The Center for Disease Control and Prevention estimates that 60 million people in the United States are infected with toxoplasmosis. Most people are not even aware they have the illness as it can often be asymptomatic. The immune system is strong enough to ward off the infection. However, for those with weakened immune systems, particularly people with HIV, toxoplasmosis can be a serious problem.

Toxoplasmosis is caused by a single-celled parasite known as Toxoplasma gondii. The parasite lives inside the intestines of animals and birds, most commonly pigs and cats. The parasite transfers to humans through a number of avenues, though rarely from person to person contact. Contact with cat feces, such as when cleaning out a litter box, can expose a person to the parasite. If they accidentally ingest particles from the feces, the parasite can invade the body. Eating food from a contaminated animal will also transfer the virus, as will utensils that were used to cut the raw meat. The skins of unwashed fruits and vegetables can carry the parasite. It is even possible to breathe the parasite in through dust particles.

Symptoms of Toxoplasmosis

In most healthy people, toxoplasmosis will not show symptoms. When they do show, the symptoms can resemble other illnesses, like the flu. Enlarged lymph nodes, headache, fever, aches, and sore throat can all be expected. If symptoms develop, they can arrive between weeks and months of exposure.

People with HIV are more likely to experience severe problems. These can include confusion, coordination difficulty, blurred vision due to inflamed retinas, and seizures. More dangerous are conditions involving the lungs, brain, and nervous system. Encephalitis, which is a serious inflammation of the brain, is a common toxoplasmosis complication among people with HIV and can be deadly if untreated.

It is possible to diagnose toxoplasmosis through a laboratory test that searches for the toxoplasmia gondii parasite. These tests are rarely performed since toxoplasmosis is not immediately suspected; it is difficult to pinpoint due to its symptoms’ mimicry of other illnesses. In general, a blood test is performed to measure antibodies in the blood.

In cases where encephalitis has developed, imaging tests such as an MRI and brain biopsy help present a clearer picture to determine toxoplasmosis.

For people without symptoms, no action needs to be taken. But for those with HIV who present symptoms, a doctor can prescribe antibiotic and antimalarial medication. The antimalarial medication, known as pyrimethamine prevents toxoplasmosis from receiving B vitamins by stopping the body from absorbing it. It is generally taken with a supplement of folic acid to offset the loss.

Sulfadiazine is an antibiotic that stops toxoplasmosis from using vitamin B. For people with HIV, there is a risk of recurrence. For this reason, it is recommended they continue treatment for as long as the body is unable to fight the illness itself. In some cases, this could mean a lifetime. There are side effects with both medications, including bone marrow suppression, anemia, and diarrhea. With sulfadiazine, up to half of people who take it have an allergic reaction that includes a skin rash and fever. These side effects are generally more severe in HIV patients.

There are several prevention techniques a person can employ to avoid infection.

Food

A good rule of thumb in prevention of toxoplasmosis is to always wash your hands and utensils after handling meats. Thoroughly cook the meat as well. The parasite can be easily transferred from raw meat to your body. The CDC recommends freezing meats before cooking it. This can lower the chance of toxoplasmosis. All fruits and vegetables need to be washed and peeled.

Animals

Cat owners need to be extra cautious when dealing with pets. Indoor cats are low risk for toxoplasmosis, but it is best not to take chances. Avoid feeding raw meat to a cat. Someone who is HIV positive should not adopt stray cats, as they are at a higher risk of carrying the infection. Wear gloves when cleaning a litter box, or have someone else handle the duties entirely. Disinfect the box with hot water on a regular basis.

General

Hands need to be washed after spending any time outside. Wear gloves when gardening to protect against exposure. Check all windows and make sure screens are secure to prevent bugs from getting in the home. There is a possibility that flies can transfer the illness after coming in contact with cat feces. When eating at restaurants, make sure all meats are fully cooked. And finally, do not drink untreated water or unpasteurized goat’s milk.

Toxoplasmosis and Cats

A cat can be a comforting companion for people dealing with HIV. The threat of toxoplasmosis does exist, but it is possible to prevent a cat from contracting it. Indoor cats do not come in contact with toxoplasmosis as much as outdoor cats, which have a chance of getting the parasite from a number of sources, including the food it hunts. By keeping a cat indoors, it is less likely to contract toxoplasmosis. Never feed the cat raw meat. A cat is just as likely to become infected by contaminated raw meat as a person. Avoid taking in stray cats, as there’s no way to tell if they have been exposed.

For most people with toxoplasmosis, there are no repercussions. But people with HIV are required to be more aware of infections. Take the necessary steps to protect against toxoplasmosis, and contact a doctor immediately if symptoms arise.