What Is Toxoplasmosis?

Toxoplasmosis is an infection in humans caused by the Toxoplasma gondii parasite ( T. gondii ), which is quite common throughout the world. Adults with good health may not require any medical treatment to recover from toxoplasmosis attacks. If the parasite attacks adults, then the immune system usually can overcome the infection. Most people infected with toxoplasmosis do not show certain symptoms, and the disease is generally not transmitted from one person to another. Once infected, the patient will have immunity to lifelong toxoplasmosis.

There are several conditions that can increase the risk of toxoplasmosis to serious health problems, namely:

• Is pregnant.
• Taking steroid or immunosuppressant drugs.
• HIV / AIDS.
• While undergoing chemotherapy.

Symptoms of Toxoplasmosis
Symptoms are something that is felt and told by the sufferer. Toxoplasmosis has several common symptoms, namely:

• In healthy humans, ie high fever, muscle pain, fatigue, sore throat, swollen lymph nodes.
• In pregnant women, causing pregnancy disorders such as miscarriage, stillbirth, or congenital toxoplasmosis that leads to brain damage, hearing loss, and visual impairment in infants at or after several months or years after birth.
• In people with immune system disorders, symptoms of toxoplasmosis infection are headache, confusion, lack of body coordination, seizures, difficulty breathing, and impaired vision.

Causes of Toxoplasmosis
Toxoplasmosis infection is caused by a parasite called Toxoplasma gondii (T. gondii). This parasite can infect the majority of animals and birds. T. gondii can be found in infected cat feces, as well as the flesh of infected animals.
Because the T.gondii parasite can only breed in wild cats and pets, it becomes the main host of it. However, cats infected with T. gondii parasites usually do not show any specific symptoms.

This parasite can last up to several months of life on the ground or water. There are several ways T. gondii parasites enter the human body, namely:

• Eating fruits and vegetables that are not washed or drinking water contaminated with cat litter.
• Incorporating hands contaminated with dirt or cat litter to the mouth.
• Eat raw or undercooked meat.
• Using equipment that has been contaminated with infected meat, such as knives, scissors, and cutting boards of infected raw meat.
• Drinking infected raw goat milk or a product made from it.

However, the parasite of T. gondii can not transmit between humans, so that a person can not transmit T. gondii infection to her child, contracted T. gondii for contact with the patient, and transmitted T. gondii parasite through breast milk. Except in some cases such as through an infected organ transplant procedure or pregnant women who are infected with acute phase can transmit the fetus.

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Diagnosis of Toxoplasmosis
Diagnosis is a doctor's step to identify a disease or condition that explains the symptoms and signs experienced by the patient.
To diagnose toxoplasmosis, what doctors usually do is

1. Blood test.

Although infected, a patient's blood test may show negative results. This means the patient's body has not started producing antibodies for T. gondii parasites. Tests need to be repeated a few weeks later because new antibodies are formed 3 weeks after infection. But in most cases, a negative result on a blood test can also mean that a person has never been infected and is not immune to toxoplasmosis.

A positive blood test results in a person infected with active toxoplasmosis, or has been previously infected, and immune to toxoplasmosis. Additional tests are needed to determine when the infection lasts.

2. Test on pregnant women.

If a person is pregnant and the results of a blood test show he is exposed to positive toxoplasmosis infection, then there are some tests to check whether the infection is also contagious to the fetus. Some of these tests are:

• Amniosintesis. In this procedure, the doctor will take a sample of amniotic fluid during pregnancy over 15 weeks. With this test can be immediately known whether the fetus is infected or not.
• Ultrasound Test. In this test, the doctor will see the effect of infection on the fetus as well as the presence of fluid in the brain (hydrocephalus). If the fetus appears to be normal, it is necessary to do some checks on the baby after birth.

After childbirth, the baby will undergo examination to see if there is damage from the infection, as well as blood tests to ascertain whether the baby is still infected.
3. Imaging Test

If a toxoplasmosis infection causes the patient to have a serious complication, additional checks are needed to identify any damage to the tissue or cyst in the brain. Additional checks required include MRI imaging and brain biopsy tests.

Treatment of Toxoplasmosis
Most cases of toxoplasmosis are classified as mild illness and require no medical treatment. Patients generally can recover completely without complications.
To treat acute toxoplasmosis in patients who have immune disorders, doctors will prescribe several types of drugs namely pyrimethamine and sulfadiazine. Medical care is required only under the following conditions:

• Affected by toxoplasmosis complications.
• In pregnancy.
• Infants are proven to be infected with toxoplasmosis before or after birth.
• Experiencing a disruption of the immune system.

In pregnant women infected with toxoplasmosis, if the fetus has not been infected, then the doctor will give antibiotics spiramycin. If the fetus has contracted toxoplasmosis, then the doctor will usually prescribe pyrimethamine and sulfadiazine.
Pyrimethamine and sulfadiazine are also commonly used to treat infants with congenital toxoplasmosis, as they may reduce the risk of long-term health problems. However, this treatment can not repair the damage caused by toxoplasmosis that has occurred. So usually there will be long-term and recurrent disturbances.

To deal with toxoplasmosis infections in people with immune system disorders, doctors generally give trimethoprim and sulfamethoxazole drugs to prevent the development of toxoplasmosis symptoms. This is because in patients who are career, the parasite remains in the patient's body in a state of inactivity. When the body's immune decreases, the parasite reactivates and causes serious health problems.

If the immune system is back to normal, then treatment can be stopped.

Complications of Toxoplasmosis
Some complications that can occur in patients with toxoplasmosis are:

• Toxoplasmosis ocular . Inflammation and eye injuries caused by parasites. This disease can cause vision impairment, emerged floater (like a small object that hovers blocking the view) on the eyes, to blindness.
• Congenital toxoplasmosis occurs when the conceived fetus is infected with toxoplasmosis. This can lead to various health problems in the fetus. For example hydrocephalus, epilepsy, hearing loss, brain damage, impaired learning ability, jaundice, ocular toxoplasmosis, and cerebral palsy .
• Cerebral toxoplasmosis . If people with immune system disorders are infected by toxoplasmosis, then the infection can spread to the brain and can threaten the lives of patients. Some of the symptoms are headache, confusion, impaired coordination, convulsions, high fever, obscure speech, ocular toxoplasmosis.

Prevention of Toxoplasmosis
There are several things you can do to reduce the risk of toxoplasmosis infection, namely:

• Use gloves when gardening or holding the ground.
• Avoid eating raw or undercooked meat.
• Wash hands before and after holding food.
• Wash all kitchen utensils cleanly after cooking raw meat.
• Always wash fruits and vegetables before consumption.
• Avoid drinking non-pasteurized goat milk or products made from it.
• Avoid cat litter on cat litter containers or soil, especially for those of you who keep cats.
• Give cat dry or canned food rather than raw meat.
• Close the sandbox where children play.

For people who keep a cat, some of the things below can reduce the risk of toxoplasmosis are:

• Keep pet cat health.
• Avoid to pick up and maintain wild cats.
• Use gloves and face masks when cleaning the dirt container.

In Indonesia, toxoplasmosis is classified as one of the vector-borne diseases and disease-carrying animals. In accordance with Article 11 of Regulation of the Minister of Health No. 82 year 2014, to prevent transmission of toxoplasmosis to the fetus, usually doctors in Indonesia recommend examination for men and women who often interact with pets and want to have children.

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