According to medical contributor Dr. Tim Johnson with ABC-TV news, “Pregnant women, women who are about to become pregnant and people with weakened immune systems, including those who are undergoing chemo or have AIDS, should avoid cats and cat litter.”
Johnson, who made the statement on November 10, is concerned women could contract a parasitic protozoa from cat feces called toxoplasmosis. However, his statement ” which was made to millions of viewers – is in contradiction to recommendations made by medical experts on infectious diseases.
“The public can easily access the medical community’s guidelines on the subject by doing a search on the Internet,” said Dr. Michael Lappin, professor of small animal internal medicine at the College of Veterinary Medicine at Colorado State University, Ft. Collins.
Lappin, who attended the American Association of Feline Practitioners Fall Conference in Chicago on November 14, is considered one of the world’s experts on toxoplasmosis. He has researched the organism and its effects for 20 years.
As often happens in the media, if a statement is made in one place, it’s reiterated elsewhere. As a result, veterinarians are now hearing from concerned clients, including some who are pregnant and considering giving up their cat.
“Absolutely, positively, you do not have to give up your cat because you are pregnant; please don’t even consider it,” urges Dr. Margie Scherk, a boarded certified feline veterinarian from Vancouver, BC Canada, who also attended the conference. “But do consider the facts,” she added.
Toxoplasmosis (Toxoplasma gondi) occurs commonly in the environment. Cats most frequently get the infection by eating an infected animal, but also by consuming undercooked meat. Following a meal of infected prey or undercooked meat, an intra-intestinal infection cycle unique to cats begins. The organism multiplies in the walls of the small intestine and ultimately comes out in the feces. Cats are the only animals to pass on the infectious stage through their feces. And while some cats with toxoplasmosis do become ill, many have no symptoms whatsoever.
According to the Centers for Disease Control and Prevention (CDC), in Atlanta, Ga., a majority of healthy people are unlikely to become very ill from toxoplasmosis. Many people don’t have any symptoms, although some may have mild flu-like signs which generally persist for 48 hours at the most. However, toxoplasmosis is a danger for those about to become pregnant or women in their first trimester because the disease can cause serious birth defects or even death in a baby as the organism travels through the placenta. (The disease is not a particular danger to the baby later in the pregnancy). Toxoplasmosis can also become a serious illness in people who have compromised immune systems.
Lappin explains the specific series of concurrent events which must occur for a person to get toxoplasmosis. First, a person must come in contact with an infected cat, and not all cats are infected. According to Lappin’s research, about 30 percent of cats are positive for toxo. Cats only pass on the disease seven to ten days of their entire lives, when there is an acute infection, which must coincide with the first trimester of the pregnancy.
What’s more, the feces eliminated by a cat carrying toxoplasmosis requires anywhere from one to five days to become actively infectious, which is why simply changing the litter box and scooping the feces within 24 hours is an effective prevention.
Lappin says he encourages women to wear gloves while changing the box, offering further protection. Scherk prefers this idea, “It’s a perfect job for your partner. You’re going to have the baby, he can at least scoop the box.”
Dr. Drew Weigner, an exclusively feline veterinarian in Atlanta, Ga., who also attended the conference, points out a solution for single mom households with no one else available to scoop. “I just tell them to use gloves and take the entire liner and throw it all out, so there’s even less contact with the feces.”
Scherk adds that hand-washing is an effective means of additional control. As for people who are immune compromised, if the person’s doctor is concerned, a partner or family member can scoop. For people who live alone, there are social service agencies and animal shelters in many communities who offer volunteer scoopers.
Weigner notes gardening and the ingestion of undercooked meats are the most common ways in which people are infected with toxoplasmosis. Unwashed fruit could also transmit the disease. The American Medical Association (AMA) and CDC suggest wearing gloves when gardening, washing hands thoroughly after handling plants in the garden or meat on the counter, and washing the counter. Washing fruit is also suggested. Neither organization suggests pregnant women or immune compromised individuals should stop gardening or eating meat.
As for scooping the litter box, the AMA and CDC suggest the same precautions recommended by the veterinarians, but neither agency even hints at the option of giving up the family cat, as Johnson did in his TV report. The medical website www.webmd.com goes further, “There is no reason, including toxoplasmosis, why a pregnant woman can’t live with a cat.”
Weigner says, “Ten years ago, I’d have maybe three or four clients tell me, ‘My doctor says I need to give up my cat.’ Today, I have about a client or two every other year who says this. My half-joking response is, ‘Then you need another doctor’.”
“I’ve worked with the medical experts on this and I know the profession as a whole most certainly understands the facts about toxo,” says Lappin. “I can’t explain why those facts haven’t trickled down to some individuals, or what the disconnect might be.”
Weigner adds, “Maybe for some doctors, telling a client to relinquish a pet cat is just an easier and faster answer to give when they’re pressed for time than to go over the precautionary measures.”
Weigner says, to his knowledge, not a single client in the past several years has followed such misguided advice to relinquish a cat just because she’s pregnant. “This speaks of both the human/animal bond, and the Internet. It’s quite easy for clients to simply confirm what I say by searching at reputable sites on the Internet or by asking another doctor for a second opinion.”
Lappin does suggest women who live with cats take a simple blood test for toxoplasmosis after learning of a pregnancy. This test can determine previous exposure to toxo, since so many have been exposed without ever being diagnosed. This is handy knowledge because, in general, once positive most people are positive for life, and protected from being re-infected. So, if while pregnant, there are symptoms concurrent with toxo, the doctor can more likely eliminate the possibility of toxoplasmosis.
Research to be released in 2007 might reveal feeding cats a raw food diet (a trend among some cat owners) could increase the odds of being infected with toxo. Certainly, keeping cats indoors can lessen the odds, although mice, roaches and other critters which may be infected do get indoors.
“I know of no human medical association that encourages people who are supposedly at risk to give up their cats,” says Scherk, “I can’t fathom where doctors who suggest giving up the cat are basing their information.”
Here is a sampling of legitimate resources for anyone who wants to learn more about toxoplasmosis:
- American Association of Feline Practitioners: http://aafponline.org/resources/guidelines/ZooFinal2003.pdf
- American Medical Association website: http://www.ama-assn.org/ama1/pub/upload/mm/36/2004_food_toxoplasma.pdf
- Centers for Disease Control and Prevention: http://www.cdc.gov/ncidod/dpd/
parasites/toxoplasmosis/default.htm and http://www.cdc.gov/ncidod/dbmd/
gbs/pregnancyinfections.pdf and http://www.cdc.gov/healthypets/
- Cornell University College of Veterinary Medicine, Ithaca, NY, Cornell Feline Health Center: http://www.vet.cornell.edu/fhc/resources/brochure/toxo.html
- Webmed.com: www.webmd.com/content.pages3/3608_971.htm