OK, here's another one of my Miami Herald artcles, reprinted from last week's Sunday Home & Design section. (No, they didn't print my title.) Enjoy!
Q. My husband and I are ecstatic—almost. We’re having a baby. But the obstetrician I’ve been referred to said we have to put our cats outside for my entire pregnancy due to the possibility of an infection with toxoplasmosis. They’ve never spent a day outside in their lives so we’re very concerned. What should we do?
A. Generally, vets aren’t in the business of contradicting physicians. But this is one area where our specialized training in diseases with zoonotic (cross-species) potential grants us the right to make a qualified exception.
Toxoplasmosis is a disease that results from infection with the Toxoplasma organism, a one-celled protozoan parasite with potentially devastating consequences to a human fetus. Anything from miscarriage to blindness can result from this infection.
Pregnant women can be exposed to the parasite after gardening and ingesting tiny bits of Toxoplasma-tainted soil from their unwashed hands, from eating undercooked or raw meats infected with the organism, and by orally ingesting even minute quantities of infected feline feces.
Strict attention to basic hygiene (hand-washing after handling cats) and letting someone else take on litterbox detail are 100% effective in preventing transmission (indeed, no evidence exists in the human literature to support Toxoplasma infection from cats under these circumstances).
To ensure your safety, there are some basic tests I recommend to ensure that you’re never exposed (and which may well free you of all your doubts). Testing your cats for antibodies to the Toxoplasma organism (a simple blood test) typically reveals that your lifetime-indoor kitties have never been exposed to this pest. They will therefore be incapable of transmitting the disease to you.
Alternatively (or additionally), a test can be performed by your doctor to see if you carry antibodies to this parasite (as was my case, after a childhood spent playing in sandboxes and a lifetime of handling cat stool). If you have a positive titer (a high antibody level against the disease) it’s as good as having been vaccinated against it—so you’re completely in the clear.
I also recommend checking with the Centers for Disease Control and Prevention, whose website supports the keeping of indoor cats in spite of the risk of toxoplasmosis. Hopefully this will eliminate all doubts on this important health concern. I wish you luck with your pregnancy!
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YEA! this should be mass mailed to EVERY OB/GYN in the nation...
cl October 23rd, 2007 10:25:00 AM
The real kicker is that even infected cats only shed the organism for 2 weeks- so even a cat that has antibodies to Toxo probably isn't actively shedding.
Megan October 23rd, 2007 12:42:00 PM
GREAT reply Dr. Patty.
My sister has 2 cats and had 3 healthy pregnancies. All her OB/Gyn ever advised was to stay away from the litterbox and wash her hands after handling the cats. She was SO PSYCHED about not having to deal with the litterbox. The youngest is now 2 and the litterbox is STILL my bro-in-law's main chore! Lol...........
Amy in Somerville October 23rd, 2007 12:51:00 PM
I was taught that one of the other TORCH virii, Cytomegalovirus (cmv), was mostly spread by school aged children, bringing it home from school and daycares. I wonder if this woman's OB recommends school-aged children being put outside as well.
Sherri October 23rd, 2007 03:51:00 PM
One wonders sometimes, given that close on 100% of people over 20 grew up in houses with cats and spent much of their childhood playing outside in the dirt.....why is the world so overpopulated with people who aren't blind?
And along with the last few years of not being sent out as a kid to play in the garden...has come the overwhelming increase in asthma, ADHD and autistic spectrum disorders. Sometimes it seems as if the more we protect humans against nature, the worse of we are as a species.
jcat October 23rd, 2007 04:07:00 PM
Even more interesting- IF she followed her OB's advice, she'd have a greater chance of being exposed to toxo then if she has kept and will continue to keep her cats indoors!
Toxo scares really really tick me off- it's either from misinformed doctors OR family members.
Trish October 23rd, 2007 07:04:00 PM
You really have to wonder sometimes why doctors keep giving out this antiquated advise.
I got the same speil 12 years ago when I was pregnant with my first AND worked for a vet. I let them know in very direct terms I was NOT getting rid of my cats nor my job. They frowned alot and made weird noises in their throats about it but I just knew it was an over reaction on their part. There is risk in everything. (like being pregnant in the first place!) I still did the litterbox, just used rubber gloves, and washed my hands alot during that time. They did test me for it and all was well.
I feel bad for all the cat owners they scare the beejeepers out of and into giving up their pets.
Marie October 24th, 2007 08:17:00 AM
"One wonders sometimes, given that close on 100% of people over 20 grew up in houses with cats and spent much of their childhood playing outside in the dirt.....why is the world so overpopulated with people who aren't blind?"
There is a reason for this- the U.S. is in a strange spot because about 50% of people have antibodies (and so have been exposed) to Toxo. The way that toxo causes birth defects is that it enters the fetus of a mother who was exposed for the first time during her pregnancy and didn't thus didn't have any antibodies. Mom's body can clear it, but the fetus is severely damage.
If you are in a country where toxo is very prevalent, very few mothers are exposed for the first time during pregnancy. If you are in a country where toxo is rare, again, very few mothers will be exposed during pregnancy. But in the U.S., there is a decent chance that you haven't been exposed prior to pregnancy, and also a fairly good chance that you could encounter toxo.
It *is* a risk, and fairly devastating to those who experience the effects of toxo infection during pregnancy. It's just that it's so darn preventable simply by not handling cat feces and cooking meat thoroughly.
Megan October 24th, 2007 12:08:00 PM
Just to be fair, a certain percentage of MDs, just like a certain percentage of people in general, actively dislike or are afraid of animals. Or the docs may just be overcautious, knowing that if they don't issue the warning, they may face a malpractice lawsuit. They also may feel that it is unwise to rely on the pet owner's abilty to keep things clean, and the safest course is to get rid of any potential problem.
But it isn't a good idea to rely on whatever you doctor says without checking; the example about docs lacking a broad understanding of zoonotic diseases is an example. And I had a doctor once tell me that keeping a pet if you have an allergic child is child abuse, and reportable. How you are managing the allergy is irrelevant.
coolside October 26th, 2007 12:27:00 PM
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