Miscarriage | Stillbirth | Premature | Pre-eclampsia | Toxoplasmosis

What is toxoplasmosis?

Toxoplasmosis is an infection caused by a parasite called toxoplasma gondii, which is a microscopic organism.

How is it caught?

It can be caught by eating anything infected with the parasite. This includes directly eating anything with infected cat faeces in it (for example soil), or eating raw and undercooked meat, or eating unwashed fruit and vegetables, or consuming unpasteurised goats milk and goats milk products.

It can also be caught from receiving blood or organ transplants.

The organism may also enter the body through cuts or abrasions in the skin. This is a possible risk when handling newborn lambs or for farmers lambing.

For the baby, toxoplasmosis can be caught from its mother whilst still in the womb. This is referred to as transplacental transmission.

How long does it take to become infected?

In the case of transplacental transmission, it can take between 4 and 8 weeks after the mother's infection for the baby to become infected.

The incubation period is 5-23 days after eating something infected with the parasite.

How do you know if you have become infected?

Toxoplasmosis does not usually have any symptoms. Most pregnant women may never know they were infected. Some women may have mild flu like symptoms. Very rarely, some people may experience a more long term illness similar to glandular fever.

The only conclusive method of detecting if you have become infected is to have a blood test.

How common is toxoplasmosis?

Studies have shown that 30% of 30-year-olds and 50% of 70-year-olds have had a toxoplasmosis infection. It is accepted that once you have had an infection you are then immune for life, you cannot catch the infection again.

It is estimated that only 15% of women booking in for antenatal care are already immune. This leaves 85% of pregnant women still at risk of contracting the infection.

The blood test

If a pregnant woman feels there is a risk that she may have been infected during her pregnancy or would like to know if she has already had the infection before her pregnancy (and is therefore immune) then a blood test can be carried out.

The toxoplasmosis blood test involves taking a sample of blood from the mother to look for antibodies to the infection. Antibodies are part of the body's response to an infection. It may take three weeks for these antibodies to be present following an infection, so the blood test must be done three weeks after any incident which may put someone at risk.

The results may come back in a week, but if they have been passed on to a Toxoplasma Reference Laboratory they may take longer.

The result may state that no antibodies were found and therefore no infection has taken place (negative blood test). Alternatively, it may state that antibodies were found and the toxoplasmosis infection has been caught (positive test). However, it is then important to determine when the infection was caught.

If the infection occurred before the pregnancy then the woman is immune and there is no risk to the baby.

If the infection has occurred recently or is currently active then there is a risk that the baby will become infected. It can take between 4 and 8 weeks for the infection to pass to the baby.

What can you do to reduce the risks of catching toxoplasmosis?

To avoid catching toxoplasmosis you can take the following precautions.

  • Only eat meat that has been thoroughly cooked through. Do not eat rare meat with any pinkness or blood in it (eating raw or undercooked meat is the most common cause of getting toxoplasmosis).
  • Wash your hands and all cooking utensils and surfaces after preparing raw meat.
  • Wash all fruit and vegetables thoroughly to remove all traces of soil.
  • Always wear gloves when gardening. Take care not to put hands or gloves to your mouth and wash your hands and gloves when finished to remove all traces of soil.
  • Wear rubber gloves when handling dirty cat litter. Take care not to put hands or gloves to your mouth and wash your hands and gloves when finished. If possible get someone else to do this job.
  • Avoid cured meats, such as parma ham and salami.
  • · Avoid unpasteurised goat's milk and products made from it.
  • Take care when visiting farms and wash hands thoroughly after any contact with sheep. Avoid handling new born lambs.
  • Cover children's sandboxes to prevent cats from using them as litter boxes.

How likely is it to catch toxoplasmosis in pregnancy?

It is estimated that 1 in 500 women catch toxoplasmosis in pregnancy. There are currently 1 million pregnancies a year in the UK, so about 2,000 women a year will catch toxoplasmosis during their pregnancy.

How likely is the baby to get toxoplasmosis?

It has been estimated that only 40% of pregnant women with toxoplasmosis will pass the infection on to their unborn child. This means that about 800 babies each year are infected with toxoplasmosis. The actual risks to the baby vary and are related to the stage of pregnancy the woman is in when the infection was acquired.

If the infection is caught in early pregnancy (first trimester), only 15% of babies are thought to be infected. If the infection is caught by the mother in the middle three months of her pregnancy (second trimester), then the risk of the baby being infected is 25%. The risk of transmission to the baby is 65% in the third trimester, which is the last three months of pregnancy.

How will the infection affect the baby?

If toxoplasmosis is caught in early pregnancy and is transmitted to the baby then there is a high risk of miscarriage. Babies infected during that first trimester or the second trimester may be born with severe abnormalities such as hydrocephalus (water on the brain), brain damage, or epilepsy. They may also suffer with deafness, blindness or growth problems. These may be so severe that the baby is stillborn.

If toxoplasmosis is caught in the third trimester of pregnancy and transmitted to the baby then babies may not suffer such severe and obvious problems. Although most of these babies may appear normal at birth, a large proportion will develop problems later in life. These are usually eye problems.

How can toxoplasmosis be treated in pregnancy?

If a woman has been confirmed as having a current infection of toxoplasmosis in pregnancy then she may be offered an antibiotic, called spiramycin, which is thought to reduce the risk of transmission to the baby.

If there is concern that the baby may already be infected, and the woman is more than 15 weeks pregnant, then she may be offered amniocentesis. Amniocentesis is the removal of a sample of amniotic fluid from around the baby through a special needle, and this fluid may be tested for toxoplasmosis. If the baby is infected then the use of certain antibiotics may reduce the severity of the infection.

At 20 weeks of pregnancy an ultrasound scan may also highlight any obvious physical abnormalities in the baby. Termination of pregnancy is also an option for some women, when an infected baby with severe abnormalities has been confirmed.

All babies born to women with confirmed toxoplasmosis in pregnancy will then be monitored closely by paediatricians. These women can breastfeed their babies as toxoplasmosis is not transmitted in breastmilk.


What is Tommy's the baby charity, doing to help?

Tommy's has taken over the work of The Toxoplasmosis Trust, an organisation set up to provide information about toxoplasmosis. We have various leaflets available on toxoplasmosis. These are available to download from this website in pdf format (see below) or from Tommy's. If you would like to receive copies of any of these leaflets, please contact Tommy's on 020 7593 1149 or email info@tommys.org with your postal address and details of the leaflets you require.

Tommy's is currently setting up a toxoplasmosis support network to enable those affected by toxoplasmosis to contact others who have been in a similar situation. This will be a list of people who have had an experience with toxoplasmosis and are willing to discuss this with others to help support them. If you have had an experience with toxoplasmosis and are willing to share your story and talk to other people in the same position, then please contact us (email info@tommys.org or telephone 0870 777 30 60 or post to Tommy's head office) with your details and we can tell you more about this network.

Tommy's is committed to raising awareness about toxoplasmosis. We hope that by providing information to women about how to reduce their risk of contracting toxoplasmosis in pregnancy, we can reduce the number of women who pass this infection on to their baby. This will then reduce the number of babies miscarried, stillborn or born with a disability as a result of congenital toxoplasmosis.