Toxoplasmosis: During pregnancy a risk

21 October 2017

© Jupiter Images / iStockphoto

Mostly the toxoplasmosis harmless - just during pregnancy for the unborn child and for people with weakened immune systems presents them a risk. However, simple rules on behavior can effectively prevent infection.

Toxoplasmosis is a caused by the parasite called Toxoplasma gondii infectious disease. The first description of this disease in humans dates back to 1923. In 1969 it was possible to fully uncover the development cycle of the parasite.

Intermediate hosts of Toxoplasma gondii are different mammals and birds, Final hosts are always cats. Since the parasite Animals and humans attacks that toxoplasmosis is one of the so-called zoonoses, So on transmissible between animals and humans diseases.

Trigger of toxoplasmosis is a certain pathogens: the Parasite Toxoplasma gondii. This single-celled organisms is widespread throughout the world. It affects birds and mammals, including humans. therefore, his name is because

As Endwirt the causative agent of toxoplasmosis takes cat among the mammals a special position: only in the small intestine of cats taking place sexual reproduction Toxoplasma gondii. From the female and male sexual forms of Toxoplasma (the gametes) are formed so-called oocysts after fertilization: This separates the infected cat with the faeces, so that the pathogens reach on the ground.

From there, potential can then intermediate hosts (Such as pigs, cattle or the human) The causative agent of toxoplasmosis receive (e.g., via vegetables or forage crops). However, before the precipitated intermediate stages of Toxoplasma gondii in humans can cause infection, they need at least three days air, moisture and heat for further development. the sporozoites and then the sporozoites Within this period, the subsequent stages of Toxoplasma gondii develop from a oocyst. These forms remain infectious for months to years may.

, man infected with the pathogen of toxoplasmosis, this affects prefers a certain part of the human immune system: the so-called reticuloendothelial system. Here is in the infected cell, a mother cell, resulting in two daughter cells transforms. repeated divisions cause in the infected cell parasites pile: The divisions take place until the affected cell is filled with parasites. It forms a pseudocyst, the wall of the cell membrane of the host cell. At this stage of development decays the pseudocyst and the Parasites spread via the blood in the body - this is called a parasitaemia.

Once the immune system responds after about a week, is the parasite true cysts with a fixed wall. These cysts are very resistant and are mainly found in the muscles and brain. At this stage, the causative agent of toxoplasmosis remains inactive for many years viable.

Toxoplasmosis can be infected in several ways. Often, the transmission of the pathogen Toxoplasma gondii by eating happens raw meat (Tartar, raw ham, salami, sausage, etc.) or undercooked meat such as minced meat, especially pork.

In addition, the person can the pathogen of toxoplasmosis on the cat feces catch - for example when cleaning the litter box or on contact with the ground, which with cat feces is contaminated. Playing in the sand, working in the garden, in agriculture or in cleaning cat litter man can take up the pathogen from the cat feces through the mouth. Even fruits and vegetables can be contaminated with cat feces and thus lead to an infection.

A pregnant woman with a cat © iStock

Contact Cats - for toxoplasmosis in pregnancy a problem? Infected cats shed the pathogen in the faeces - but this risk exists only in cats that eat raw meat. And who pays, or in dealing with cats on hygiene (because of an already made by infection) is immune to toxoplasmosis anyway, has no reason to worry!

Rarely Toxoplasmosis is caused by a transmission from human to human. This possibility is, however, just at a Primary infection of pregnant women: If a pregnant woman infects the first time with the pathogen, they can transfer it to an unborn child (prenatal or congenital toxoplasmosis). At the beginning of pregnancy, the risk of transmission is low and decreases towards the end to. In other cases of infection from person to person is almost locked out.

Toxoplasmosis is the incubation period (I.e., the period between infection with the virus and the appearance of the first symptoms) two to three weeks.

The incidence of toxoplasmosis increases with age: The proportion of infected people within an age group increases with each decade of life by about 10 percent. Up to 70 percent of over-50s Toxoplasma gondii carry within them.

In recent years, around 10 to 20 children have been infected in the womb or at birth with Toxoplasma gondii in Germany annually. This puts the congenital toxoplasmosis the rarer notifiable infectious diseases.

The costs associated with toxoplasmosis symptoms can be very different: Get in rare cases flu-like Complaints (for example, low-grade fever, fatigue, swollen lymph nodes), which disappear by itself. In most cases, the infection is, however, without Therefore, signs of illness and goes unnoticed.

Whether toxoplasmosis causes symptoms depends mainly on Time of infection and from State of the immune system of those affected from. A distinction three forms of disease:

Anyone after birth infected and intact immune system has often ill (80-90%) not at all. In the remaining cases causes acquired after birth (postnatal) Toxoplasmosis symptoms resemble a flu - for example:

Accompanying postnatal toxoplasmosis causes the lymph nodes to swell, especially in the neck area (so-called. Cervical lymph nodes toxoplasmosis). The symptoms usually disappear by itself.

In people with weakened immune systems may toxoplasmosis violent symptoms Trigger: The pathogen Toxoplasma gondii often affects the central nervous system (CNS: brain and spinal cord). at healthy People survive the cysts of the pathogen after infection for life in the brain, without Complaints cause. However, if the immune system weakened (Eg by AIDS or by drugs that suppress the immune system), however, caused great from the surviving cysts inflammation.

These symptoms make a targeted treatment necessary: untreated toxoplasmosis results in a weakened immune system in such cases within a few weeks to death.

If a woman during pregnancy for the first time infected, they rarely develop symptoms. But the pathogen is a probability of about 50 percent of the expectant mother to the fetus about. Such (prenatal) before or acquired during birth (congenital) toxoplasmosis severe consequences to have. Are possible (depending on the timing and intensity of infection):

What is the extent the symptoms of acquired before birth toxoplasmosis depends on the exact Time of infection From: An infection beginning pregnancy leads to severe damage of the fetus; finds the infection later instead, the extent of the changes less.

If a pre- or congenitally infected baby initially apparently healthy at birth, the infection can also be felt later. Thus, the congenital toxoplasmosis after months or years Cause symptoms such as:

To diagnose toxoplasmosis, the doctor has the detect germs. This is both directly as well as indirectly possible.

To the pathogen of toxoplasmosis directly to demonstrate, the doctor removes a tissue sample - for example from a lymph node or from the uterus. but the direct detection of the pathogen in tissue samples can only be achieved by treating the sample first with specific staining. However, this pathogen is not very specific, so he is used less frequently.

The usual method of diagnosing toxoplasmosis is the pathogen indirectly demonstrated. This requires a blood sample necessary: ​​Using a blood test, the doctor can determine if the body has antibodies against the pathogen formed. In this test, an increase in antibody levels you can already demonstrate a week after infection (titer).

For toxoplasmosis is a limited reporting requirementAfter the Infection Protection Act only the direct or indirect detection of pathogens in an infection that occurs in the womb or at birth (so-called. congenital toxoplasmosis), Unnamed reported.

In a toxoplasmosis during pregnancy targeting the therapy to from a To prevent your child's infection. A suitable means is the antibiotic spiramycin - from the 16th week of pregnancy, it may also be used in combination with pyrimethamine. At the same time you get folic acid to prevent damage to the bone marrow.

If your child infected with toxoplasmosis nevertheless, it gets the same drugs used to treat after birth.

Even if a local Toxoplasmosis infection of the eye have or if your immune system damage (e.g. as a result of HIV infection), treatment with said drugs is recommended. Alternatively, the antibiotic clindamycin can be used in affected eyes while you may additionally receive atovaquone in terms of chemoprophylaxis with immunodeficiency.

to an unborn child infected during pregnancy with toxoplasmosis, the forecast of the time and the intensity of infection is dependent. About 90 percent in pregnancy infected with the pathogen Toxoplasma gondii children at the time of birth healthy. However, can still after months or years late damage - as a developmental disability - adjusted. In rare cases, the transition of toxoplasmosis of the expectant mother to an unborn child to miscarriage or stillbirth.

Has a man weakened immune system (For example, because he has AIDS or taking medications that suppress the immune system), toxoplasmosis is often more difficult. Not infrequently, an inflammation of the brain (encephalitis) developed. In addition, other organs can be affected - such as:

Potential complications of toxoplasmosis in immunocompromised people are pneumonia or inflammation of the heart muscle (myocarditis). Left untreated, the disease results in a weakened immune system within a few weeks to death.

Unlike many other infectious diseases can be in front of a toxoplasmosis Not protect by get vaccinated: There is no vaccination against Toxoplasma gondii available.

Once you toxoplasmosis undergone , you are, however, a lifetime immune ie protected against re-infection - the infection. What this means for pregnant women: If a woman in front her pregnancy has already infected with Toxoplasma gondii and is ill, it can not fall ill again because so in this case no risk to the fetus consists.

You prevent a toxoplasmosis, is particularly important

Whether you immune or not are immune, you can determine by an examination of your blood for antibodies. If this falls Toxoplasmosis Test negative, it is during pregnancy (as part of prenatal care) repeated as necessary in order to early detect a recent infection and treat.

ICD-10 diagnostic codes:

Here you will find the appropriate ICD-10 code "toxoplasmosis":


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