I’ve decided that the zoonotic disease, toxoplasmosis, which often is discussed on the Internet negatively, is a risk management exercise for the pregnant mum. For me, the phrase “risk management” is appropriate in this instance. It’s about identifying and understanding the risk and mitigating the possibilities of infection. There is still some misunderstandings surrounding this disease.
Potential severe consequences demand risk management
The risk needs to be assessed in terms of its likelihood of occurrence and potential impact. Okay, we know that a Toxoplasma gondii infection of a pregnant mum can harm their unborn baby. Or the baby can be born normally but develop problems in the future. These problems can be severe such as cognitive impairment, eye and ear problems. It can result in the loss of the unborn child.
Occurrence can be eliminated
They are severe enough to assess the risk as potentially high in terms of its impact. That point I think needs to be made. But what about the likelihood of occurrence? This is an area I think which is misunderstood.
It is an area which significantly reduces the level of risk. Also, this level of risk can be mitigated. But it must be said that the mitigation must be total. I can understand fully why pregnant mums might be fearful of having a cat in the family when they are pregnant.
Getting rid of cats is an extreme mitigation exercise
There are some women who think that pregnant mums who keep their cats are bad mothers. I’ve recently written about a couple of workplace women, one of them was pregnant and her friend said that she was a bad mother for not getting rid of her four cats. The pregnant mum was baffled at the severity of the suggestion.
But the critical woman was supported by her female friends at the workplace, which must have been difficult for the pregnant mum but she held her ground and had assessed the risk I think sensibly.
Usual mode of transmission does not concern cats
Risk assessment can involve what is called qualitative and quantitative analysis to determine the severity of risks and their potential consequences. As mentioned, the potential consequences are high but let’s look at the chances getting an infection of Toxoplasma gondii from a cat or getting it from another source.
The point to be made here is that toxoplasmosis is normally transmitted to people through the ingestion of the parasite by eating undercooked or raw meat, by handling contaminated soil and through contact with cat faeces containing the parasite in the form of Toxoplasma gondii oocysts (small eggs in a shell).
Most human infections of toxoplasmosis come from eating undercooked or raw meat. In my assessment, the next in line possibility would come from contaminated soil. This means gardening and turning over soil where the family cat has defecated. Third in line in terms of risk would be an infection from handling cat litter while cleaning out the cat litter tray because of what I say next.
Eliminating the risk with cat litter tray
It is entirely possible to completely eliminate this risk by letting someone else other than the pregnant mum do the litter box cleaning. The same would largely apply to gardening.
Very limited time when cat sheds oocysts
And in assessing the risk, people need to realise that although cats can shed the toxoplasma gondii parasite in their faeces the period of shedding can last for about 1-2 weeks after the initial infection of the cat. This happens once in a cat’s life. Cats become infected by ingesting infected prey such as birds or rodents.
Hunting and indoor cats
So, let’s look at that risk. You live with a full-time indoor cat with little or zero chance of eating a mouse or a bird. Therefore, keeping a domestic cat indoors full-time would be a very effective way of mitigating the possibility of the risk becoming a reality. Note: I realise it would be hard to keep an indoor/outdoor cat inside but if you have a full-time indoor cat already you can see how the risk is mitigated.
And knowing that a domestic cat can only shed the toxoplasma gondii oocysts for a very short period of time in their life must help calm the nerves and reduce the risk.
Risk management vis-a-vis handling foods
Returning to undercooked meat and handling vegetables, this is where risk management can really take place for the pregnant mum. She can allow her husband or partner to handle these foods during pregnancy. That would be one method of risk management.
Or she might where gloves when gardening. She should wash vegetables thoroughly. As part of the risk assessment, it’s worth noting that the pregnant mum would get the disease by handling vegetables which contain the oocysts and then putting their hands into their mouth. That’s how the transmission takes place. This would be unusual anyway, once again reducing the risk.
Knowledge and hygiene
The woman armed with this knowledge can take steps to mitigate the risk further. It’s about knowledge and acting upon that knowledge to eliminate risk. Proper hygiene is the answer including washing hands and thoroughly cooking meat.
Extreme mitigations not needed
The point here is that the cat should not be automatically vilified. Although the women who criticised the pregnant mum that I mention above had good intentions, their response to the fact that the pregnant mum was going to keep cats was extreme and to be honest misinformed.
