Toxoplasmosis

Toxoplasmosis is an infection you can get from eating undercooked meat or touching cat poop or a litter box. It’s caused by a very common parasite called Toxoplasma gondii. The parasite is so tiny you can’t see it.

More than 40 million people in the United States may have the parasite. Very few people have symptoms because a healthy immune system usually keeps the parasite from causing an infection.  However, toxoplasmosis can cause health problems for you and your baby during pregnancy.

How do you get infected with toxoplasmosis?

You can come in contact with the parasite that causes the infection through:

• Eating raw or undercooked meat or shellfish
• Eating unwashed fruits and vegetables
• Touching cat litter or poop
• Touching kitchen utensils and cutting boards used to prepare raw or undercooked meat and fruits and vegetables
• Touching dirt or sand
• Touching stray cats

What are the signs and symptoms of toxoplasmosis?

You may not know if you have the infection. Many times there are no symptoms. For some people, it feels like the flu. Symptoms can include:

• Achy muscles
• Headache
• Fatigue (tiredness)
• Fever
• Swollen glands
• Blurry vision
• Eye redness

These symptoms can last for a month or longer. If you think you have toxoplasmosis, talk to your health care provider. Your provider can give you a blood test to find out if you have the infection. Even though blood tests are a regular part of prenatal care, you don’t usually get tested for toxoplasmosis. So be sure to talk to your provider if you think you have the infection.

Can toxoplasmosis cause problems before pregnancy?

If you have toxoplasmosis within 6 months of getting pregnant, you may be able to pass it to your baby during pregnancy. Talk to your health care provider about being tested. Wait 6 months after a toxoplasmosis infection before trying to get pregnant.

Can toxoplasmosis cause problems during pregnancy?

 Yes. Pregnancy complications caused by toxoplasmosis include:

• Preterm birth – Birth that happens before 37 weeks of pregnancy
• Stillbirth  – When a baby dies after 20 weeks of pregnancy
• Miscarriage -- When a baby dies before 20 weeks of pregnancy

If you get toxoplasmosis just before or during pregnancy, you may pass the infection to your baby even if you don’t have any symptoms. The risk of passing the infection to your baby depends on how far along in your pregnancy you were when you were infected. The later in your pregnancy that you get infected (third trimester), the more likely it is that your baby will also get infected. But the earlier in pregnancy you get infected, the more serious the baby’s problems may be after birth. For example, your baby could have damage to the liver, brain and eyes. Up to 1 in 2 babies (50 percent) who are infected with toxoplasmosis during the pregnancy are born early (preterm). Some infected babies may die.

If you have toxoplasmosis during pregnancy, there are several ways your health care provider can check to see if your baby is infected:

Amniocentesis. An amniocentesis (also called amnio) can test the fluid around your baby for infection.  You can get this test at 15 to 20 weeks of pregnancy. It also can be tested for other problems with the baby, like birth defects or genetic problems.

Ultrasound. About 1 in 3 babies infected with toxoplasmosis have a problem that can be seen on an ultrasound. Ultrasound (also called sonogram) is a prenatal test that uses sound waves to show a picture of your baby before they are born. Ultrasound helps your provider check on your baby’s health and development. Most pregnant people get an ultrasound in their second trimester at 18 to 20 weeks of pregnancy.

Blood test. Your baby’s blood can be tested for toxoplasmosis after birth.

How can toxoplasmosis during pregnancy harm your baby?

Most babies born with toxoplasmosis have no symptoms. But about 1 in 10 babies (10 percent) with the infection are born with problems, including:

• Eye infections or eye inflammation
• Swollen liver and spleen
• Jaundice (when a baby's eyes and skin look yellow.)
• Seizures or convulsions
• Fluid on the brain (hydrocephalus)
• Swollen lymph nodes
• Large head size (macrocephaly) or smaller-than-normal head size (microcephaly)
• Feeding problems
• Low birthweight
• Skin rash or bruising

Without treatment, newborns may develop problems later in life, even if they show no symptoms earlier. This can happen even 20 or 30 years later. These problems include:

• Intellectual and developmental disabilities (problems with how the brain works that can cause your baby trouble or delays in physical development, learning, communicating, taking care of themselves or getting along with others).
• Eye infections and vision problems
• Pneumonia
• Cerebral palsy (a group of conditions that affects the parts of the brain that control the muscles. It can cause problems with movement, posture,standing up straight and balance).
• Seizures or convulsions
• Hearing loss

Each year, between 800 and 4,400 babies in the United States are born with toxoplasmosis. If you think you had toxoplasmosis during pregnancy, be sure your baby is tested.

How is toxoplasmosis treated during pregnancy?

If you are infected during pregnancy, both you and your baby should be closely monitored during your pregnancy and after the baby is born. Getting treated with certain antibiotics helps reduce the chance of your baby getting toxoplasmosis. Antibiotics are medicines that treat certain types of infections. This treatment also helps reduce the seriousness of any symptoms your baby may have.

If you’re infected before 18 weeks of pregnancy, your provider may give you an antibiotic called spiramycin. This medicine helps reduce the chance of your baby getting the infection.

If you’re infected after 18 weeks of pregnancy, your provider may give you different antibiotics called pyrimethamine, sulfadiazine or leucovorin. These medicines are recommended for use after 18 weeks of pregnancy. If you take them before 18 weeks of pregnancy, they may cause birth defects in your baby.

How is toxoplasmosis treated in your baby after birth?

If your baby shows symptoms of toxoplasmosis, the provider may treat your baby with antibiotics. Your baby may continue these antibiotic treatments until their first birthday, sometimes even longer.

Should you nurse your baby if you had toxoplasmosis during pregnancy?

Yes. Your provider can give you a blood test to find out if you are still infected. If you are healthy and no longer infected, the chances of giving your baby toxoplasmosis while nursing is very small. Don’t nurse your baby if you have cracked and bleeding nipples or breast inflammation if you were infected recently.

How can you prevent toxoplasmosis?

Here’s how to protect yourself from toxoplasmosis:

• Don’t eat raw, undercooked or contaminated meat, especially lamb, pork or venison. Cooked meat should not look pink, and the juices should be clear. Use a meat thermometer to check the temperature of the meat before you eat it.
• Don’t eat raw, undercooked or contaminated shellfish, such as oysters, clams or mussels.
• Do not drink raw milk, especially goat’s milk.
• Wash your hands with soap and water after handling fruits, vegetables or raw meat, poultry (such as chicken or turkey) or shellfish.
• Don’t touch your eyes, nose or mouth when handling raw meat.
• Clean cutting boards, work surfaces and utensils with hot, soapy water after using them with fruits, vegetables or raw meat.
• Peel or thoroughly wash all raw fruits and vegetables before eating.
• Use work gloves when you’re gardening. Wash your hands afterward.

If you have a cat:

• Don’t let your cat go outside your home, where it may eat spoiled food or come in contact with the parasite.
• Change your cat’s litter box daily. Ask someone else to clean the litter box. If you have to do it yourself, wear gloves. Wash your hands thoroughly when you’re done emptying the litter.
• Only feed your cat canned or dried cat food from the store or well-cooked table food. Don’t feed your cat raw or uncooked meat.
• Stay away from children’s sandboxes. Cats like to use them as litter boxes.
• Don’t touch stray cats or kittens.

Last updated August 2021