Authors: Zain Arshad, Hamza Hafeez, Zohaib Saeed, Rao Zahid Abbas, Muhammad Tahir Aleem
1.
Department of Parasitology, University of Agriculture, Faisalabad.
2. MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, 210095 Nanjing, P.R. China.
Introduction
Toxoplasma
gondii (T. gondii), a single-celled parasite, causes the
disease Toxoplasmosis. It is the most common parasitic disease,
and infection occurs in all warm-blooded animals, including pets and humans.
The life cycle of T. gondii involves the cats necessarily, but rarely
the infection occurs in them. Its transmission involves eating of undercooked
and contaminated meat, exposure to infected cat feces, and mother to fetus
during pregnancy. The major threat includes the abortion of a fetus during
pregnancy. Flu-like symptoms also appear in some cases, but mostly the people
affected with this do not show clear sign and symptoms. In infected newborn and
people with a compromised immune system, it may cause serious and severe
complications. So, there is a major need to know
about the public health significance of toxoplasmosis.
Public Health Significance
Public
health is the science of protecting and improving the health of people and
their communities, which can be achieved by improving healthy lifestyles,
researching and diagnosing the disease, and preventing the disease. As far as
the public health significance of T. gondii is concerned, it is
found in mammals and birds worldwide. Humans are at high risk of acquiring the
infection but without clinical signs and symptoms. Severe complications in
immunocompromised patients and in the fetus may occur during pregnancy. The
domestic cat is the main host of T. gondii. Infection in cats mainly
occurs by ingestion of small infected mammals (rodents and birds), but rarely
from infected cat feces. The intermediate hosts include sheep, goats, rodents,
cattle, swine, chicken, and birds.
Adults acquire the toxoplasmosis infection by consumption
of raw and undercooked meat containing the tissue cysts. Consumption of
contaminated, unfiltered water and unpasteurized milk can also cause outbreaks.
Children can be affected by the ingestion of dirt or sandpit sand contaminated
with oocysts after the fecal contamination done by cats. Transmission by blood
transfusion and organ transplantation may also occur. If the infection occurs
during pregnancy, it will result in transplacental transmission. The infection
is not contagious except in utero condition. After excretion by cats, the
oocysts sporulate and, after 1-5 days, become infective and remain infective
for more than a year in water and soil. Everyone can acquire the infection, but
susceptibility to primary infection is more in women of childbearing age of
about 75%.
Preventive Measures
Immunization is not available for the toxoplasmosis infection. Immunocompromised
people and pregnant women should follow the following advice:
·
Use thoroughly cooked meat, and uncooked meat
should be avoided
· Avoid
consuming unpasteurized milk, and it's by-products
· All
raw vegetables and fruits should be washed before eating
· Hands
should be washed thoroughly before meals
· Gloves
should be used for the cleaning of cat litter trays and if possible, delegate
this to others
· Ensure
the cleaning and emptiness of cat litter trays daily, also check for the
regular
disinfection with boiling water
In the scenario of control of the
case, isolation is not required by the patient. In immunocompromised people and
for infections during pregnancy, specific anti-protozoal drugs should be
allocated. Prophylactic treatment during immunosuppression in immunosuppressed
people is also required, generally with cotrimoxazole therapy. Prolonged
treatment is required for the infants who gain the infection before birth to
prevent the risk of active infection. There is no risk for the children whose
mothers have evidence of previous immunity of more than six months. Primary
infection is rare in pregnancy, although transplacental spread to the fetus may
occur up to one-third percent. In pregnancy, the primary infection causes
serious fetal disease. In the first trimester, the fetal infection rate is low
(up to 15 percent). In later pregnancy, the infection rate is generally very
high. There is a significant reduction in the effects appear on the baby if
diagnosis infection transmission to the fetus, amniocentesis with PCR can be
done. Active infection to the newborns is treated empirically until the ruling
out of congenital disease. After the confirmation of infection, one should
continue the treatment for 12 months to reduce long term effects. In healthy
and non-pregnant people, who have been diagnosed with toxoplasmosis, there is
no need for treatment besides conservative management. While in pregnant and immune-compromised
people, there is the need for medical management to avoid complications. The
best approach, though, is prevention.
Conclusion
No comments:
Post a Comment