The Health | October, 2019
14
column
Cat
lovers
beware!
Your lovable pet might be
the cause for toxoplasmosis,
the silent killer
DEADLY SMALL: The parasitic protozoa, Toxoplasma gondii, transmitted mainly by many warm-blooded
animals like birds or mammals.
H
ave you ever heard of toxo-
plasmosis? No? Then let’s
learn more of this infection
by going through these two
cases.
A 56-year old man, who
recently had chemotherapy, came to the
hospital complaining of a 10-day history
of painful red eye, sensitivity to light and
blurring vision on the left eye. Following a
comprehensive evaluation, a diagnosis of
ocular toxoplasmosis (eye toxoplasmosis)
was made. He was immediately started on
treatment. His vision subsequently improved.
He was then continued on a few medications
to prevent recurrence of the eye problem.
The next case is of a newborn baby girl
who was admitted to the neonatal intensive
care unit 23 hours after delivery due to high
grade fever and redness of the left eye. Labo-
ratory screening tests done on the mother
previously was positive for toxoplasmosis.
The baby also tested positive. A diagnosis of
congenital toxoplasmosis was made. The baby
was started on treatment. However, she had
multiple episodes of seizures and her condi-
tion deteriorated. She later succumbed to
her condition due to sepsis and multi-organ
failure.
What is toxoplasmosis?
Toxoplasmosis is caused by parasitic proto-
zoa, Toxoplasma gondii, transmitted mainly
by many warm-blooded animals like birds or
mammals. Toxoplasmosis is caused by ingest-
ing the microscopic eggs of the parasites or
eat cysts in undercooked meat, drinking
unpasteurized milk, contaminated vegetables
and other foods, from the soil or via handling
the of infected cat litter. In healthy adults, the
symptoms of infection generally pass unno-
ticed, thanks to the immune system attacking
the parasites and preventing the illness. They
may only experience flu-like symptoms such
as fatigue, headache, fever and swollen lymph
nodes. In individuals with weakened immune
system, it may cause severe symptoms as
outlined by the two cases.
In both cases, the man and the baby devel-
oped inflammation of the eye. The man may
have had previous infection which resolved
without symptoms. However, due to weak-
ened immune system after chemotherapy,
reactivation of the parasite occurred in the
eye causing pain, blurring of vision and pos-
sible permanent blindness if left untreated.
The baby was an example of the devas-
tating effects of congenital toxoplasmosis
in which toxoplasmosis was passed down
sepsis
alert
By Dr Dian
Nasriana
&
through the placenta from the mother to the
child in the womb. The baby also developed
brain inflammation causing seizures. As the
infection overwhelms the immature immune
system, the infection spreads to the body
culminating in sepsis and death.
Why do cat lovers
need to know this?
Cats are the usual host for these parasites. The
parasites can only mature to adulthood and
produce eggs in the gut of a cat. The eggs enter
the environment through the cat litter. The
eggs must mature in the soil for 1 to 5 days
before they become contagious for people or
other animals.
In the two cases, both the mother and the
man were identified to be cat-lovers and have
pet cats at home.
How do we prevent
toxoplasmosis?
To reduce the chances of ingesting food with
Toxoplasma gondii,
1. Do cook all meat until the meat is no
longer pink.
2. Always wash your hands thoroughly after
Life cycle of Taxoplasma
Dr Tan
Toh Leong
any outdoors activity. If possible, use
gloves.
3. Thoroughly wash all fruits and vegetables
as well as the cutting boards, other kitchen
surfaces, cutlery and utensils after han-
dling and preparing raw meat, fruits and
vegetables.
4. Pregnant women are advised to minimize
any gardening activity.
5. Cat litter boxes should be cleaned
regularly.
6. It is advised to feed your pet cats only com-
mercially made cat food and keep them
from eating undercooked kitchen meat
scraps. Do bring them to the veterinarian
for regular check-ups. — The Health
Dr Dian Nasriana binti Nasuruddin is the
Treasurer of the Malaysian Sepsis Alliance and
a Senior Lecturer and Chemical Pathologist
Consultant, UKM Medical Center, Universiti
Kebangsaan Malaysia.
Dr Tan Toh Leong is the President and
Founder of Malaysian Sepsis Alliance and
a Senior Lecturer &Emergency Medical
Consultant, UKM Medical Center, Universiti
Kebangsaan Malaysia.