Short Video. shows/monsters-inside- me/videos/toxoplasma-parasite/

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3 The word Toxoplasma Originated from the Greek word toxon, which meant "bow." The Latin word toxicum, which meant "poison." The original Greek meaning is the one used for the word Toxoplasma, meaning "bow shaped organism. The word gondii is the name of a North African desert rodent which is related to the organism that T. gondii was originally found in.

4 Short Video shows/monsters-inside- me/videos/toxoplasma-parasite/

5 Etiology Toxoplasma gondii is an obligate intracellular parasite of the coccidia subclass T. Gondii causes Toxoplasmosis

6 Morphology Trophozoite The intracellular parasites (tachyzoite) are 3x6µm, crescent shaped organisms that are enclosed in a cell membrane to form a pseudocyst measuring µm in size

7 Pseudocyst -- intracellular tachyzoites of Toxoplasma gondii Morphology

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9 Morphology A cyst of Toxoplasma gondii filled with bradyzoites; cyst in cardiac muscle

10 Cyst in brain

11 Morphology A sporulated oocyst of Toxoplasma gondii. The oocyst contains two sporocysts, each of which contain four crescent-shaped sporozoites Only cats produce and pass Toxoplasma oocysts; approximate diameter = 10 µm

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13 Pathogenesis In general, most of the human population infected with Toxoplasma are asymptomatic carriers There are a number of factors which determine whether an infected host will express disease symptoms The strain of the pathogen (RH strain) The susceptibility of the host -- immunocompromised Age of the host new born infants Degree of acquired immunity

14 Pathogenesis The tachyzoites directly destroy host cells

15 Clinical features Although Toxoplasma infection is common (~13% overall world prevalence), it rarely produces symptoms in normal individuals Could be classified as Congenital toxoplasmosis Acquired toxoplasmosis

16 Congenital Toxoplasmosis Two types: Asymptomatic Congenital Toxo 60% of infected may suffer from Long Term Sequela Symptomatic Congenital Toxo 40% of infected more likely if mother infected in 1st/2nd Trimester Severe damage to fetus = stillbirth or abortion or may be severely affected

17 Asymptomatic Congenital Toxo Diagnosis: + IgM titer in serum of newborn (TORCH +) no overt clinical disease at birth Long Term Sequela: within 7 years of birth - children born to women with high levels of Toxo antibody had 2x > frequency of deafness 60% more microcephaly (small head) 30% more Low IQ babies

18 Epidemiology Worldwide cases of congenital toxoplasmosis are estimated at between 140,900 and 1,127,200, based on an estimated rate of 0.1 to 0.8% of million live births in 1992 Some countries have instituted screening programs of pregnant women About 5-10% of AIDS patients complicated with toxoplasmosis

19 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.

20 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.

21 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.

22 There are three forms of Toxoplasma gondii Tachyzoite Rapidly reproducing form Bradyzoite A slower reproducing form, contained in tissue Sporozoite Contained in oocysts

23 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")

24 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.

25 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.

26 Pathologic lesions of disease EYE

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29 OUTBREAK OF TOXOPLASMOSIS ASSOCIATED WITH MUNICIPAL DRINKING WATER BRITISH COLUMBIA l/e-2118.pdf

30 OUTBREAK OF TOXOPLASMOSIS ASSOCIATED WITH MUNICIPAL DRINKING WATER BRITISH COLUMBIA 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

31 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.

32 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 litter boxes. Change litter boxes 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.

33 Thank you