Toxoplasmosis in pregnancy

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What is toxoplasmosis?

Why is toxoplasmosis dangerous in pregnancy?

How common is toxoplasmosis during pregnancy?

How can you catch toxoplasmosis?

How do I reduce the risk of catching toxoplasmosis?

What are the symptoms of toxoplasmosis?

How is toxoplasmosis diagnosed?

How is toxoplasmosis treated in pregnancy?

If I have toxoplasmosis how likely is it that my baby will be infected?

How do I find out if the baby is infected before birth?

How may my baby be affected by toxoplasmosis?

What is the treatment for babies infected with toxoplasmosis

Is it safe to breastfeed if I have toxoplasmosis?

Will I pass the infection on to my baby if I get pregnant again?

What is toxoplasmosis?

Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii. The parasite lives mainly in cats but can infect other animals and people.

Why is toxoplasmosis dangerous in pregnancy?

Lots of people don’t know they’ve had toxoplasmosis. Once you’re infected, the parasite lives in your body and does not usually cause problems. But pregnant women and birthing people can pass the infection to their unborn baby through the placenta.  

If you are infected more than a few months before you get pregnant, you will have developed immunity, and this will protect your baby. 

If you get it while you're pregnant, or just before, it can increase your risk of miscarriage and stillbirth, or cause serious health problems for your baby.

How common is toxoplasmosis during pregnancy?

The chances of getting toxoplasmosis for the first time during pregnancy are small. Around 350 people in total are diagnosed with toxoplasmosis in England and Wales each year.

How can you catch toxoplasmosis?

You can be infected by:

• eating raw or undercooked meat (meat showing any traces of pink or blood)
• eating cured, dried or smoked meats like salami
• eating raw oysters, clams or mussels
• drinking unpasteurised goats’ milk or eating any products made from it
• contact with sheep or lambs
• eating unwashed fruit and vegetables which may be contaminated by cat poo
• touching cat poo (for example, when changing the litter box) and then touching food.

You cannot catch toxoplasmosis through contact with someone who’s got it, or from stroking a cat or having a cat as a pet.

How do I reduce the risk of catching toxoplasmosis?

Do:

• wash your hands before preparing and eating food
• wash hands, knives and chopping boards thoroughly after preparing raw meat
• wash fruit and vegetables thoroughly to get rid of any traces of soil
• cook all meat thoroughly
• wear gloves while doing any gardening and wash your hands well afterwards. 

Do not:

• eat raw or cured meats like salami or Parma ham
• have unpasteurised goats' milk or any eat products made from it
• touch pregnant sheep or lambs.  

Find out more about foods to avoid in pregnancy and food safety. 

If you live with a cat:

• avoid cat poo in soil and cat litter, wearing gloves if you need to empty the litter tray and washing your hands afterwards. Or have someone else change the litter
• the litter box should be changed daily, as it takes several days for your cat's poo to become infectious
• do not feed your cat raw or undercooked meat.

Remember you cannot catch toxoplasmosis just from stroking your cat.

What are the symptoms of toxoplasmosis?

It does not usually cause any symptoms and most people do not realise they have had it.

But some people get flu-like symptoms, such as:

• high temperature (fever)  
• aching body
• headache
• tiredness
• feeling sick
• sore throat
• swollen glands.

Some people have more serious symptoms, including:

• blurred vision
• slurred speech
• unsteady walking
• confusion.

If you have these symptoms, it does not mean you definitely have toxoplasmosis. But you should ask for an urgent GP appointment, get help from NHS 111 or contact your midwife.

How is toxoplasmosis diagnosed?

Toxoplasmosis infection can be found through a blood test. You won’t be routinely offered a test for toxoplasmosis as part of your antenatal care. But if you are worried, you can ask your midwife or GP for a blood test.

Sometimes the person with suspected toxoplasmosis may have a brain scan, if they have a weakened immune system and are showing signs that their brain may be affected, such as a reduced level of consciousness.

How is toxoplasmosis treated in pregnancy?

Medicines can help you to get better and may help prevent or reduce harm to your baby. You may be offered:

• antibiotics
• a medicine that kills parasites (an anti-parasitic medicine)
• a supplement called calcium folinate, which works in a similar way to folic acid. This is because the anti-parasitic medicine stops your body from being able to absorb folic acid properly. Folic acid is essential for the healthy development of your baby.

You will probably take these drugs for the rest of your pregnancy.

You may need to be treated in hospital if you’re very ill.

If I have toxoplasmosis how likely is it that my baby will be infected?

Your baby may not get infected. The risk is lowest if you’re infected early in pregnancy and gets higher later in pregnancy. But if you get infected early on you have an increased risk of miscarriage. Babies infected early in pregnancy are more likely to have serious health problems.

How do I find out if the baby is infected before birth?

Your doctor may offer you an amniocentesis. This is when your doctor puts a thin needle through your tummy to take a sample of amniotic fluid (the fluid around your baby in your womb). This will be tested for infection. Amniocentesis does not show how toxoplasmosis may be affecting your baby.

Your doctor or midwife can talk to you about the test, including the possible benefits and risks, to help you decide whether to have it.

You may be offered an ultrasound scan to look for possible problems. Sometimes these scans can show problems related to the infection, but often they cannot be seen.

How may my baby be affected by toxoplasmosis?

 Your baby will be tested for the infection after they are born and checked for any problems. They will also have the usual general health checks including the newborn physical examination.  

This information can be difficult to read but try to remember that these effects are rare. It’s thought that in Europe around 1 in 1000 babies born alive to people with toxoplasmosis will have toxoplasmosis.

Most babies with toxoplasmosis seem healthy at birth. But many will have health problems months or years later. These may include:  

• eye infections
• hearing problems
• seizures
• learning difficulties
• delayed growth.

Treatment can help reduce the chance of these problems happening.

Some babies with toxoplasmosis have signs of a severe infection when they are born. They may have:

• eye infections
• an enlarged liver and spleen
• jaundice (yellowing of the skin and eyes)
• pneumonia. 

Babies infected early in pregnancy may be blind or have other problems linked to their development in the womb. Sadly, some are stillborn or die a few days after birth.

What is the treatment for babies infected with toxoplasmosis?

If your baby has toxoplasmosis they might need medicine for their first year to make sure the infection has gone.

Your baby will have regular checks of their eyes and hearing. An eye infection called chorioretinitis is the most common long-term problem from toxoplasmosis and can permanently damage your baby’s sight. If your baby has eye problems they will be treated by an eye specialist.

Is it safe to breastfeed if I have toxoplasmosis?

Yes. The parasite that causes toxoplasmosis has never been found in human breast milk.

Breastfeeding has great benefits for your baby and for you too. Read our breastfeeding information and support to find out more.

If you have cracked and bleeding nipples, or your breasts are inflamed, you may have some blood in your breast milk. Toxoplasmosis could be in that blood and infect your baby, but it is very unlikely and there is no record of this ever happening. Talk to your GP, midwife or health visitor if you have any pain during breastfeeding.  

Make sure your doctor knows you are breastfeeding so they can make sure any medication you are taking is safe for your baby. 

Will I pass the infection on to my baby if I get pregnant again?

No, as long as your immune system is healthy.

More support and information

If you need someone to talk to, our midwives are available to help. You can call our pregnancy line for free on 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected]. We also have a specialist helpline, the Tommy's Midwives Helpline for Black and Black-Mixed Heritage women and birthing people, for information and support for any aspect of your pregnancy journey.