Your lovable pet might be the cause for toxoplasmosis, the silent killer
Have you ever heard of toxoplasmosis? No? Then let’s learn more of this infection by going through these two cases.
A 56-year old man, who recently had chemotherapy, came to the hospital complaining of a 10-day history of painful red eye, sensitivity to light and blurring vision on the left eye. Following a comprehensive evaluation, a diagnosis of ocular toxoplasmosis (eye toxoplasmosis) was made. He was immediately started on treatment. His vision subsequently improved. He was then continued on a few medications to prevent recurrence of the eye problem.
The next case is of a newborn baby girl who was admitted to the neonatal intensive care unit 23 hours after delivery due to high grade fever and redness of the left eye. Laboratory screening tests done on the mother previously was positive for toxoplasmosis. The baby also tested positive. A diagnosis of congenital toxoplasmosis was made. The baby was started on treatment. However, she had multiple episodes of seizures and her condition deteriorated. She later succumbed to her condition due to sepsis and multi-organ failure.
What is toxoplasmosis?
Toxoplasmosis is caused by parasitic protozoa, Toxoplasma gondii, transmitted mainly by many warm-blooded animals like birds or mammals. Toxoplasmosis is caused by ingesting the microscopic eggs of the parasites or eat cysts in undercooked meat, drinking unpasteurized milk, contaminated vegetables and other foods, from the soil or via handling the of infected cat litter. In healthy adults, the symptoms of infection generally pass unnoticed, thanks to the immune system attacking the parasites and preventing the illness. They may only experience flu-like symptoms such as fatigue, headache, fever and swollen lymph nodes. In individuals with weakened immune system, it may cause severe symptoms as outlined by the two cases.
In both cases, the man and the baby developed inflammation of the eye. The man may have had previous infection which resolved without symptoms. However, due to weakened immune system after chemotherapy, reactivation of the parasite occurred in the eye causing pain, blurring of vision and possible permanent blindness if left untreated.
The baby was an example of the devastating effects of congenital toxoplasmosis in which toxoplasmosis was passed down through the placenta from the mother to the child in the womb. The baby also developed brain inflammation causing seizures. As the infection overwhelms the immature immune system, the infection spreads to the body culminating in sepsis and death.
Why do cat lovers need to know this?
Cats are the usual host for these parasites. The parasites can only mature to adulthood and produce eggs in the gut of a cat. The eggs enter the environment through the cat litter. The eggs must mature in the soil for 1 to 5 days before they become contagious for people or other animals.
In the two cases, both the mother and the man were identified to be cat-lovers and have pet cats at home.
How do we prevent toxoplasmosis?
To reduce the chances of ingesting food with Toxoplasma gondii,
1. Do cook all meat until the meat is no longer pink.
2. Always wash your hands thoroughly after any outdoors activity. If possible, use gloves.
3. Thoroughly wash all fruits and vegetables as well as the cutting boards, other kitchen surfaces, cutlery and utensils after handling and preparing raw meat, fruits and vegetables.
4. Pregnant women are advised to minimize any gardening activity.
5. Cat litter boxes should be cleaned regularly.
6. It is advised to feed your pet cats only commercially made cat food and keep them from eating undercooked kitchen meat scraps. Do bring them to the veterinarian for regular check-ups. — The Health
Dr Dian Nasriana binti Nasuruddin is the Treasurer of the Malaysian Sepsis Alliance and a Senior Lecturer and Chemical Pathologist Consultant, UKM Medical Center, Universiti Kebangsaan Malaysia.
Dr Tan Toh Leong is the President and Founder of Malaysian Sepsis Alliance and a Senior Lecturer &Emergency Medical Consultant, UKM Medical Center, Universiti Kebangsaan Malaysia.