History

Toxoplasmosis is a Zoonotic disease, caused by Toxoplasma gondii, an

obligate intracellular parasite.

Toxoplasma gondii was first discovered in 1908 by Nicolle and Manceaux,

in Tunis, on a Gundi (Ctenodoactylus gundi).

It wasn't until 1939 that Wolf, Cowen and Paige were to conclude that
toxoplasma gondii had an effect on humans.
 Etiology
Toxoplasma gondii is an obligate intracellular parasite of the
coccidia subclass displaying typical sexual and asexual life
cycles.

T. Gondii causes Toxoplasmosis

 Toxoplasmosis facts
The feline is the only definitive host, but other warm blooded animals,
including humans, can serve as an intermediate host. It does not
discriminate in any way on sex, age or species. However it is rare in dogs.

Toxoplasmosis is a world spread disease. Alone in the US around 60 million

people carry the toxoplasma parasite without even showing symptoms. It
is a big concern for pregnant women, and immune-compromised people.
 What causes Toxoplasmosis

Toxoplasmosis is caused by ingesting contaminated vegetables, water, fruit and

undercooked/raw meat.

By ingesting contaminated feces, for example after cleaning out a litterbox.

Or by doing garden work, and not maintaining a healthy hand washing regime.
 Signalment
Toxoplasmosis is found in most warm blooded animals of any age, sex or species.
The feline is the only definitive host, but humans and other animals can serve as
an intermediate host.
In the US it is the leading food-born disease causing death.
It can be very detrimental for pregnant women or animals, causing abortions
around the 3rd trimester.
 Transmission
Toxoplasmosis is zoonotic

Transmission can occur in 3 ways

Fecal-oral
Eating contaminated meat/prey
Transplacental

The parasite can only produce oocytes (or eggs) when infecting a cat. The
organism then multiplies in the wall of the small intestine and produces oocysts
during the intraintestinal infection cycle.
 There are three forms of Toxoplasma gondii

Tachyzoite Rapidly reproducing form

Bradyzoite A slower
reproducing form,
contained in tissue

Sporozoite Contained in oocysts

 Tachyzoite
Tachyzoites invade cells in the body in order to multiply. They invade a cell,
multiply themselves, destroy the cell, and this releases more tachyzoites to infect
other cells.
Tachyzoites are seen in many tissues and organs throughout an infected body
during the acute phase of the disease.
The acute phase is also called the extraintestinal phase because it can effect cells
outside the intestines.
Only cats show the intestinal phase of the infection.

Stained tachyzoite
 Bradyzoites
Two or three weeks after the first infection, the Toxoplasma microorganism
begins to divide more slowly and a protective membrane forms around the
parasite cells.
The cysts containing the parasite cells are called zoitocysts and the cells
inside the cysts are called bradyzoites.
The tissue cysts are formed primarily in brain, eye, heart muscle, and
skeletal muscle.
Bradyzoites persist in tissue for many years, possibly for the life of the
host.
Bradyzoite
 Oocysts
In cats, the Toxoplasma parasites infect the lining of the small intestine where
they reproduce asexually.
After a few days of rapid reproduction the cells transform into a sexual
form, combine, and become enclosed in a cyst called an oocyst.
Oocysts contain the sporozoite form of the Toxoplasma parasite.
Oocysts are found in both wild and domestic cats but not in any other
animals or birds.
 Oocysts cont.
Animals become infected by ingesting food contaminated with oocysts from feces
or with tissue cysts (bradyzoite) from the flesh of infected animals.
Infected cats shed millions of oocysts in their feces during the two-week
period of the intestinal phase of the infection (i.e., when asexual
reproduction of the Toxoplasma microorganisms occurs).
These oocysts can survive in soil for several months and are the major
source of infection.
Once swallowed, the oocyst burst in the intestines and spreads to the rest
of the body through the bloodstream.
 http://animal.discovery.com/videos/monsters-
inside-me-toxoplasma-parasite.html
 Clinical signs & symptoms

Fever
Loss of appetite
Lethargy
Other symptoms may occur depending on whether the infection is acute or
chronic, and where in the body the parasite is found.
In cats it is most commonly seen effecting the lungs and eyes.
And in the dog, the gastrointestinal, neurological and the respiratory system.
 Diagnosis
History
Serology testing measuring the IgM & IgG anti-bodies
Sabin-Feldman Dye Test (DT)
Differential agglutination test (also known as the "AC/HS test")
 Treatment
The best treatment is prevention, by not feeding animals raw meat
There is no need for treatment in a healthy animal.
For an immune-compromised animal a 2-3 week treatment of clindamycin is
administered.
 Prognosis
For healthy animals and humans the prognosis is good. The disease should be
hibernating and not causing any damage.
For individuals with weakened immune systems, the prognosis is not good. The
disease has to be kept down with medicine, and complications can occur
depending or what tissues of the body are being effected.
For example, if toxoplasmosis is effecting the eye, the body will try and attack the
foreign invader, which can lead to blindness.
Immune-compromised hosts infected with toxoplasmosis may have encephalitis,
pneumonitis and myocarditis as manifestations of the infection.
These infections are usually fatal if not recognized and treated.
Pathologic lesions of disease
EYE
 Prevention
Avoid eating raw meat, unwashed fruit and vegetables
Keep children's sand boxes covered.
Wash hands after dealing with raw meat, gardening, and changing litterboxes.
Change litterboxes daily (the oocytes shedded in the feces don't become
infectious for 1-5 days)
Don't feed animals raw meat.
If pregnant wear gloves when changing litterboxes, and keep cats indoors to
insure they don't hunt and eat contaminated prey/meat.
There is only one vaccine available. It is exclusively for sheep and it is only
approved for use in Great Britain
 Client education
What is toxoplasmosis? It is a disease caused by the parasite toxoplasma gondii.
It is found anywhere in the world, effecting any species, even though the cat is
required for the organism's lifecycle.

Can my indoor cat get toxoplasmosis? If you have an indoor cat that is fed only a
commercially produced pet food the cat should not be at risk of getting
toxoplasmosis. Indoor/outdoor cats are at risk because we can not track their
every move to insure they don't eat contaminated meat/prey.
 Client education Cont.
Can I get toxoplasmosis? Yes, humans can get toxoplasmosis, it is a zoonotic
disease.
Will it be harmful to me as a human? In healthy humans it shouldn't be harmful.
If you get toxoplasmosis do you have it for the rest of your life? Yes,
toxoplasmosis will stay in your system for the rest of your life. As long as you are
not immune-compromised the disease shouldn't do any harm.
Can you pass toxoplasmosis to your baby if pregnant, and should I get rid of my
cat? Toxoplasmosis can be transferred transplacentally, meaning it can be
transferred from mother to child in the womb. It doesnt mean you have to get
rid of your cat. Keep the cat as an indoor cat, and wear gloves/wash hands after
changing litter (or simplify things and get someone else to change the litterbox
daily.)
 Side notes

Victoria, British Colombia suffered the first documented outbreak of Toxoplasmosis

in 1997
It was speculated that feline feces contaminated a surface water reservoir with
Toxoplasma gondii oocysts. A thorough investigation of the watershed in Victoria
followed the outbreak, and evidence proved that cats, cougars and deer mice
contaminated with oocytes would shed them near the water's edge. This made
the water contaminated, and infected more than 110 people with toxoplasmosis,
including 12 newborns. Further investigation was made into the food distributors
in Victoria, but no evidence of contamination was found.
 Side note continued
In 1995 the British Columbia Center for Disease Control became aware of a sudden
increase in acute toxoplasmosis in Victoria, where two separate and independent
ophthalmologists diagnosed seven cases of acute toxoplasmosis with retinitis.
Neither ophthalmologist had any other cases of toxoplasmosis in the previous 5
years.
The threat of epidemics is even more concerning because of studies which have
been conducted for more than 30 years researching the bond between
toxoplasmosis and schizophrenia.
Studies of rats and mice have shown that infection with toxoplasmosis causes them
to have higher rates of mental retardation, impaired memory and impaired
learning.
 References

http://www.cdc.gov/ncidod/eid/vol9no11/03-0143.htm
http://www.stanleyresearch.org/dnn/LaboratoryofDevelopmentalNe
urovirology/ToxoplasmosisSchizophreniaResearch/tabid/172/Def
ault.aspx
http://ci.vbi.vt.edu/pathinfo/pathogens/gondii.html
http://www.ccohs.ca/oshanswers/diseases/toxoplasmosis.html
http://animal.discovery.com/videos/monsters-inside-me-
toxoplasma-parasite.html