Toxoplasmosis Health Article

Definition

Toxoplasmosis is an infectious disease caused by the one-celled protozoan parasite Toxoplasma gondii. Although most individuals do not experience any symptoms, the disease can be very serious, and even fatal, in individuals with weakened immune systems.

Description

Toxoplasmosis is caused by a one-celled protozoan parasite known as Toxoplasma gondii. Cats, the primary carriers of the organism, become infected by eating rodents and birds infected with the organism. Once ingested, the organism reproduces in the intestines of cats, producing millions of eggs known as oocysts, which are excreted in cat feces daily for approximately two weeks. In the United States, it is estimated that approximately 30% of cats have been infected by T. gondii. Oocysts are not capable of producing infection until approximately 24 hours after being excreted, but they remain infective in water or moist soil for approximately one year. When cattle, sheep, or other livestock forage through areas with contaminated cat feces, these animals become carriers of the disease. Fruits and vegetables can also become contaminated when irrigated with untreated water that has been contaminated with cat feces. In humans and other animals, the organisms produce thick-walled, dormant structures called cysts in the muscle and other tissues of the body.

Most humans contract toxoplasmosis by eating cyst-contaminated raw or undercooked meat, vegetables, or milk products. Humans can also become infected when they come into contact with the T. gondii eggs while cleaning a cat's litterbox, gardening, or playing in a sand-box, for instance. Once infected, an individual is immune to reinfection. The incubation period or period between infection and the start of the disease ranges from several days to months.

Anyone can be infected by T. gondii, but usually only those individuals with weakened immune systems (immunocompromised) develop symptoms of the disease. For them, toxoplasmosis can be severe, debilitating, and fatal. Immunocompromised individuals at risk include those with AIDS, cancer, or other chronic illnesses.

There is no person-to-person transmission, except from an infected mother to her child in the womb. Approximately six out of 1,000 women contract toxoplasmosis during pregnancy. Nearly half of these maternal infections are passed on to the fetus. Known as congenital toxoplasmosis, this form of the disease is acquired at birth by approximately 3,300 infants in the United States every year. The risk of fetal infection is estimated to be between one in 1,000 to one in 10,000. In children born with toxoplasmosis, symptoms may be severe and quickly fatal, or may not appear until several months or even years after birth.

Causes and symptoms

Healthy individuals do not usually display symptoms. When symptoms do occur, they are usually mild, resembling infectious mononucleosis, and include the following:

• enlarged lymph nodes
• muscle pains
• fever that comes and goes
• general sick feeling

The distinction is made between acquired toxoplasmosis, in which an individual becomes infected, and neonatal congenital toxoplasmosis, in which a fetus is born with the infection because the mother became infected during pregnancy. If a fetus becomes infected early in pregnancy, the disease can cause the fetus to spontaneously abort, be stillborn. If full-term, the infant may die in infancy or suffer from central nervous system lesions. If the mother becomes infected in the last three months of pregnancy, however, the prognosis is good and the baby may not even display any symptoms.

In adults, if the infection continues for an extended period of time, chronic toxoplasmosis can cause an inflammation of the eyes called retinochoroiditis, which can lead to blindness, severe yellowing of the skin and whites of the eyes (jaundice), easy bruising, and convulsions.

Adults with weakened immune systems have a high risk of developing cerebral toxoplasmosis, including inflammation of the brain (encephalitis), one-sided weakness or numbness, mood and personality changes, vision disturbances, muscle spasms, and severe headaches. If untreated, cerebral toxoplasmosis can lead to coma and death. This form of encephalitis is the second most common AIDS-related nervous system infection that takes advantage of a person's weakened immune system (opportunistic infection).

Diagnosis

A diagnosis of toxoplasmosis is made based on clinical signs and supporting laboratory results, including visualization of the protozoa in body tissue or isolation in animals and blood tests. Laboratory tests for toxoplasmosis are designed to detect increased amounts of a protein or antibody produced in response to infection with the toxoplasmosis organism. Antibody levels can be elevated for years, however, without active disease.