Toxoplasmosis is a disease caused by parasites, which is most often characterized by chronic or latent leakage, which is dangerous due to its complications on the nervous system, organs of the reticuloendothelial system, eyes, myocardium and muscle tissue.
By type of transfer
Based on the mechanism of infection by pathology, toxoplasmosis can be congenital or acquired. In the case of congenital toxoplasmosis, fetal death often occurs intrauterinely or immediately after birth. Such death is most often triggered by a common infection or severe lesions of the nervous system and other organs. Sometimes, if the child survives, he may develop oligophrenia due to toxoplasmosis. This complication develops rapidly, takes on severe forms and begins to manifest itself in the first months of a child’s life.
Acquired toxoplasmosis can be acute or chronic. The acute form of acquired toxoplasmosis has symptoms like typhoid. It is characterized by symptoms such as high body temperature, an enlarged spleen and liver, or symptoms that characterize central nervous system damage of a predominant nature - vomiting, paralysis, headaches, convulsions, and so on. But most often acquired toxoplasmosis occurs in a chronic form. Also, the disease can sometimes occur and is hidden (latent, asymptomatic).
By type of flow
According to the type of flow, the acquired toxoplasmosis, as mentioned above, is divided into acute form, chronic form and latent (hidden) flow.
Acute toxoplasmosis often occurs without any symptoms. Only in 10-20% of cases of morbidity do patients observe a bilateral painless increase in lymph nodes in the axillary or cervical zone. In some patients, symptoms may arise in the acute form of the disease, such as flu, - mild fever, myalgia, general malaise, hepatosplenomegaly, and sometimes pharyngitis similar to infectious mononucleosis. Such acute symptoms of toxoplasmosis, such as slight anemia, atypical lymphocytosis, mild hepatic enzyme elevations, leukopenia, are considered to be quite common. Such symptoms may persist for a long time, but have no development or spread.
A very common form of the disease is chronic toxoplasmosis. It is characterized by symptoms such as subfebrile body temperature, pain in the head, enlarged liver, lymph nodes, reduced performance. Sometimes pathologies of the eyes, heart, and various systems in the human body develop. However, most often chronic toxoplasmosis is asymptomatic. This latent form of the disease is carried by rodents and cats. With good immunity, pathology lives in the body and never manifests itself. In this case, the incubation period can take from 3 to 14 days.
Etiology and transmission routes
The causative agent of toxoplasmosis is considered to be an obligate intracellular parasite of Toxoplasma gondii, the size of which does not exceed 4-8 micrometers. There are 3 forms of Toxoplasma, determined by its environment:
- tissue cyst;
Oocysts and tissue cysts are invasive for humans and infection with them can occur when contaminated meat is used in food, in some cases through contact with the ground, feeding on unwashed fruit and berry and vegetable crops.
Toxoplasma oocysts can be viable for a very long time if they are provided with moist and warm living conditions, which increase the risk of their transmission. In case of contact with the human body, invasive Toxoplasma transforms into tachyzoites, which further provokes the clinical manifestations of human pathology.
People can become infected with toxoplasmosis in several main ways. First, it is raw food or insufficiently thermally processed stuffing, meat, direct contact with the feces of cats or the ground where the cat goes to the toilet. Secondly, it is the transplacental transmission of the disease from the sick mother to the fetus. Third, an organ or blood transplant from an infected source.
More than 65% of cases of morbidity are caused by food products containing the pathogen. This is the so-called primary infection. As for infection from cats, street animals that eat raw meat of other animals have the greatest threat to human health.
Toxoplasmosis development cycle
Toxoplasmosis in cats can occur when it eats raw meat of other animals (mice, sparrows, cows). The animal also becomes infected when licking the surface of the earth, human footwear, sniffing the excrements of other animals, drinking from a puddle, as well as from the mother cat.
When Toxoplasma enters the cat's body, they begin to divide into 2 groups. The first group of Toxoplasma, once in the intestinal lumen of the animal, actively divides, forming germ cells - macrogametes and microgamates. Such cells merge, as a result of mergers, zygotes arise, then oocysts (initially non-invasive), which, together with the faeces, exit to the external environment. This whole process lasts 5 days, after which the oocysts become infectious. Contagious oocysts are released for 3-21 days, after which the cat can already be considered non-infectious.
Representatives of the second group of Toxoplasma, trapped in the cat's body, penetrate the red bone marrow, spleen, and other organs involved in blood formation. Further, from such organs with the bloodstream and lymph flow, they are spread to other parts of the animal's body, forming necrosis of all types of tissues. After a short time, the immune system produces antibodies to fight against toxoplasmas, and they are trapped in cysts inside the cells of the body.
Toxoplasma oocysts secreted in the feces of cats, with air temperatures from +4 to +55 degrees, can wait intermediate hosts for a very long time. The process may take a couple of years. In this case, the feces are located in the ground on which the grass grows, which is eaten by domestic and farm animals, the sandbox, into which children can climb, and so on. When oocysts get back into the warm-blooded body of an animal or a human, in the liver tissues, myocardium, etc., an active asexual reproduction of Toxoplasma begins. In intermediate host organisms, parasites can exist in the form of trophozoites that multiply using the longitudinal division method. More detailed process of the sexual and asexual life cycle of the parasite that causes toxoplasmosis, can be seen in the picture.
Symptoms of Toxoplasmosis
Symptoms of chronic toxoplasmosis do not occur immediately. First, there may be ailments, joint and muscle pain. This may take several months. Then an aggravation may begin, which will be indicated by an increase in body temperature, chills. Also, as a characteristic sign of chronic toxoplasmosis, experts call an allergic rash on the skin of the body. If complications occur, various organs may be affected, which will provoke hepatitis, pneumonia, cardiac muscle, and myocarditis may occur in a patient.
Also, toxoplasmosis can often give complications to the central nervous system, which causes encephalitis, meningitis, radiculitis. If the patient’s brain is affected, the following symptoms occur:
- unbearable pain in the head;
- crawling crawling;
- loss of sensitivity;
- the onset of coma or paralysis.
In acute toxoplasmosis, fever suddenly arises, the spleen and liver increase significantly, and the occipital and cervical lymph nodes increase. If you do not start treatment of acute toxoplasmosis in a timely manner, then it can turn into a chronic form, which periodically throughout life will worsen, causing intoxication processes in the body. As a result of such intoxication, the functions of the nervous system are disturbed, a person begins to have memory problems, and irritability arises. It can also disrupt the gastrointestinal tract, causing constipation, nausea and vomiting. Sometimes it can develop vegetative-vascular dystonia, suffer organs of vision with the formation of uveitis, retinitis or chorioretinitis. If toxoplasmosis develops in the body with HIV infection, then it may well provoke a fatal outcome.
With good immunity, such a disease will not develop in the human body. It is possible to diagnose a chronic form of pathology only by laboratory tests, especially if it occurs in a hidden, most common form.
Symptoms during pregnancy
In 90% of all cases of toxoplasmosis during pregnancy, the disease has no severe symptoms. Thus, a woman can be infected, but not infectious to others or to her unborn child. Severe symptoms may develop due to weakening of the immunity with concomitant infectious processes, bacterial diseases, the initial stage of AIDS and so on. The incubation period after the parasite enters the human body will vary from 1 to 3 weeks.
Acute toxoplasmosis in the event of pregnancy proceeds similarly to the flu. At the same time, there is hyperthermia within 37.5-38 degrees, malaise, weakness, pain in the head, lymph node enlargement, sometimes hepatosplenomegaly. During the course of toxoplasmosis in pregnant women, eye complications are very rare, and only if the woman’s immunity is very low can serious complications such as meningitis, myocarditis, pneumonia and other things start.
Course of the disease
The entrance gate of toxoplasmosis is the digestive organs. There are also known cases of infection by laboratory using a syringe containing a culture of toxoplasmosis. The pathogen is introduced into the lower part of the small intestine, and then with the help of lymph flow enters the regional lymph nodes. Here, inflammatory reactions begin to develop with infectious granulomas similar in cell composition to brucellosis or tuberculosis. Lymph nodes at the same time greatly increase in size.
After that, Toxoplasma enters the bloodstream, spreads to all parts of the body and is fixed in organs such as the spleen, liver, eyes, nervous system, muscular skeletal tissue, and others. In places of dislocation accumulate parasites in the form of cysts that can persist for several years, decades and even the rest of life, which provokes inflammatory reactions, foci of necrosis, in which calcium salts are deposited and calcinate is formed.
Due to the vital activity of parasites in the body, allergens, antigens, to which the body itself produces antibodies, are released, which can be determined by carrying out various immune reactions. Such antibodies protect against subsequent infection with even the most virulent strains of the disease and lead to latent flow of toxoplasmosis in the majority of infected individuals. In the case when the immune defense in the body is weakened, exacerbations of toxoplasmosis occur, and the latent form becomes acute. Exacerbations are triggered by intercurrent diseases (colds, flu) and can occur even 10–20 years after infection. Such exacerbations may be accompanied by severe toxoplasmosis encephalitis during the treatment of the underlying disease with cytostatics, as well as immunosuppressants.
Generalization of latent toxoplasmosis in HIV-infected patients leads to a malignant course of the pathological process, necrotic diffuse or localized meningoencephalitis with the involvement of many organs in the process (heart, lungs, liver). Layering of toxoplasmosis on AIDS can be fatal.
The main role of the pathogenesis of the chronic form of toxoplasmosis is played by the reactive hypersensitivity of the delayed type to the antigen of toxoplasma and the products of its vital activity.
Types of analyzes
The clinical picture of toxoplasmosis is so diverse that it does not allow specialists to diagnose the disease only by symptoms. In this case, toxoplasmosis can only be assumed, and the results of some laboratory studies are needed to confirm the causative agent.
The main diagnostic method for the determination of toxoplasmosis is a serological examination. In order to confirm the presence of toxoplasmosis in the body with the help of blood tests, it is necessary to apply either an enzyme immunoassay (ELISA) or a polymerase chain reaction (PCR) technique.
The enzyme immunoassay demonstrates the presence of an immunoglobulin protein M and G. M-group antibodies arise from the moment of infection and last for up to 21 days thereafter. After 3 weeks, their blood level decreases sharply, that is, only the acute stage of the disease will be characterized by the appearance of immunoglobulins M in the analyzes.
On the third day after infection, antibodies of the G-group appear in the blood, which increase every day due to an increase in body resistance. These antibodies will remain in the patient for the rest of their lives and will act as a barrier to re-infection. When they are detected in a blood test, it can be concluded that the infection occurred long ago or recently, but this plays a significant role for therapy, especially if the patient is a pregnant woman. If necessary, clarify the timing of infection, the duration of the pathology requires a PCR-diagnostic study. It will show the timing of infection, and the time since the occurrence of antibodies in the body, and accurately confirm or refute the very presence of toxoplasmosis in the blood.
How to prepare and take tests
There is no special preparation for the delivery of tests for toxoplasmosis. In order for the diagnosis to be accurate and not smeared by the patient taking various drugs, the following is required before the test is taken:
- cancel any prescribed antibiotics at least 2 weeks prior to the day of testing;
- eliminate the consumption of coffee, alcohol, reduce fried, spicy, fatty, smoked and sour foods 2 days before the analysis;
- refuse perfumed cosmetics (perfumes, detergents) for 12 hours before the date of analysis;
- to warn the attending physician about the admission of drugs aimed at combating chronic diseases;
- come to the laboratory for delivery of venous blood in the morning on an empty stomach.
If you fulfill the above recommendations, then there is a chance to get the most truthful results of the tests and quickly identify the disease.
The duration of readiness of tests for toxoplasmosis can vary in different clinics from 1 to 3 days.
Treatment for toxoplasmosis
Most often, toxoplasmosis occurs in healthy people by itself, without the use of drug therapy. Pregnant women and newborns need therapy, but it is important to know here that during treatment it is necessary to eliminate symptoms and remove the acute phase of the pathology. In the case of an ophthalmic form of the disease, treatment should be prescribed and vary, depending on the stage of the disease, by ophthalmologists. It is important for patients with HIV infection or other causes of weakened immunity to take medicine until symptoms disappear, and to diagnose AIDS, toxoplasmosis will have to be treated for life.
Toxoplasmosis therapy is required only for those who have a very weakened immune system. To prevent pathology, Biseptol is used, but it cannot be used in case of an acute form of pathology. According to a 2012 study, effective treatment of latent and active forms can be considered treatment of toxoplasmosis with a combination of two antimalarial drugs of the ELQ class (Endochin-like quinolones).
In the national treatment of toxoplasmosis, means are used to help destroy the parasite that has entered the human body. Many popular recipes, unlike drugs, can quickly help patients without significant side effects. Many of them have no contraindications, even in the case of childhood and pregnancy. However, any therapy, including folk, must necessarily be coordinated by the attending physician.
Among the main products from which the preparations are prepared for treatment, experts of traditional medicine with toxoplasmosis distinguish herbal preparations, garlic with milk, pumpkin seeds, horseradish, propolis.
To make a medicine based on milk and garlic, peel and chop 2 cloves of garlic, pour them with a glass of milk and simmer this mixture over a slow fire for 15 minutes. Then the broth is cooled, filtered and drunk throughout the day in small sips. Such treatment is not contraindicated for pregnant women, but it is not recommended for children.
Among the effective herbal preparations in the fight against toxoplasmosis, there are several leaders. The first harvest includes 100 grams of chamomile flowers and tansy, 50 grams of gentian root and bitter wormwood, and 125 grams of buckthorn bark. All ingredients must be crushed into powder and mixed. A tablespoon of such a mixture is poured with boiled water and infused in a thermos overnight. In the morning the infusion is filtered and taken before meals for 50 minutes.
For the second collection will need 25 grams of flowers of tansy, 35 grams of grass three-leaf watch and 10 grams of centaury. All ingredients are mixed, filled with 1 liter of boiling water and this infusion must be wrapped for the whole day. After the herbs settle, the infusion is filtered and drunk warm according to the following scheme:
- 100 grams before breakfast;
- 300 grams before lunch;
- 200 grams before dinner.
Apply this infusion to treat toxoplasmosis can all categories of patients, including children and pregnant women.
Pumpkin seeds have long been known for their highly effective anti-parasitic properties, expelling worms from the human body. However, a drug based on them will help to effectively deal with toxoplasmosis. To do this, dry seed kernels are ground to a powdery state, mixed with a glass of warmed milk and taken in the morning on an empty stomach. You can use milk with pumpkin seeds for both pregnant women and children. If it is not possible to prepare a medicine, you can simply eat pumpkin seeds on an empty stomach in the morning.
For the preparation of another effective means aimed at eliminating Toxoplasma, it is necessary to grate the horseradish root and mix it with sour cream. Use this sauce is necessary during the meal as a seasoning for any dish. Eat horseradish with sour cream should be at least 3 times a day for 3 days. If after this you are examined for toxoplasmosis, in most cases the disease will be absent in the tests, but if there is no effect, the treatment is prolonged. Horseradish treatment is suitable for all categories of adult patients, including pregnant women, but not for children.
Another effective prescription for the treatment of toxoplasmosis involves the use of bird cherry broth. For its preparation, young branches of bird cherry (100 grams) are finely cut into clay or enameled dishes and poured with two liters of cold boiled water. Water is set on fire and boiled for 30 minutes, cooled, filtered. It is necessary to drink warm medicine within 1 month on cup before any meal. The recipe is universal, there are no restrictions on the use of any categories of patients.
One of the most popular ingredients for many traditional medicines is propolis. It should not be used by pregnant women, young children and people who are allergic to bee products. In other cases, when toxoplasmosis is very effective alcohol tincture of propolis, which is prepared by pouring 100 grams of propolis 0.5 liters of medical alcohol. All this for three days should be insisted in a dark place. Then the finished medicine is used as follows - 40 drops of tincture are added to 1/3 cup of water and drunk for half an hour before each meal for 7 days, then they do not take the medicine for 7 days and then take it again for 7 days. This cycle must be repeated twice. It is important to remember that when using propolis alcohol tincture it is absolutely impossible to eat dairy.
Toxoplasmosis prophylaxis is especially important for pregnant women for whom the disease is an increased threat. This is especially true of those who do not have immunity to the disease, because it has never been sick.
If a pregnant woman works with the ground (in the garden, for example), she should definitely wear latex gloves on her hands, which protect the skin with possible microcracks from intended contact with toxoplasma. It is important to wash very well before eating vegetables and fruits. For cutting raw meat, you will also need gloves to prevent skin contact. Carefully wash your hands after meat. It should be thoroughly roasted or boiled, and not consumed in a semi-cooked state (steaks can be eaten only in a state of complete roasting, for example, no light or medium degrees).
If you have a domestic cat, you shouldn’t clean its toilet in a state of pregnancy, let someone else do it. A pet cannot be kissed, since in the acute stage of toxoplasmosis of an animal, infectious particles are contained in its saliva and secretions from the eyes or nose. It is better to immediately analyze the pet for the presence of Toxoplasma in the blood and in the absence of the disease try not to let it out on the street not to feed on raw meat.
Vaccinations with toxoplasmosis
Vaccinations from toxoplasmosis do pet cats. Vaccination of cats is the most effective means of preventing disease in humans. At the same time, a weak concentration of the causative agent is introduced into the body, to which the animal's body begins to develop immunity. In newborn kittens, immunity from toxoplasmosis occurs due to mother's milk.
Very rarely cats with toxoplasmosis die. More often, they are just seriously ill, which is also not very good, which is why an animal can be vaccinated extremely necessary. Currently, 2 types of feline vaccines are known. The first vaccines are able to protect the animal from a specific disease, and the second are multicomponent and immediately able to form immunity against a number of infections.
Even the high cost of continuous vaccination of domestic animals does not reduce the effectiveness of this procedure both for their population and for the people with whom they come in contact. Sometimes, to increase protection, they can offer vaccination to a person in addition to an animal.
Complications of the disease
In the early stages of pregnancy, the embryo lays all the internal organs. The factors affecting the fetus at this moment are responsible for the full development of the kidneys, liver, and heart of the child. With the development of toxoplasmosis by a woman at this stage, the baby may experience all sorts of developmental abnormalities, sometimes incompatible with their future life. According to experts, when a pregnant woman is infected with toxoplasmosis at 10-24 weeks of carrying a child, the risk of health problems for a baby is 6%. If pathology occurs up to the 30th week of pregnancy, the fetus may experience abnormal development of the eye or brain, leading to blindness, cataracts, underdevelopment of the brain, hydrocephalus.
The probability of infection with pregnant toxoplasmosis is 5-10 cases per 1000 people. In the case of a severe infection in a pregnant woman, organs such as the spleen, liver, jaundice may begin, the functionality of the digestive and hematopoietic systems may be upset. Pregnancy itself can end in miscarriage at any time.
Previously, the identification of toxoplasmosis in pregnant women necessarily terminated the pregnancy. It was an absolute contraindication for further childbearing. Today, doctors approach the further course of pregnancy individually, using the possibilities of complete diagnostics and various methods of treatment.
With an increase in the duration of pregnancy, the probability of infection of the unborn child increases, but the risk of serious consequences decreases due to the complete formation of the internal organs of the baby in the late stages of gestation.
Toxoplasmosis in children
In young children, toxoplasmosis is able to impair the functioning of the cardiovascular, nervous and digestive systems. Strabismus may also develop, or the lens of the child’s eyes may become clouded.
Experts identify the acquired and congenital types of the disease. For a child, congenital toxoplasmosis is the most dangerous, since in this way, the newborns very often reveal an underdevelopment of vital organs, as well as blindness, various pathologies of the nervous system. There are also cases of involuntary abortion in women who tolerate toxoplasmosis during pregnancy. Therefore, it is important to take responsibility for the prevention of this disease in a child.
Specialty: pediatrician, infectious diseases specialist, allergist-immunologist.
Total experience: 7 years.
Education: 2010, SSMU, pediatric, pediatrics.
Experience infectious diseases more than 3 years.
He has a patent on the topic “A method for predicting a high risk of the formation of a chronic pathology of the adeno-tonsillar system in frequently ill children”. As well as the author of publications in the journals VAK.