Toxoplasmosis is a disease caused by protozoa (Toxoplasma), which is characterized by damage to the nervous and lymphatic systems, eyes, skeletal muscles, myocardium and other organs and tissues.
Content
Toxoplasma
Toxoplasma gondii (toxoplasma) is an obligate intracellular parasite, the final host of which is felines (lynx, cat, etc.).
Animals become infected by eating meat from infected animals, as well as by ingesting cysts.
In the cat's intestines, cysts are destroyed and, after passing certain stages of development, are transformed into oocysts, which are released with feces.
Maturation of oocysts occurs in the external environment at an air temperature of 4-37ºС and sufficient humidity, lasting from 2 days to 3 weeks. Mature oocysts are resistant to adverse factors and exist in the external environment for 1.5 years.
Humans are the intermediate host for Toxoplasma.
How can you get infected?
The definitive hosts of toxoplasmosis are representatives of the cat family, which release oocysts into the external environment with feces. More than 300 species of mammals, including humans, as well as more than 60 species of birds serve as intermediate hosts.
Infection of intermediate hosts, including humans, occurs as follows:
- if personal hygiene rules are not observed,
- when eating poorly cooked meat and eggs from animals infected with Toxoplasma,
- when cutting up the carcasses of infected animals through microtraumas in the skin,
- in utero, with an infected mother’s body.
The risk of transmission of infection from an infected mother to her fetus increases sharply with increasing gestational age: from 6% at 13 weeks to 72% at 36 weeks.
Toxoplasmosis
This disease is found everywhere. The level of infection of the population increases in proportion to age and ranges from 5-10 to 50-80%.
There are congenital and acquired toxoplasmosis.
If the mother is infected during pregnancy, the risk of infection of the fetus is quite high and can range from 6 to 60%. In this case, the probability of fetal death increases by 3 times, and the probability of premature birth by 10 times.
Statistics say that the death of a newborn occurs in 10% of all cases of infection of the mother, and in 8-10% the baby’s brain and eyes are damaged.
Development of the disease
During toxoplasmosis there are 2 stages:
- spicy and
- chronic.
The gateway to infection is the digestive organs. The introduction of the pathogen occurs in the small intestine, mainly in its lower sections. At the same time, these parts of the intestine become inflamed.
Pathogens penetrate through the abdominal lymph nodes into the lymphatic system and blood and enter the brain, striated muscles, and liver. Inflammation also develops in these organs and specific granulomas are formed.
During the active phase of Toxoplasma reproduction, toxic-like substances are released, which lead to the slow development of allergic reactions of the body to them.
With good immunity, most pathogens die. The rest invade cells and form cysts. Toxoplasma slowly multiplies inside the cysts, continuously releasing substances to which the human body produces specific antibodies. In this way, specific immunity is formed and the acute phase of the disease becomes chronic.
Toxoplasmosis is a disease that suppresses the immune system. If an infected person has a serious immune disorder (HIV infection, long-term use of immunosuppressants), toxoplasmosis takes on a malignant course. In this case, specific parasitic sepsis or necrotizing meningoencephalitis may develop, often with a fatal outcome.
Classification of types of toxoplasmosis by domestic infectious disease specialists:
- According to the method of infection, congenital and acquired toxoplasmosis are distinguished,
- by pathogenetic stage - acute and chronic stages of the disease,
- according to the state of the immune system - toxoplasmosis in immunocompetent people and in patients with AIDS.
The incubation period lasts 5-23 days (on average about 2 weeks).
Symptoms of toxoplasmosis
Most often, with normal immunity, the acute stage of the disease is asymptomatic.
Vivid symptoms appear quite rarely and are characterized by the following signs:
- inflammation of the cervical and axillary lymph nodes,
- general moderate intoxication,
- chills,
- temperature rise of more than 38.5⁰С,
- headache,
- sharp muscle pain (myalgia),
- diarrhea,
- stomach ache.
In 20% of cases, loss of part of the visual field develops.
From the second week of illness, general intoxication decreases, diarrhea disappears, but signs of damage to the musculoskeletal system and cardiovascular system intensify.
At 3-4 weeks the symptoms subside.
Diagnostics
The leading role in the diagnosis of toxoplasmosis belongs to laboratory and allergological research methods.
If specific IgG antibodies are detected using a serological test, this confirms the fact of infection. Detection of IgM indicates an acute stage of toxoplasmosis.
The simultaneous detection of IgG and IgM indicates the duration of infection from 1 to 3 months.
If only specific IgG is present in the patient’s blood, it allows us to draw a conclusion about the chronic stage of the disease (infection period is more than 4 months).
The absence of specific IgG and IgM excludes toxoplasmosis.
When testing for hypersensitivity, a special solution is injected under the skin on the inside of the forearm. The test is positive when redness with a diameter of more than 10 mm forms at the injection site, which persists for 48 hours.
Treatment
Treatment of the disease should be carried out under the supervision of a doctor!
The following are several treatment regimens adopted by infectious disease specialists. All drugs have side effects and must be selected individually by a doctor.
of pyrimethamine is most effective .
An alternative is doxycycline in combination with spiramycin.
There is a complex drug called Fansidar.
In 60-70% of cases, when treated with these drugs, adverse reactions occur in the form of skin rashes and inhibition of bone marrow hematopoiesis. To prevent these reactions, it is advisable to divide the course of treatment into 3 cycles with a 10-day break between them.
Other drugs used for treatment:
- co-trimoxazole,
- spiramycin.
Prevention
Patients with acquired toxoplasmosis should be under medical supervision for a year. You should visit an infectious disease doctor once every 3 months.
Women planning pregnancy should be screened for toxoplasmosis.
During pregnancy you should:
- limit contact with felines,
- wash your hands thoroughly after contact with soil and raw meat,
- eat well-cooked meat,
- wash vegetables, fruits, herbs thoroughly, pouring boiling water over them,
- be examined for toxoplasmosis every 3 months,
- destroy flies, cockroaches and rodents that carry oocysts.
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