Congenital Toxoplasmosis Symptoms & Causes

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In-Depth

At Boston Children’s Hospital, we understand that you may have a lot of questions when your child is diagnosed with congenital toxoplasmosis, such as:

  • What exactly is this condition?
  • What are potential complications in my child’s case?
  • What are the treatments available?
  • Are there any possible side effects from treatment?
  • How will the disease affect my child in the long term?
  • Most importantly – is my child going to be OK?

We’ve tried to provide some answers to those questions here, and when you meet with our experts, we can explain your child’s condition and treatment options fully.

Background

According to the Centers for Disease Control and Prevention, more than 60 million men, women and children in the United States have toxoplasmosis. Most people infected with toxoplasmosis have no symptoms (and don’t need any treatment). However, pregnant women should be especially careful about exposing themselves to the parasite because toxoplasmosis can be very serious in a newborn baby.

Fortunately, the risk of maternal transmission of the parasite to the fetus during the first trimester of pregnancy (when the baby is most vulnerable) is relatively low, at 15 to 20 percent. However, by the third trimester, a pregnant woman with toxoplasmosis has a 60 percent chance of infecting her child.

Causes of Congenital Toxoplasmosis 

The toxoplasma gondii parasite can enter the body in a number of ways (most commonly, through the mouth). If you’re pregnant, be especially careful to avoid these situations:

  • consuming raw or undercooked meat
  • eating raw eggs
  • handling cat feces and/or cat litter (though this doesn’t mean you can’t have a pet cat — see our FAQ section for more information
  • exposure to insects (e.g., flies) that have been in contact with cat feces

Symptoms of Congenital Toxoplasmosis

Many (up to 90 percent of) babies born with congenital toxoplasmosis experience no immediate symptoms. However, one sign of infection is a premature birth or an abnormally low birth weight.

As an infected baby grows, more signs and symptoms can appear. These may include the following:

  • swollen lymph nodes
  • bruises
  • jaundice
  • anemia
  • enlarged liver or spleen

Toxoplasmosis can also cause some more serious problems, including the following:

  • retinal damage
  • hydrocephalus a buildup of cerebrospinal fluid in the brain
  • intracranial calcificationsthese indicate areas of the brain that have been damaged by the parasite, and are often linked to the following conditions:
  • intellectual disabilities
  • seizures
  • motor and developmental delays
  • hearing loss

Long-term outlook

If your child is treated early, there should be no serious consequences of toxoplasmosis. However, if treatment is delayed, your child may suffer some serious health problems as a result of the infection. For more information, see the Treatment and Care tab.

Questions to ask your doctor

Many parents are concerned about toxoplasmosis and can have lots of questions about the condition and how it can affect their baby.

You may find it helpful to jot down questions as they arise—that way, when you talk to your doctor, you can be sure that all of your concerns are addressed.

Here are some questions to get you started:

  • Should I have a blood test for toxoplasmosis?
  • Our family has a cat. How can I make sure the cat’s litter and waste are handled safely so that the parasite doesn’t spread?
  • Do I need to avoid gardening or other yard work to prevent exposure to infected soil?
  • What else can I do to prevent infection?
  • I’m infected. Is there any way to avoid passing it on to my baby?
  • What steps can we take if my baby does get infected? What treatment(s) do you recommend, and why?
  • Are there any potential side effects from treatment?
  • What’s the long-term outlook for a baby with toxoplasmosis?

Frequently Asked Questions (FAQ) about Congenital Toxoplasmosis

Q: What is toxoplasmosis?

A: Toxoplasmosis is a disease caused by the parasite toxoplasma gondii and is usually acquired by the parasite getting into the body by the mouth (for instance, by eating undercooked meat).

Q: Why is toxoplasmosis a problem?

A: While most people infected with toxoplasmosis have no symptoms (and don’t need any treatment), pregnant women should be especially careful about exposing themselves to the parasite because toxoplasmosis can be very serious in a newborn baby.

Q: What can I do to prevent infection?

A: If you’re pregnant, be especially careful to avoid these situations:

  • consuming raw or undercooked meat
  • consuming raw eggs
  • gardening or doing other yard work that puts you in direct contact with soil
  • exposure to cat feces and cat litter
  • exposure to insects (e.g., flies) that have been in contact with cat feces

Q: Our family has pet cats. Do we have to get rid of them to be safe from toxoplasmosis?

A: No.Although cats can transmit the toxoplasma gondii parasite to pregnant women through their feces (where infected parasite eggs can be shed), there is no demonstrated link between toxoplasmosis and simply owning a cat. Here’s why:

Cats themselves can only become infected with toxoplasma gondiiif they eat prey containing the parasite, or come into contact with infected soil. For these reasons, cats kept indoors are highly unlikely to become carriers of the parasite. In addition, only pregnant women are at elevated risk of toxoplasmosis through handling cat litter and/or feces. Other family members, including young children, do not face this elevated risk.

Many pregnant women (and their families) fear that they need to part with the family cat to be safe from toxoplasmosis—but that’s not the case at all. You can keep your cat while taking these steps to prevent toxoplasmosis infection:

  • Keep cats indoors. A cat that doesn’t go outside can’t eat infected prey or come into contact with infected soil.
  • Don’t come into direct contact with cat litter or feces.Have another family member take care of cleaning the litter box and disposing of cat waste. If you must handle litter box duties yourself, always wear disposable gloves and be sure to wash your hands thoroughly afterward.

Q: What are the chances that my baby will be infected if I am?

A: It depends on when you are infected.

  • The risk of maternal transmission of the parasite to the fetus during the first trimester of pregnancy (when the baby is most vulnerable) is relatively low, at 15 to 20 percent.
  • However, by the third trimester, a pregnant woman with toxoplasmosis has a 60 percent chance of infecting her child.

Q: How is toxoplasmosis diagnosed?

A: A blood test before or during pregnancy can determine if you have been exposed to the toxoplasma gondii parasite.

  • If you are infected, another type of test can determine whether your baby is infected.
  • In addition, fetal ultrasounds can determine if your baby's organs are damaged.

Currently, physicians in the United States do not routinely screen pregnant women for toxoplasma gondii, so if you suspect you may have been exposed to the parasite, ask your doctor to perform a blood test.

Q: What symptoms might my baby have?

A: Many babies show no immediate signs of infection. However, as a baby grows, she may show more signs of infection, which may include the following:

  • swollen lymph nodes
  • bruises
  • jaundice
  • anemia
  • enlarged liver or spleen

There are also more serious symptoms; for more information on these, see the Symptoms [LINK] tab.

Q: What are our treatment options?

A: Here at Boston Children’s, physicians in our Division of Infectious Diseases treat congenital toxoplasmosis in infants.

  • If detected early through a blood test, antiparasitic treatments can eliminate toxoplasmosis before the parasite harms the fetus.
  • We treat babies born with congenital toxoplasmosis with anti-toxoplasmosis medications, usually for 1 year after birth.
  • One of our experts will determine which combination of medications is best suited for your baby.

Q: What is my child’s long-term outlook?

A: If your child is treated early, there should be no serious consequences of toxoplasmosis. However, if treatment is delayed, your child may suffer some serious health problems as a result of the infection.

Q: What makes Boston Children’s different?

A: Our physicians are expert, compassionate and committed to focusing on the whole child, not just his condition—that’s one reason we’re frequently ranked as a top pediatric hospital in the United States.

And at Boston Children’s, we consider you and your child integral parts of the care team and not simply recipients of care. You and your care team will work together to customize a plan of care for your child.

Fetal-Neonatal Neurology Program
Learn more about our program for babies with congenital neurological conditions.
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- Sandra L. Fenwick, President and CEO

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