Feline Toxoplasmosis and Pregnancy: Do I Need To Give Up My Cat?
My daughter just gave birth to her first child the other day — a very happy occasion for sure. It made me think about how trends can come and go over the years: formula feeding vs. breast feeding, bulky crib bumpers vs. lighter weight crib liners, using cloth or disposal diapers — which is truly more environmentally friendly — to swaddle or not to swaddle? The list is endless.
At one time obstetricians were even in the habit of advising pregnant women to get rid of their cats! Today we know that such a drastic step is unnecessary, but the reason behind that recommendation is still worth discussing.
The concern was over a zoonotic disease transmitted between cats and people called toxoplasmosis. We now understand a lot more about the life cycle of the organism, modes of transmission (it’s not just cats), and the risk of infection so we can be much more specific and rational when advising pregnant women.
Some sort of guidance does, however, need to be provided. I stress this because apparently my daughter’s obstetrician never even asked if she had pets. That is, unfortunately, a swing of the pendulum too far in the other direction.
Toxoplasmosis in cats
The toxoplasma organism is a microscopic coccidian that only reaches reproductive stages in the cat but can exist in its immature stages in other mammals and birds. Unfortunately, these immature stages can still cause damage and inflammation in the affected host. This rarely happens in adults with healthy immune systems but can be a significant problem in the case of congenital infection of a baby where the result can be stillbirth, birth defects, neurologic or ocular diseases. This was why worried obstetricians were advocating that pregnant women got rid of their cats entirely. [Editor's note: Giving up your cat is not necessary! Some simple precautionary measures (detailed below and identified by talking with your obsterician) can keep your whole family safe and happy. Even the U.S. Center for Disease Control agrees that pregant cat owners do not need to give up their pets. Read the CDC's report here.]
The high incidence of the disease in cats only added to previous concerns over toxoplasma. According to the Companion Animal Parasite Council (CAPC), studies in the United States indicate a mean seroprevalence (cats with evidence of past exposure to the toxoplasma organism) runs about 40%. That’s a lot; however, an infected cat only sheds infective eggs for 1-3 weeks after exposure meaning that the reported number of cats shedding eggs at any given time is less than 1%. That’s a lot less. Add to this the fact that the eggs shed are not yet infective (that takes another 1-5 days outside of the cat), and it becomes relatively easy to avoid exposure from your own cat. (See our Toxoplasmosis 101 here.)
Other sources of toxoplasmosis
The other reason that women need to be aware of toxoplasmosis is because having a cat in your home is NOT the only source of exposure. Stray cats in your neighbor may be using your yard as their litter pan, so gardening or handling unwashed produce may also put you in contact with the microscopic eggs.
People can also acquire the organism the way cats typically do — by eating mammals and birds that harbor the immature stages. Your cat may be hunting and eating smaller animals than you are, but the risk is still there.
Preventing toxoplasmosis infection
First of all, the risk to an unborn child occurs if a woman is NEWLY infected with Toxoplasmosis while she is pregnant or just before she becomes pregnant. Typically, once a woman produces her own antibodies against the organism, those antibodies protect the fetus. The important thing is that women be diligent about reducing exposure when trying to get pregnant and during pregnancy by following some simple steps:
- Keep cats indoors to discourage their exposure and do not acquire new cats during this time.
- Feed cats only cat food. Do not feed them meat.
- Have someone else in the household manage the litter pans.
- If you must manage litter pans clean them daily while wearing gloves and wash your hands well afterwards.
- Always wear gloves when gardening or working outdoors and wash your hands well afterwards.
- Wash or peel fruits and vegetables before eating them.
- Wash hands and utensils after preparing meals.
- Do not eat raw or undercooked meats.
Pets add a great deal to our experience of life. I cannot imagine not sharing our home with our cats. But along with the joy of pet ownership comes responsibility, and that includes the responsibility to be informed and to take precautions to protect both pets and people.
Take the precautions listed above to protect your unborn baby. Babies are one of life’s greatest joys. They are also life’s greatest responsibility and we must take every precaution to keep them safe and healthy. Babies and pets can share both our homes and our hearts.
Always discuss your concerns about your baby’s health with your physician.
If you have any questions or concerns, you should always visit or call your veterinarian -- they are your best resource to ensure the health and well-being of your pets.
Do You Have to Give up Your Cat?
The short answer to this question is no. If you make sure that there is no possible way that your cat might be exposed to the parasite, you do not have to get rid of your feline companion. There are, however, certain preventive measures that you can ensure.
Keep your cat indoors as the likelihood of her becoming infected are significantly lower if she has almost no way of coming in contact with the environment where the parasite might be located. If you are pregnant, you ought to avoid changing cat litter. Simply ask someone else to do it for you. If there’s no way of circumventing this task, wear gloves and wash your hands thoroughly after changing the litter.
If you have the habit of feeding your cat food that you prepare in your home, always make sure that the meat has been cooked thoroughly. If possible, change your cat’s diet and start feeding her only commercial canned or dry food.
Do not get a new cat if you are pregnant, especially stray kittens. Since there is no way of you knowing whether the perimeter of your house is parasite-free, perhaps you should avoid gardening. If it is one of your favorite activities, you can still perform it, but you have to make sure that you wear gloves while doing so. Always wash your hands with soap and water after handling soil or sand.
Can Toxoplasmosis Be Treated?
There is medication available both for people who don’t plan on becoming pregnant anytime soon and for women who are infected during pregnancy. Both the mother and the baby have to be monitored closely, especially after the baby is born.
Healthy people who only express mild symptoms might not even require any type of treatment, as long as they are not pregnant. Given the effect that this parasitic infection has on a person’s eyesight, it is recommended that people with eye disease undergo treatment so as to ensure that the condition doesn’t become more severe.
Both your cat and yourself can be tested for toxoplasmosis. Even if this is possible all over the world, routine screening is not recommended in low-risk populations. In Canada, only Nunavik and some parts of northern Quebec have screening programs due to high endemic seroprevalence. Routine screening is not recommended in countries where the incidence is low, including the United States and United Kingdom.
Therefore, it is your responsibility as a cat parent to get your cat tested before becoming pregnant.
It would be cruel for you to get rid of your cat, especially if you have taken the animal to the vet and he or she has performed a blood test and determined that your pet doesn’t carry Toxoplasma. You can enjoy your cat’s companionship and love even if you are pregnant so long as you ensure the preventive measures we have highlighted above.
Keep in mind that, within the cat population, only outdoor cats who hunt rodents and indoor cats who are fed raw meat are exposed to T. gondii. The time span where the cat will excrete oocysts lasts for just under two weeks, so if the animal was exposed to the parasite as a kitten, it is quite unlikely that the adult will transmit the disease to humans.
The cat’s litter box must be cleaned daily, but it is highly recommended that this is done by a person other than the pregnant woman. Always wash your hands thoroughly after coming in contact with your pet’s feces so as to avoid touching your mouth or eyes.
Fear of toxoplasmosis during pregnancy
I recently found out that I am pregnant. My husband and I have two cats and he is worried about toxoplasmosis. He thinks we should get rid of the cats! What exactly is toxoplasmosis and do I really need to re-home my cats?
Toxoplasma gondii is a parasite that can infect a large range of birds and mammals however the definitive hosts are members of the felid family including domestic cats. Cats become infected with T. gondii by ingesting infected small mammals and birds or, more rarely, by ingesting contaminated soil or water. Other animals including humans are infected by eating infected meat, by ingestion of feces of a cat that has itself recently been infected, and by transmission from mother to fetus.
After a cat has been exposed, multiplication of the parasite occurs in the intestines. The eggs of the parasite, or oocysts, can be found in the cat’s feces at 3 days after infection and may be released for up to 20 days. Oocysts sporulate (become infectious) outside the cat within 1-5 days and remain viable in the environment for several months. Cats generally develop immunity after their first exposure and thus cats will only shed once in their lifetime.
Healthy human adults that are infected usually do not develop any noticeable symptoms occasionally mild flu like symptoms are recognized. The greatest risk is to those who are immunocompromised and to fetuses infected in the first trimester of pregnancy. Women who have been exposed to toxoplasmosis in the past likely have immunity which imparts immunity to the fetus. A simple blood test can determine whether or not a woman has had previous exposure and therefore whether or not she is at risk. If a woman receives her first exposure to T. gondii while pregnant, the fetus is at particular risk for congenital toxoplasmosis which can cause serious neurological problems.
Because of their fastidious nature, the passing of non-infective oocysts, and the short duration of oocyst shedding, direct contact with cats is not thought to be a primary risk for human infection. Women are far more likely to contract toxoplasmosis from eating infected meat or from gardening. That being said, pregnant cat owners should never handle cat feces, especially in the first trimester. In general cat owners can reduce their pets’ exposure risk by keeping all cats indoors and not feeding them raw meat.
It is important to talk to your doctor and follow his or her recommendations however there is no need to give up your beloved feline friend if you follow some simple hygenic precautions.
Toxoplasmosis & Pregnancy
I recently found out that I'm expecting, which is a minor miracle since we've been trying to conceive for years and I am now in my early 40's. The thing is, we have 9 cats, and we've all heard the stories and read the warning labels on cat litter about pregnant women and cat feces. This is my first pregnancy and since I am likely to have complications due to my age alone, I'd like to explore all other risk factors. My goal is to carry this child to full term and give birth to a happy healthy baby. I've done my research about this but still have some questions and am not quite sure where to go to ask them. I figured that alot of people on here probably have large feline families like me and surely some of you have been pregnant/had children while living with that many cats, and maybe someone can help.
So what I do know is that cat feces can carry a parasite known as toxoplasmosis which can cause major problems in unborn children and infants, even miscarriage. Most of the time there are no symptoms in cats or humans. Cats get the parasite from eating a rodent that has the parasite or from playing in soil (nobody says why exactly soil is a risk, but I assume it's because animals that have the parasite may have defecated in it?). Everything I've read says that indoor-only cats rarely come in contact with it, unless they are fed raw or undercooked meat (humans can get it this way also). I've also read that a woman who already has the parasite prior to conception of a child will not pass it to her child because her immune system is already familiar with it and will protect the baby (similar to a vaccine, in a way).
Of my 9 cats, one was indoor/outdoor prior to my taking him in 7 or 8 months ago, and (much to his disappointment) he has been indoor only since. 2 have escaped and gotten outside for no more than a day, both about 2-3 years ago. The rest either came to me as young kittens, barely weaned, or were born in my house (a litter that resulted from the above mentioned escape), and have never even seen the outside except for in a kennel on the way to the vet. They live on a diet of commercial canned food and kibble, the only time they've ever eaten real meat is from my plate when I eat. I know it is plausible that if my ex-indoor/outdoor cat had it, he might have spread it to the others.
All of my cats have eaten off my plates and silverware, drank from my cups, one has even eaten directly out of my mouth at times. I know that's not exactly hygenic, but for a very long time I had accepted that my cats were the only children I would ever have and I treated them as such. Also, I was the one who changed the litter boxes up until a few weeks ago. So if any of my cats have it, there is a very good chance that I have already been exposed, therefore, my unborn child isn't at risk.
I am just wondering, how common is this parasite? Does anyone know? I've read that it's very uncommon and that there is greater risk of getting it from store-bought meat and produce that hasn't been washed or cooked thouroughly. But obviously it must be an issue if there are warnings right on bags of litter, am I right? Does anyone out there really know? I've read too many horror stories to just let this go.