Jump to content

User:Unenthusiastic/sandbox

From Wikipedia, the free encyclopedia

acute

[edit]

latent

[edit]

[1]


Pregnancy precautions

[edit]

Congenital toxoplasmosis is a special form in which an unborn fetus is infected via the placenta.[2] A positive antibody titer indicates previous exposure and immunity, and largely ensures the unborn fetus' safety. A simple blood draw at the first prenatal doctor visit can determine whether or not a woman has had previous exposure and therefore whether or not she is at risk. If a woman receives her first exposure to T. gondii while pregnant, the fetus is at particular risk.[3]

For pregnant women with negative antibody titers, indicating no previous exposure to T. gondii, serology testing as frequent as monthly is advisable as treatment during pregnancy for those women exposed to T. gondii for the first time decreases dramatically the risk of passing the parasite to the fetus. Treatment is very important for recently infected pregnant women, to prevent infection of the fetus. Since a baby's immune system does not develop fully for the first year of life, and the resilient cysts that form throughout the body are very difficult to eradicate with antiprotozoans, an infection can be very serious in the young.

Despite these risks, pregnant women are not routinely screened for toxoplasmosis in most countries (Portugal,[4] France,[5] Austria,[5] Uruguay,[6] and Italy[7] being the exceptions) for reasons of cost-effectiveness and the high number of false positives generated. As invasive prenatal testing incurs some risk to the fetus (18.5 pregnancy losses per toxoplasmosis case prevented),[5] postnatal or neonatal screening is preferred. The exceptions are cases where fetal abnormalities are noted, and thus screening can be targeted.[5]

Some regional screening programmes operate in Germany, Switzerland and Belgium.[7]


Pregnant women should avoid handling raw meat, drinking raw milk (especially goat milk) and be advised to not eat raw or undercooked meat regardless of type.[8] Because of the obvious relationship between Toxoplasma and cats it is also often advised to avoid exposure to cat feces, and refrain from gardening (cat feces are common in garden soil) or at least wear gloves when so engaged.[8] Most cats are not actively shedding oocysts since they get infected in the first 6 months of their life. They shed oocysts for only a short period of time (1–2 weeks.)[9] However, these oocysts get buried in the soil, sporulate and remain infectious for periods ranging from several months to more than a year.[8] Numerous studies have shown living in a household with a cat is not a significant risk factor for T. gondii infection,[8][10][11] though living with several kittens has some significance.[12]

In 2006, a Czech research team[13] discovered women with high levels of toxoplasmosis antibodies were significantly more likely to have baby boys than baby girls. In most populations, the birth rate is around 51% boys, but women infected with T. gondii had up to a 72% chance of a boy.[14][15] In mice, the sex ratio was higher in early latent toxoplasmosis and lower in later latent toxoplasmosis.[15]

  1. ^ Robert-Gangneux, F.; Darde, M.-L. (2012). "Epidemiology of and Diagnostic Strategies for Toxoplasmosis". Clinical Microbiology Reviews. 25 (2): 264–296. doi:10.1128/CMR.05013-11. ISSN 0893-8512.
  2. ^ Sterkers Y, Ribot J, Albaba S, Issert E, Bastien P, Pratlong F (2011). "Diagnosis of congenital toxoplasmosis by polymerase chain reaction on neonatal peripheral blood". Diagnostic Microbiology and Infectious Disease. 71 (2): 174–6. doi:10.1016/j.diagmicrobio.2011.06.006. PMID 21856107.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  3. ^ Torgerson, Paul R; Mastroiacovo, Pierpaolo (2013). "The global burden of congenital toxoplasmosis: a systematic review". Bulletin of the World Health Organization. 91 (7): 501–508. doi:10.2471/BLT.12.111732. ISSN 0042-9686.
  4. ^ Circular Normativa sobre Cuidados Pré-Concepcionais – Direcção-Geral de Saúde
  5. ^ a b c d Sukthana Y (March 2006). "Toxoplasmosis: beyond animals to humans". Trends Parasitol. 22 (3): 137–42. doi:10.1016/j.pt.2006.01.007. PMID 16446116.
  6. ^ [1][dead link]
  7. ^ a b De Paschale M, Agrappi C, Clerici P, Mirri P, Manco MT, Cavallari S, Viganò EF (2008). "Seroprevalence and incidence of Toxoplasma gondii infection in the Legnano area of Italy". Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. 14 (2): 186–9. doi:10.1111/j.1469-0691.2007.01883.x. PMID 18034857.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  8. ^ a b c d Kapperud G, Jenum PA, Stray-Pedersen B, Melby KK, Eskild A, Eng J (1996). "Risk factors for Toxoplasma gondii infection in pregnancy. Results of a prospective case-control study in Norway". American Journal of Epidemiology. 144 (4): 405–12. doi:10.1093/oxfordjournals.aje.a008942. PMID 8712198.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  9. ^ Hill D, Dubey JP (2002). "Toxoplasma gondii: transmission, diagnosis and prevention". Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. 8 (10): 634–40. doi:10.1046/j.1469-0691.2002.00485.x. PMID 12390281.
  10. ^ Cook AJ, Gilbert RE, Buffolano W, Zufferey J, Petersen E, Jenum PA, Foulon W, Semprini AE, Dunn DT (Jul 15, 2000). "Sources of toxoplasma infection in pregnant women: European multicentre case-control study. European Research Network on Congenital Toxoplasmosis". BMJ (Clinical research ed.). 321 (7254): 142–7. doi:10.1136/bmj.321.7254.142. PMC 27431. PMID 10894691.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  11. ^ Bobić B, Jevremović I, Marinković J, Sibalić D, Djurković-Djaković O (September 1998). "Risk factors for Toxoplasma infection in a reproductive age female population in the area of Belgrade, Yugoslavia". European journal of epidemiology. 14 (6): 605–10. doi:10.1023/A:1007461225944. PMID 9794128.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  12. ^ Jones JL, Dargelas V, Roberts J, Press C, Remington JS, Montoya JG (2009). "Risk Factors forToxoplasma gondiiInfection in the United States". Clinical Infectious Diseases. 49 (6): 878–884. doi:10.1086/605433. PMID 19663709.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  13. ^ Kanková S, Sulc J, Nouzová K, Fajfrlík K, Frynta D, Flegr J (2007). "Women infected with parasite Toxoplasma have more sons". Die Naturwissenschaften. 94 (2): 122–7. doi:10.1007/s00114-006-0166-2. PMID 17028886.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  14. ^ Ian Sample, science correspondent (2006-10-12). "Pregnant women infected by cat parasite more likely to give birth to boys, say researchers | Science". London: The Guardian. Retrieved 2013-02-14. {{cite news}}: |author= has generic name (help)
  15. ^ a b Cite error: The named reference Dalimi was invoked but never defined (see the help page).