Conditions Congenital Toxoplasmosis

Congenital toxoplasmosis (TOXO) can occur when a pregnant mother becomes infected with a parasite known as Toxoplasma gondii. Although the mother will generally not notice any symptoms, the infection may spread to the baby before birth or in the process of labor and delivery. Babies with TOXO are often born too early and can have a variety of health problems affecting the eyes, nervous system, skin, and ears. For some babies with TOXO, detecting the infection early and beginning proper treatment immediately may help prevent some of the severe health outcomes associated with the condition.      

Your baby’s doctor may ask you if your baby is showing any of the signs of congenital toxoplasmosis (see Early Signs below). If your baby has certain signs, your baby’s doctor may suggest starting immediate treatment.

If your baby’s newborn screening result for congenital toxoplasmosis (TOXO) was positive, your baby’s doctor or the state screening program will contact you to arrange for your child to have additional testing. During the newborn screening test, your baby’s dried blood spot was checked for toxoplasma antibodies, which are proteins the body makes when it is exposed to an infection. If these antibodies are present, it is very important to go to your follow-up appointment for a confirmatory test. 

Follow-up testing will involve rechecking your baby’s blood for signs of a recent toxoplasma infection (toxoplasma antibodies). Your baby’s doctor may also recommend that he or she have a thorough eye exam and CT scan or MRI scan of the brain since some babies with TOXO have problems with their eyes and nervous system soon after birth.

Condition Type

Other Disorders

Frequency

How common is congenital toxoplasmosis?

Congenital toxoplasmosis affects an estimated 400 to 4,000 newborn babies in the United States each year. 

Also known as

  • TOXO

Follow-Up Testing

Your baby’s doctor may ask you if your baby is showing any of the signs of congenital toxoplasmosis (see Early Signs below). If your baby has certain signs, your baby’s doctor may suggest starting immediate treatment.

If your baby’s newborn screening result for congenital toxoplasmosis (TOXO) was positive, your baby’s doctor or the state screening program will contact you to arrange for your child to have additional testing. During the newborn screening test, your baby’s dried blood spot was checked for toxoplasma antibodies, which are proteins the body makes when it is exposed to an infection. If these antibodies are present, it is very important to go to your follow-up appointment for a confirmatory test

Follow-up testing will involve rechecking your baby’s blood for signs of a recent toxoplasma infection (toxoplasma antibodies). Your baby’s doctor may also recommend that he or she have a thorough eye exam and CT scan or MRI scan of the brain since some babies with TOXO have problems with their eyes and nervous system soon after birth.

About Congenital Toxoplasmosis

Early Signs

Most babies with congenital toxoplasmosis (TOXO) appear healthy at birth. However, if TOXO is not treated, many will develop signs or symptoms of the infection months to years later.  A few babies will show clear signs of infection before or shortly after birth.

Early signs of TOXO include:

  • Fever
  • Feeding difficulties
  • An unusually large or small head
  • Vision problems
  • Hearing loss
  • Difficulty feeding
  • Swollen lymph nodes
  • Yellowing of the skin (jaundice)
  • Skin rash  (slight bruising or red spots)
  • Seizures
  • Intellectual disability
Treatment

Babies born with congenital toxoplasmosis (TOXO) are treated with a combination of anti-toxoplasmosis medications (such as pyrimethamine, sulfadiazine, and leucovorin) for one year after birth.  If certain symptoms of the eyes or nervous system are already present, steroids may be prescribed, as well. 

Expected Outcomes

The outcome of congenital toxoplasmosis (TOXO) depends on the severity of the infection.  Babies who become infected during the first trimester of pregnancy usually have the most severe symptoms.  However, detecting TOXO early and beginning proper treatment immediately may help prevent some of the severe health outcomes associated with the infection. This is why newborn screening for TOXO is so important.      

Even with treatment, complications from the infection may occur, such as intellectual disability, neurological disorders, and vision problems. 

Causes

Congenital toxoplasmosis occurs when a pregnant mother becomes infected with a parasite known as Toxoplasma gondii.  About half of toxoplasmosis infections are caused by eating raw or undercooked infected meat. Other ways to catch the parasite include eating unwashed contaminated produce, drinking contaminated water, or handling contaminated soil, cat litter, or meat and then touching your mouth, nose, or eyes. The infection is usually not spread from person to person, except during pregnancy.  

Although a mother may not have any signs or symptoms of the infection, toxoplasmosis can be passed to the baby before birth or in the process of labor and delivery.  The risk of passing the parasite on to the baby is lowest with the mother is infected in the first trimester (10-25%) and highest when the mother is infected in the third trimester (60-90%).  However, the earlier in the pregnancy that a baby becomes infected, the more severe the outcome. This is because the parasite can cause more problems when various parts of the body (such as the eyes, nervous system, skin, and ears) are still developing.     

Support for Congenital Toxoplasmosis

Support Services

Support groups can help connect families who have a child or other family member affected with Toxoplasmosis with a supportive community of people who have experience and expertise in living with the condition. There are a number of message boards that have been created for families to use who want to learn more about toxoplasmosis.  A few of them are listed here:

Accessing Care

If you are pregnant and believe that you are at risk for toxoplasmosis, contact your doctor immediately to schedule an appointment.  Work with your baby’s health care provider to determine the next steps for your baby’s care.  Your doctor will be able to determine if treatment is necessary, and if so, what type of treatment will be most beneficial for your baby.

Families' Experiences

At this time we have not located a family story for this particular condition. If your family is affected by congenital toxoplasmosis and you would like to share your story, please contact us so other families may learn from your experience.

References & Sources

Visit the U.S. National Library of Medicine-PubMed Health database for more condition information

Visit KidsHealth for more information on toxoplasmosis

Visit the Centers for Disease Control and Prevention website for more resources on toxoplasmosis

Visit the Centers for Disease Control and Prevention website for more resources on HIV - See more at: http://babysfirsttest.org/newborn-screening/conditions/human-immunodeficiency-virus#sources

Visit the Centers for Disease Control and Prevention website for more resources on HIV - See more at: http://babysfirsttest.org/newborn-screening/conditions/human-immunodeficiency-virus#sources

Visit the American Academy of Family Physicians for more condition information

Guerina N, Hsu H, Meissner C, et al. Neonatal Serologic Screening and Early Treatment for Congenital Toxoplasma gondii Infection. N Engl J Med. 1994; 330: 1858-1863.

http://www.nejm.org/doi/full/10.1056/NEJM199406303302604#t=article

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