Diagnosis (ref: Dr.

Shubha Phadke, MD, DM (Medical Genetics), Professor Department of Medical

Genetics Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow-226014)

Fetal effects of Toxoplasmosis, Rubella, cytomegalovirus or Herpes simplex infections: If a pregnant

woman gets infected with toxoplasma gondii, rubella or cytomegalovirus during pregnancy then there is
a high chance of the fetus getting infected. But transmission of infection can occur only if the maternal
infection is during pregnancy. Past infections do not pose any risk to the fetus. The fetal infections may
lead to spontaneous abortion or fetal effects like cataract, retinopathy, cardiac defects, microcephaly,
hydrocephalus, mental retardation, deafness or acute septicaemia like illness during neonatal period. It
should be noted that all maternal infections do not get transmitted to the fetus and many (50-90%) of
the infected foetuses are clinically normal

The only indications for TORCH test are:

i. Fever with rash in a pregnant woman

ii. Contact of pregnant woman with a case with fever and rash
iii. Calcification in fetal brain, liver, fetal verticulomegaly detected by Ultrasonography in the fetus
iv. Clinical presentation in a neonate an infant suggestive of infection, Serological tests for Herpez
simplex infection are too unreliable to be used for clinical purposes. Presence to active lesion of
genital herpes may indicate delivery by caesarean section. Most of the herpes simplex infections
are due to perinatal transmission and fetal infection due to transplacental transmission is
extremely rare

Diagnosis (CDC)

A Toxoplasma-positive reaction, stained by immunofluroescence (IFA). (CDC

Photo)
The diagnosis of toxoplasmosis is typically made by serologic testing. A test that
measures immunoglobulin G (IgG) is used to determine if a person has been
infected. If it is necessary to try to estimate the time of infection, which is of
particular importance for pregnant women, a test which measures
immunoglobulin M (IgM) is also used along with other tests such as an avidity
test.

Diagnosis can also be made by direct observation of the parasite in stained tissue
sections, cerebrospinal fluid (CSF), or other biopsy material. These techniques are
used less frequently because of the difficulty of obtaining these specimens.

Parasites can also be isolated from blood or other body fluids (for example, CSF)
but this process can be difficult and requires considerable time.

Molecular techniques that can detect the parasite’s DNA in the amniotic fluid can
be useful in cases of possible mother-to-child (congenital) transmission.

Prevention & Control

 

People who are healthy should follow the guidelines below to reduce risk of
toxoplasmosis. If you have a weakened immune system, please see guidelines
for Immunocompromised Persons.

Reduce Risk from Food

To prevent risk of toxoplasmosis and other infections from food:

Cook food to safe temperatures. A food thermometer should be used to measure

the internal temperature of cooked meat. Color is not a reliable indicator that
meat has been cooked to a temperature high enough to kill harmful pathogens
like Toxoplasma.  Do not sample meat until it is cooked. USDA recommends the
following for meat preparation:

For Whole Cuts of Meat (excluding poultry)

Cook to at least 145° F (63° C) as measured with a food thermometer placed in
the thickest part of the meat, then allow the meat to rest for three minutes before
carving or consuming.  *According to USDA, “A ‘rest time’ is the amount of time
the product remains at the final temperature, after it has been removed from a
grill, oven, or other heat source. During the three minutes after meat is removed
from the heat source, its temperature remains constant or continues to rise,
which destroys pathogens.”

For Ground Meat (excluding poultry)

Cook to at least 160° F (71° C); ground meats do not require a rest time.

For All Poultry (whole cuts and ground)

Cook to at least 165° F (74° C). The internal temperature should be checked in the
innermost part of the thigh, innermost part of the wing, and the thickest part of
the breast. Poultry do not require a rest time.

More on: Fight BAC: Safe Food HandlingExternal

 Freeze meat for several days at sub-zero (0° F) temperatures before

cooking to greatly reduce chance of infection. *Freezing does not reliably
kill other parasites that may be found in meat (like certain species
of Trichinella) or harmful bacteria. Cooking meat to USDA recommended
internal temperatures is the safest method to destroy all parasites and
other pathogens.
 Peel or wash fruits and vegetables thoroughly before eating.

Wash counter tops carefully. Photo courtesy of USDA.

 Wash cutting boards, dishes, counters, utensils, and hands with soapy
water after contact with raw meat, poultry, seafood, or unwashed fruits or
vegetables.
 Do not drink unpasteurized goat’s milk.
 Do not eat raw or undercooked oysters, mussels, or clams (these may be
contaminated with Toxoplasma that has washed into seawater).

More on: Handwashing
The U.S. Government and the meat industry continue their efforts to reduce T.
gondii in meat.

Reduce Risk from the Environment

To reduce risk of toxoplasmosis from the environment:

 Avoid drinking untreated water.

 Wear gloves when gardening and during any contact with soil or sand
because it might be contaminated with cat feces that contain Toxoplasma.
Wash hands with soap and water after gardening or contact with soil or
sand.
 Teach children the importance of washing hands to prevent infection.
 Keep outdoor sandboxes covered.

Have someone else clean the litter box. (CDC Photo)

 Feed cats only canned or dried commercial food or well-cooked table food,
not raw or undercooked meats.
 Ensure that the cat litter box is changed daily. The Toxoplasma parasite
does not become infectious until 1 to 5 days after it is shed in a cat’s feces.
 If you are pregnant or immunocompromised:
1. Avoid changing cat litter if possible. If no one else can perform the
task, wear disposable gloves and wash your hands with soap and
water afterwards.
2. Keep cats indoors to prevent them from hunting and reduce the
chances they will become infected with Toxoplasma.
3. Do not adopt or handle stray cats, especially kittens. Do not get a
new cat while you are pregnant or immunocompromised