Toxoplasmosis in pregnancy: how to lower the risk

Toxoplasmosis is caused by the parasite Toxoplasma gondii. Cats are its main host and shed microscopic eggs in their faeces, which can then contaminate soil, water and unwashed vegetables. People can also be infected by eating meat from animals that carry cysts in their tissues.

The NHS says most infected people have no symptoms. Some feel as though they have mild flu with a high temperature, headache, sore throat, tiredness and swollen glands. Because the illness is often silent, many women only find out they were infected from a blood test.

The concern is a first infection during pregnancy, when the parasite can cross the placenta. Tommy's says that if you were infected before you became pregnant, immunity typically protects your baby, while catching it in pregnancy increases the risk of miscarriage, stillbirth or serious problems in the baby.

Tommy's reports that in Europe around 1 in 1,000 live-born babies of women with toxoplasmosis are thought to have it, and affected infants may have eye infections, hearing problems, seizures or learning difficulties. The baby's risk and the severity differ with the stage of pregnancy at infection.

A short list of sources accounts for most infections. Tommy's names undercooked or raw meat, cured meats such as salami, raw shellfish, unpasteurised goat's milk, contact with sheep and lambs, unwashed produce contaminated by cat faeces and handling litter without protection.

The NHS also mentions that pregnant women who have contact with sheep, particularly at lambing time, should talk to a doctor if they develop flu-like symptoms afterwards.

These measures are inexpensive and effective. None requires you to give up your pet.

• Do not empty cat litter trays while pregnant. If you must, wear disposable gloves, clean the tray daily and wash your hands afterwards.

• Wear gloves for gardening and wash your hands well after handling soil or contact with cat faeces.

• Cook meat thoroughly, especially lamb, pork and venison, until there is no pink and juices run clear.

• Avoid raw or cured meats such as salami unless they are cooked, and avoid raw shellfish.

• Wash fruit, vegetables and salad carefully, and wash chopping boards and knives after raw meat.

• Avoid unpasteurised goat's milk and products made from it.

Tommy's says routine screening for toxoplasmosis is not standard in the UK. A blood test can detect antibodies and, together with the timing of any symptoms, show whether an infection is recent. If it is suspected, a specialist laboratory test and a discussion with fetal medicine or an infectious diseases team usually follow.

If infection in the baby is a concern, further tests such as amniocentesis and detailed scans may be discussed, with the benefits and limits explained in advance.

The NHS notes that antibiotics are prescribed for pregnant women with toxoplasmosis, and Tommy's describes treatment with antibiotics, anti-parasitic medicines and calcium folinate supplementation throughout pregnancy. The aim is to reduce the chance and severity of infection reaching the baby, and the regimen depends on the timing and test results, so a specialist leads it.

After birth, babies at risk have a paediatric assessment that may include eye and hearing checks and blood tests. Congenital toxoplasmosis is covered in a separate guide.

Contact your midwife, GP or NHS 111 if you develop a flu-like illness and have handled cat litter without protection, worked with sheep, or eaten undercooked meat. Do not wait for symptoms to settle if they are accompanied by visual disturbance, severe headache or confusion. Reduced baby movements always need prompt same-day assessment in any pregnancy.