as fever, chills, sweats, headache, muscle ache, and sore throat
Swollen lymph nodes
In severe cases, toxoplasmosis can cause damage to the brain, eyes, or other organs. A person can also develop from an acute Toxoplasma infection or one that had occurred earlier in life and is now reactivated.
If the eyes are damaged as a result of toxoplasmosis, the person may experience reduced vision, blurred vision, pain (often with bright light), redness of the eye, and sometimes tearing. The eye doctor sometimes prescribes medicine to treat active disease. Whether or not medication is recommended depends on the size of the eye damage, the location, and the characteristics of the damage (acute active, versus chronic not progressing).
A Toxoplasma infection occurs by one of the following:
Eating undercooked, contaminated meat or shellfish (for example, oysters, clams or mussels).
Accidental ingestion of undercooked, contaminated meat or shellfish after handling them and not washing hands thoroughly. However, Toxoplasma cannot be absorbed through intact skin.
Eating food that was contaminated by knives, utensils, cutting boards and other foods that have had contact with raw, contaminated meat or shellfish.
Drinking water contaminated with Toxoplasma.
Accidentally swallowing the parasite through contact with cat feces that contain Toxoplasma. This might happen by
Cleaning a cat’s litter box when the cat has shed Toxoplasma in its feces;
Touching or ingesting anything that has come into contact with cat feces that contain Toxoplasma; or
Accidentally ingesting contaminated soil (e.g., not washing hands after gardening or eating unwashed fruits or vegetables from a garden).
Mother-to-child (congenital) transmission.
Receiving an infected organ transplant or infected blood via transfusion, though this is rare.
To prevent toxoplasmosis, simply practise safe food handling, wash your hands with soap and water after gardening or cleaning out a cat’s litter box and wash your kitchen utensils after using them.
Once a diagnosis of toxoplasmosis is confirmed, you and your doctor can discuss whether treatment is necessary. In an otherwise healthy person who is not pregnant, treatment usually is not needed. If symptoms occur, they typically go away within a few weeks to months.
For pregnant women or persons who have weakened immune systems, medications are available to treat toxoplasmosis.
To treat ocular toxoplasmosis (eyes affected by toxoplasmosis), an antibiotic called trimethoprim/sulfamethoxazole 160/800mg (commonly known as Bactrim) is usually given twice daily for at least 6 weeks. For pregnant women with ocular toxoplasmosis, intravitreal clindamycin can be considered.
In congenital toxoplasmosis (mother passes toxoplasmosis infection to baby), a regimen of pyrimethamine/sulfadoxine (Fansidar®) + sulfadoxine + folinic acid is usually prescribed. Note that Fansidar® is an orphan drug and needs special procurement to buy.
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Disclaimer: As a service to our users and general public, Doc2Us provides health education contents. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
UpToDate - Toxoplasmosis: Acute systemic disease
Ministry of Health - National Antibiotic Guidelines 2019
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