When the expectant mother for the first time comes to womenconsultation, the doctor may ask whether in the family, where it should be born baby, cat. This is not idle curiosity: that cats are most often the source of infection of toxoplasmosis - diseases that pose a serious threat to the health of the unborn child. Of course, it is not necessary to give her favorite "in good hands" - just be aware of the precautions that can help a pregnant woman to avoid the disease.
Toxoplasmosis - a disease caused byintracellular protozoa Toxoplasma gondii, which are ubiquitous and affect herbivorous, carnivorous and omnivorous animals, birds and reptiles. Acquired toxoplasmosis in adults often occurs in the latent (hidden) form. In the acute form may be affected by the brain, the eyes, the lymphatic system, liver, spleen, heart and other organs.
Infection with Toxoplasma
Toxoplasma exist in three forms:
- free parasites (tachyzoites);
- cysts (forms of a microorganism protected by a dense shell and very resistant to external influences);
- oocysts (this form of the parasite can be found only in the faeces of the cat family).
Cysts are formed in the body of animalsfreeform parasites and stored in this form in various tissues and organs. At the use of contaminated meat animals (sheep, pigs, poultry, etc.) Become infected person.
The oocysts generated from parasites and free-formof cysts only in the intestinal cells of the representatives of the cat family and is then excreted in their feces. Period allocation cats oocysts of 7-20 days, and during the day a cat allocates 10 million parasites. After initial infection in animals develop immunity that protects them from re-infection. To purchase the infectious properties of oocysts undergo a number of changes; it occurs in an environment at a temperature of 4-37about (The optimum temperature - 24about) In 2-3 days. The warm moist soil, they retain their infectious properties of more than one year. Humans become infected by coming into contact with any material contaminated with the feces of infected cats, for example, if you pet the cat, caring for her, and in contact with soil or sand contaminated with faeces.
It is widely believed that toxoplasmosis may transmit not only cats and dogs but. It is not so: the body canine Toxoplasma do not breed.
Thus, human infection occursby ingestion of cysts or oocysts, and transfusion of infected blood products and transplantation of infected organs. In pregnant women, the placenta can be affected fetus.
Manifestations of the disease toxoplasmosis
In the gastro - intestinal tract of the human cystsor oocysts allocated parasites that enter cells in the gastro - intestinal tract. There they breed and then cause rupture of cells and penetrate into the neighboring cells. Then pathogens enter the bloodstream and spread throughout the body, affecting all organs and tissues (lymph nodes, eyes, brain, heart, lungs, kidneys, pancreas, skeletal muscle). The disease is manifested by an increase and morbidity of various groups of lymph nodes, there may be fever, headache, impaired consciousness, muscle aches and joint pain, rash, enlarged liver and spleen, signs of a lesion of other organs.
In a healthy person, in response to the introduction ofinfection develops an adequate immune response, and free parasites are removed from the tissues. Nevertheless, in the form of cysts which are in a special protective sheath, they may remain in the body throughout the life of the host and cause reinfection. When the oppression of immunity infection is not constrained by cells of the immune system, and continues to spread, causing acute inflammation of the tissues of the brain, the lungs, the heart, which, in turn, can lead to death.
How dangerous is toxoplasmosis during pregnancy?
If the infection occurs women with toxoplasmosisduring pregnancy, the disease pathogens can be transmitted to the fetus. However, this happens rarely. If Toxoplasma still infect the baby, pregnancy can result in spontaneous abortion, stillbirth, premature birth or birth of an infected child to term. Congenital infection develops in approximately 30% of children. Children born to mothers infected during the first trimester of pregnancy, congenital toxoplasmosis occurs in 17% of cases and occurs quite difficult. Upon infection in the third trimester of pregnancy, the disease is seen in 65% of children, but in this case it is asymptomatic. Manifestations of congenital toxoplasmosis are different: it is a rise in body temperature, appetite disorders, rash, generalized lymphadenopathy (increase in the number of groups of lymph nodes), enlarged liver and spleen, jaundice, hydrocephaly, microphthalmia (small size of the eyeball), and seizures. Intracerebral lesions and chorioretinitis (inflammation of the choroid and retina) can be found by the time the baby is born, but often appear later.
The risk of fetal infection is not dependent onseverity of infection in the mother. If a woman is infected with toxoplasmosis for more than 6 months prior to pregnancy, it can not transmit the infection to the child. When the infection occurs in less than 6 months, the fetus risk of transmission is negligible, but it does occur in rare cases.
Diagnosis and treatment of toxoplasmosis
The grounds for diagnosis"Toxoplasmosis" are: allocation of Toxoplasma from blood, detection of disease pathogens in bodies, the results of laboratory tests - identification of the blood of antibodies to Toxoplasma. Detection free of parasites in blood and tissues indicates acute stage of infection, the detection of cysts is no evidence of acute infection, since the latter can be stored in the tissue for a long time.
So as a direct allocation of Toxoplasma - enoughtime-consuming process, often used in practice survey antibodies in the blood. IgM class antibodies detected for the diagnosis of acute toxoplasmosis as they appear in the blood within 5 days after infection, their level significantly and rapidly increases and then decreases or disappears within a few weeks or months. IgG antibodies are detected in 1-2 weeks after infection. After 6-8 weeks, their number gradually decreases, but in a small amount, they will never sohranyayuturoven antibodies indicates the severity of the disease.
Every woman considering pregnancy, you need to determine the level of antibodies to Toxoplasma in order to identify infections.
If the results of the analysis you suspectprimary infection with toxoplasmosis, then you need to consult the infectious diseases hospital or specialist treatment and research of toxoplasmosis. It offers get tested again in 2-3 weeks.
In a study of pregnant women it can be difficultdetermine infection occurred before or after conception and therefore whether the fetus is infected. An additional method of diagnosing a disease in pregnant women can serve as identification of Toxoplasma in the amniotic fluid. Upon infection with toxoplasmosis during the first trimester of - the high probability of severe fetal lesions or recommend abortion or early holding of a specific treatment as a result of which the risk of congenital infection of the fetus is greatly reduced but not completely eliminated.
Measures of prevention of toxoplasmosis
Compliance with preventive measures is especially important forimmunocompromised patients and to those patients who have not been detected antibodies to toxoplasmosis, i.e. lifetime there is no contact with this pathogen. For the destruction of the meat cysts need to warm up to 60 aboutC after cooking raw meat handshould be thoroughly washed, you can not taste raw ground beef. The above products before use must be heat treated, and fruits and vegetables which may be contaminated with oocysts must be washed thoroughly. Pregnant women should avoid contact with the feces of cats.
An effective vaccine against toxoplasmosis does not yet exist, so compliance with the elementary rules of hygiene is by far the main method of preventing this disease.