Transcript Cytomegalovirus Infection and Pregnancy

Toxoplasmosis and
Pregnancy
Max Brinsmead MB BS PhD
May 2015
Toxoplasmosis
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Caused by the protozoan parasite Toxoplasma gondi
Is endemic in most societies
And the definitive host is cats
Has a complex life cycle but infectious oocysts can live
for many months in soil
10 – 25% of adults have serologic evidence of previous
infection
In most it causes a mild illness with fever, malaise and
lymphadenopathy
But transplacental infection can cause congenital
disease
Congenital Toxoplasmosis
Mental retardation
 Learning difficulties
 Cerebral calcifications
 Chorioretinitis blindness
 Hydrocephalus
 Epilepsy
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Vertical Transmission
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50% of congenital Toxoplasmosis is due to
eating contaminated meat, mostly pork
Remainder to to contact with cats’ faeces or
contaminated soil
~1:200 women will become infected during
pregnancy
Of these ~1:10 will deliver a baby with
congenital Toxoplamosis
Infection in early pregnancy is less likely to cross
the placenta
But this has more serious effects when it does
Diagnosis of Toxoplasmosis
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Requires identification of both IgM and IgG in a
previously seronegative woman
IgM can persist for months after primary
infection
False positive IgM can occur
Infections acquired prior to pregnancy pose no
risk to the fetus
Treatment
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Acute infections can be treated with Spiramycin
or sulphadiamine/pyrimethamine
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This will reduce the risk of vertical transmission
by ~50%
Preventing Congenital
Toxoplasmosis
Pregnant women should:
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Cook meat thoroughly and check core
temperature with a cooking thermometer
Prevent contamination of food by uncooked
meat
Avoid contact with cat faeces
Wash or peel vegetables and avoid contact with
soil
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