Sexual Health and Gynecology - Tracking

<h2>How to prevent toxoplamosis?</h2>
<ol><ol type="1">
<li class="MsoNormal" style="margin: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: l0 level1 lfo1; tab-stops: list .5in;">Do not eat raw or undercooked meat, especially lamb or pork. </li>
<li class="MsoNormal" style="margin: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: l0 level1 lfo1; tab-stops: list .5in;">Do not eat locally prepared cold cuts.</li>
<li class="MsoNormal" style="margin: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: l0 level1 lfo1; tab-stops: list .5in;">After handling raw meat, wash your hands immediately with soap. Do not touch your eyes, nose, or mouth, or other body parts. When cooking, avoid tasting meat before it is fully cooked.</li>
<li class="MsoNormal" style="margin: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: l0 level1 lfo1; tab-stops: list .5in;">Do not empty a cat’s litter box. Have someone else, wearing gloves, do it.</li>
<li class="MsoNormal" style="margin: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: l0 level1 lfo1; tab-stops: list .5in;">Change litter daily before any Toxoplasma oocysts can "ripen" and become infectious (Stage F). Dispose of used litter safely, preferably in a sealed plastic bag. If pregnant, avoid changing the litter box if possible (or use rubber gloves).</li>
<li class="MsoNormal" style="margin: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: l0 level1 lfo1; tab-stops: list .5in;">Wash all fruits and vegetables before eating them. Wash vegetables thoroughly before eating, especially those grown in backyard gardens. Boil water from ponds or streams before drinking when camping or hiking.</li>
<li class="MsoNormal" style="margin: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: l0 level1 lfo1; tab-stops: list .5in;">Don’t feed your cat raw or undercooked meat.</li>
<li class="MsoNormal" style="margin: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: l0 level1 lfo1; tab-stops: list .5in;">Keep your cat indoors to prevent it from hunting birds or rodents, which can be infected with many types of bacteria.</li>
<li class="MsoNormal" style="margin: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: l0 level1 lfo1; tab-stops: list .5in;">Wear gloves while gardening.</li>
<li class="MsoNormal" style="margin: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: l0 level1 lfo1; tab-stops: list .5in;">Avoid children’s sandboxes because cats may use them as litter boxes.</li>
<li class="MsoNormal" style="margin: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: l0 level1 lfo1; tab-stops: list .5in;">Cover sand boxes when not in use to discourage cats defecating in them.</li>
<li class="MsoNormal" style="margin: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: l0 level1 lfo1; tab-stops: list .5in;">Wash hands with soap and water after working with soil or after handling raw or undercooked meat.</li>
<li class="MsoNormal" style="margin: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: l0 level1 lfo1; tab-stops: list .5in;">Cutting boards, knives, and the sink and counters should be washed well after cutting meat.</li>
<li class="MsoNormal" style="margin: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; mso-list: l0 level1 lfo1; tab-stops: list .5in;">Cook meat thoroughly until the internal temperature reaches 152ºF (66ºC) in a conventional oven. Microwaving is not a sure way to kill Toxoplasma in meat.</li>
</ol></ol>
<a title="toxoplasmosis infection" href="infections/toxoplasmosis-and-pregnancy">How do I get toxoplasmosis infection?</a>
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Toxoplasmosis Prevention

<h2>How do I get infected with toxoplasmosis?</h2>
Most people get infected with toxoplasmosis by eating undercooked meat or meat products such as lamb, beef, or game (including salami), having contact with soil, or by inhaling or swallowing infected cat litter.
When cats (and only cats) become infected with toxoplasmosis, they harbor the toxoplasma "oocytes" in their intestines. These oocytes are excreted through their feces into the cat litter. This is the so-called 'intestinal phase' of the toxoplasma life cycle and it only occurs in cats (wild as well as domesticated cats). The oocytes can be inhaled or swallowed and infect others, or if the cat feces goes into the earth, people and other animals can get it when the soil gets into their mouths.
The extraintestinal phase occurs in all infected animals (including cats) who come in contact with the oocytes. Infected animals (including humans) produce "tachyzoites" and, eventually, "bradyzoites" or "zoitocysts." These tacgyzoites, bradyzoites, and zoitocysts reside in muscle, and when you (or other animals) eat undercooked meat, you can get infected.
You can also get infected with toxoplasma by putting infected soil into your mouth (always wash your hands!) or by eating undercooked meat (including salami and other similar foods) from an animal who has become infected. Cats are the only animals excreting the oocytes in their feces.
<a title="Toxoplasmosis Prevention" href="infections/toxoplasmosis-prevention">Toxoplasmosis Prevention</a>

How do I get infected with toxoplasmosis during pregnancy?

Toxoplasmosis and Pregnancy

<h2>What is roseola?</h2>
Roseola is a disease in young children, usually up to 4 years of age. It is characterized by high temperatures (103-105 degrees F) that last 3-5 days which usually resolves on its own. This is then followed by the appearance of a rash that lasts a few hours to a few days, mostly on the upper arms, legs, and face. The rash is usually most prominent on the neck and trunk and consists of many small red 2-5mm spots that blanch when pressed. The agent responsible for Roseola is a virus called HHV-6 or human herpes virus 6. 
<h2>Who gets roseola?</h2>
Most young children get infected with roseola, but they are not diagnosed with it because they only have a fever and usually no rash. Once you are infected, you are immune for the rest of your life and you cannot get it again. 
<h2 class="MsoNormal" style="margin: 0in 0in 0pt; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto;">How is it spread?</h2>
The Roseola virus is usually spread by tiny droplets of fluid from the nose and throat of an infected child, and it could be could picked up from another child's hands or tissues, or drinking glass, or just by being in the same room. Make sure all family members — especially those taking care of the baby — wash their hands frequently. (This is a good idea whenever your child has a fever because you won't know that you're dealing with roseola until you see the classic rash).
<h2 class="MsoNormal" style="margin: 0in 0in 0pt;">Is it harmful in pregnancy?</h2>
Pregnant women get exposed to the virus all the time. By the time they are pregnant most women carry the antibody which means they had the disease already, so they are immune and cannot get it again.
There are only very few reported cases where Roseola has affected the fetus, so the risk to the fetus after exposure is generally considered very low, especially when the vast majority of women are immune.

Most young children get infected with roseola, but they are not diagnosed with it because they only have a fever and usually no rash. Once you are infected, you are immune for the rest of your life.

Is Roseola Harmful During Pregnancy?

The major concern and biggest risk of toxoplasma is if&nbsp;you became infected for the very first time during your pregnany. About 40-50% of women test positive for toxoplasmosis before pregnancy and are unlikely to infect the fetus. If a woman has no history of the infection and doesn't carry the antibody at the beginning of her pregnancy, she and her fetus are at higher risk if she does come down with a primary toxoplasmosis infection while pregnant. A simple test for a protein called IgG will tell you if you have had it before or not.

During the first trimester, only about 10% of fetuses become infected if the mother is infected, but the illness increases the risk of fetal complications, including severe congenital malformations and even death. After the first trimester, there's about a 60% chance that the fetus will become infected if the mother has a primary T. gondii infection, though at this stage, the majority of fetuses will have few or no symptoms. Presently, there are no recommendations in the U.S. for routinely testing pregnant women for toxoplasma. A positive result during pregnancy can be confusing because it's difficult to pinpoint the exact time of infection. The best time to get tested is before you get pregnant. If you test negative before or early in pregnancy, take precautions to prevent a toxoplasma infection: Avoid exposure to cat feces, and don't eat undercooked or raw meat. And get tested again later in pregnancy to make sure you haven't become infected.
<a>More Toxoplasma FAQs at Palo Alto Medical Foundation</a>

The major concern and biggest risk of toxoplasma is if you became
infected for the very first time during your pregnany. A simple test for a protein called IgG will tell you if you have had it
before or not.

Toxoplamosis and Infections

In a new study published by the Archives of Diseases in Childhood, women who exclusively breastfed for the first six months of life were less likely to report common infections&nbsp;in their infants. Exclusivity means breastmilk was the only source of food consumed by infants. Researchers followed a group of 1,000 infants for one year. At one month, three months, six months, nine months and one year – common infections were noted. The most common infant infections include respiratory, urinary, eye and ear infections. Also noted were upset stomach and thrush. Breastfeeding is supported as the healthiest choice for moms and infants because antibodies pass from mom to the baby via breastmilk – this study supports that claim. Exclusive breastfeeding was rare in the study with only 24.6% of women doing so at one month of age. By six months, that number dropped to only 10%. Previous studies have reported significant drops in breastfeeding numbers between one and six months post delivery. In this study, babies who were exclusively breastfed longer were less likely to contract infections and when they did get sick, the infection lasted fewer days. Of the starting 1000, only 91 were exclusively breastfed at six months and all suffered from fewer infections and less severe illness. Researchers note that women who breastfed and bottle fed with formula did not gain the full advantage of exclusive breastfeeding. Those infants fell closer to the formula feeding group than the breastfed only group of infants. Source: Fani Ladomenou, Joanna Moschandreas, Anthony Kafatos, Yiannis Tselentis, Emmanouil Galanakis. Archives of Diseases in Childhood. 28 September, 2010.

In a new study published by the Archives of Diseases in Childhood, women who exclusively breastfed for the first six months of life were less likely to report common infections

Breastfeeding Exclusively May Prevent Infection

<h2>What is cytomegalovirus (CMV)?</h2>
Most people do not know that CMV infection is the most common cause of congenital viral infection in the United States, affecting about one to two out of 100 newborn babies.
<h2>How can you get&nbsp;cytomegalovirus (CMV)?</h2>
CMV may be found in body secretions, such as urine, saliva, feces, blood and blood products, breast milk, semen and cervical secretions and it can stay in these secretions for months to years after the initial infection. The principal mode of infection in adults is contact with young children in the household or in day-care centers. Close contact includes kissing and getting saliva or urine on your hands and then touching your nose or mouth. CMV may also be transmitted through sexual contact. A pregnant woman who is infected can pass the virus to her developing baby before or during labor, or during breastfeeding.
<a href="/love/std-sexually-transmitted-infections-diseases" target="_self">Learn about common sexually transmitted diseases</a>
Most initial CMV infections in adults go unnoticed, although some people experience non-specific ‘flu-like’ symptoms such as fever, fatigue, sore throat, headache, decreased appetite and swelling of the lymph glands, liver and spleen. A CMV infection is usually harmless, but it can be life-threatening for people with immune problems, such as those with cancer or HIV infections. And if a person carries&nbsp;CMV during pregnancy it can also infect the fetus by passing across the placenta, possibly creating problems.

When you become infected with CMV for the very first time, you develop a ‘primary’ infection. Contrary to other viral infections such as German measles or chickenpox, which provide immunity for life after an infection, a previous infection with CMV prior to pregnancy does not protect you from becoming infected again or from&nbsp;infecting the fetus, though the chance of this happening is very small. After the primary infection you can continue to shed the virus intermittently for the rest of your life without any symptoms. This is called a ‘recurrent’ infection.
About 30-60% of all children have serologic evidence of prior infection by the time they reach school age, and about 45-85% of women in the United States have been infected with CMV prior to pregnancy and carry the antibody against CMV in their blood. Women of lower socioeconomic means have a higher chance of having been exposed to the virus than women of higher socioeconomic means.
<h2>CMV and pregnancy</h2>
About 0.2-2% of all pregnant women develop a primary infection during pregnancy, and if that happens, about one-half of the fetuses become infected. The chance of a fetal infection is higher later on in pregnancy, but a fetal infection early into a pregnancy has more severe consequences than an infection in the third trimester.
About 10-15% of all congenitally infected fetuses are born with problems such as intrauterine growth restriction (IUGR), jaundice, nonimmune hydrops, eye infections, enlargement of the liver and spleen (hepatosplenomegaly), low platelets and brain abnormalities such as microcephaly (small heads), hydrocephaly, and calcifications of the brain.
Over 90% of infected babies without symptoms at birth will have no problems, but about 10% can develop problems later on such as mental retardation, learning disabilities, eye problems, hearing loss, and other developmental problems.
<h2>How is CMV diagnosed?</h2>
The CMV blood test looks for two different kinds of antibodies: IgG antibodies signify an infection in the past, anytime between 4 weeks and many years. The IgG stays positive forever. The IgM antibody identifies more recent infections, maybe within the last months, and it usually becomes negative within months after an infection.
The diagnosis of a primary infection is usually made when someone who tested negative for the antibody in the past, now tests positive.
If IgM antibody is found in the newborn baby, that usually means the baby was infected inside the uterus, while a positive IgG has usually come from the mother and crossed the placenta. A baby can also get tested after delivery with a culture for CMV. Before delivery, a congenital infection of the fetus can be detected by doing an amniocentesis and finding a positive virus culture and/or a positive PCR test in the amniotic fluid.
At present, no specific prevention or&nbsp; treatment for CMV is known. Good hand-washing may decrease your chance of getting infected, and concerns have been raised about having small children in day-care settings while mom is pregnant. Routine testing of pregnant women without any symptoms is also presently not suggested. However, if you are exposed to small children, screening for prior CMV infection before pregnancy may be indicated. We suggest that you discuss this with your doctor.
<h2>What are my risks of infecting the baby with cytomegalovirus CMV during pregnancy?</h2>
CMV infections per 10,000 pregnancies with approximate percentages:
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<td style="border: 1pt solid windowtext; padding: 0in 5.4pt; width: 6.15in; background-color: transparent;" colspan="3" width="590">&nbsp;</td>
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<td style="padding: 0in 5.4pt; width: 239.4pt; background-color: transparent;" width="319">&nbsp;</td>
<td style="padding: 0in 5.4pt; width: 99pt; background-color: transparent;" width="132">
Approx percent (%)
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Numbers
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Total pregnancies:
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&nbsp;
</td>
<td style="padding: 0in 5.4pt; width: 1.45in; background-color: transparent;" width="139">
10,000
</td>
</tr>
<tr>
<td style="padding: 0in 5.4pt; width: 239.4pt; background-color: transparent;" width="319">
Never infected with CMV:
</td>
<td style="padding: 0in 5.4pt; width: 99pt; background-color: transparent;" width="132">
45%
</td>
<td style="padding: 0in 5.4pt; width: 1.45in; background-color: transparent;" width="139">
4,500
</td>
</tr>
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<td style="padding: 0in 5.4pt; width: 239.4pt; background-color: transparent;" width="319">
Primary infection of mothers in pregnancy
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<td style="padding: 0in 5.4pt; width: 99pt; background-color: transparent;" width="132">
0.2-2%
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9-90
</td>
</tr>
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<td style="padding: 0in 5.4pt; width: 239.4pt; background-color: transparent;" width="319">
Fetuses/Babies infected
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50%
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4-45
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Infected Babies born with symptoms
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10-20%
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0-9
</td>
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Infected babies born without symptoms
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80-90%
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<td style="padding: 0in 5.4pt; width: 1.45in; background-color: transparent;" width="139">
4-36
</td>
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Babies developing symptoms later in life
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<td style="padding: 0in 5.4pt; width: 99pt; background-color: transparent;" width="132">
10%
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<td style="padding: 0in 5.4pt; width: 1.45in; background-color: transparent;" width="139">
0-4
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Infected babies without problems
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<td style="padding: 0in 5.4pt; width: 99pt; background-color: transparent;" width="132">
90%
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<td style="padding: 0in 5.4pt; width: 1.45in; background-color: transparent;" width="139">
4-36
</td>
</tr>
</tbody>
</table>
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CMV stands for Cytomegalovirus, which is a DNA herpesvirus that  infects  up to 85% of all people in the United States at some point in  their  lives.

Cytomegalovirus (CMV) Infection 

Q: I am 8 weeks pregnant and my blood tested positive for toxoplasmosis. What does this mean?
&nbsp;
A: The initial test for toxoplamosis is an antibody test for IgG. Among American women of childbearing age, 40-50% carry IgG antibodies against the parasite because they've been exposed to it in the past. Testing positive for the IgG toxoplasma antibody usually means they are immune and are unlikely to infect the fetus. After an initial infection with Toxoplasma gondii, you'll test positive for the IgG antibody forever. Most likely, you became infected before your pregnancy and need not worry. Having the antibody makes you partially immune, so there's little chance that you would infect your fetus. There is another toxoplasma antibody test called IgM. The IgM test signifies a more recent infection, maybe up to one to two years ago, though it's difficult to be exact.

I am 8 weeks pregnant and my blood tested positive for toxoplasmosis.

Toxoplasma - Positive Test

The four major factors affecting your chance of getting pregnant are:
<ul>
<li>The mother's age. The older the woman is, the longer it takes to get pregnant.</li>
<li>Regular ovulation. With irregular or no ovulation (anovulation), you cannot get pregnant.</li>
<li>A normal sperm count. The less sperm he has, the longer it may take to get pregnant. With an abnormal count (that is, below 20 million/cc) your chances getting pregnant are quite low.</li>
<li>The patency of your fallopian tubes. They must be open and working well for you to get pregnant.</li>
</ul>
If each of these four factors is OK, then your chance of becoming pregnant in each ovulatory cycle is about 25-30%. Your chances are lower or even zero when even one or more of these factors is abnormal. About 50% of couples get pregnant within four to five months of trying to conceive, about 75% of couples will conceive during the first eight months, and up to 85% of couples will conceive within the first year of TTC. The ability to conceive in any given cycle falls after age 30. Keep in mind that with irregular menstrual cycles it may take longer to conceive because it's harder to figure out when you're ovulating. If you haven't got pregnant after a year of trying (six months if you are over 35), you may want to talk with your doctor about your options.