什么是弓形虫病？症状，原因，诊断，治疗和预防

Toxoplasmosis is an infectious disease caused by the parasite弓形虫弓形虫。

Although猫和their feline relatives are the only hosts in whichT. Gondii复制品，寄生虫在人类和许多其他动物中发现，包括啮齿动物，鸟类，猪和绵羊。（（1)

猫在T. Gondii’slife cycle and the spread of toxoplasmosis to people.

猫被感染T. Gondii根据美国兽医医学协会（AVMA），吃了鸟类感染的鸟类或小型哺乳动物后。（（2)

The parasites then reproduce in the cat's small intestine and form oocysts, which are thick-walled cysts containing zygotes.

The cat eventually sheds the oocysts in its feces. “Cats usually only shed oocysts in their feces once during their lifetime, with a few exceptions, and many infected withT. Gondii可能永远不会脱落卵囊。”希瑟斯托克代尔·沃尔登（Stockdale Walden），博士，盖恩斯维尔佛罗里达大学兽医学院的寄生虫学助理教授。

A single cat can shed millions of oocysts for up to three weeks after infection, according to the Centers for Disease Control and Prevention (CDC).

沃尔登说，大多数受感染的猫没有表现出迹象或症状，但是脱落卵囊的猫科动物可以感染其垃圾箱。人类可以在清洁垃圾箱后或触摸与包含的猫的粪便接触后意外摄入的卵囊感染。T. Gondii。Other animals become infected when they ingest soil, water, or plants contaminated with oocysts.（（3)

通常，感染的人T. Gondiiare not even aware they have it.

“Most people don’t have symptoms with toxoplasmosis or have mild symptoms like fever and muscle aches, as with any infection,” saysAmy Edwards, MD, a pediatric infectious disease specialist at UH Rainbow Babies & Children’s Hospital in Cleveland. “It’s usually pretty nonspecific.”

根据美国国立卫生研究院（NIH）的说法，其他症状可能包括：（（4)

• 头部和颈部的淋巴结扩大和嫩淋巴结
• 头痛
• 咽喉痛

如果你有弱immune system, such as from艾滋病病毒或癌症，您可能会遇到更严重的症状，例如：

• 混乱
• Fever and headache
• Blurred vision
• 癫痫发作
• Nausea
• Poor coordination

您可以通过摄入被污染的食物或饮料来获得弓形虫病T. Gondii。根据the CDC, this can happen by: (3)

• Eating uncooked or raw meat that's infected with the parasite, particularly venison, pork, or lamb
• 喝水or another liquid that’s been contaminated with the parasite
• Eating food that's been contaminated with the parasite through direct contact or indirectly through knives, utensils, or cutting boards
• 处理后不小心摄入被感染的肉的微小颗粒，无法洗手
• Eatingfruit or vegetablesthat have been in contact with soil or water contaminated with the parasite and have not been washed, peeled, or cooked

You can also get toxoplasmosis by swallowing particles of oocyst-laden cat feces, such as if you touch your mouth after cleaning or changing your cat's litter, handle objects that have come into contact with cat feces, or garden without gloves.

在极少数情况下，您可以通过输血or an organ transplant, the CDC reports.

弓形虫病通常由blood testthat checks for antibodies to the parasite, according to the Mayo Clinic.

If a woman tests positive during pregnancy, a doctor will check to see if the baby is infected. This is done by testing fluid from the amniotic sac for evidence of toxoplasmosis. Ultrasounds can also detect certain signs of infection, including fluid buildup in the brain.（5）

For most people, toxoplasmosis will go away on its own, Dr. Edwards says. Eventually, after a few weeks or months, your immune system will fight off the disease.

Those requiring treatment will be put on medication that can take weeks or even months to clear the infection, Edwards says.

患有健康免疫系统的人通常不需要治疗，但是抗生素和抗疟药可能有助于症状。

根据梅奥诊所的说法，通常用于感染的健康（非妊娠）成年人的药物包括乙胺嘧啶和磺胺嘧啶，以及叶酸（leucovorin）。（5）

免疫系统弱的人，例如与之相处的人艾滋病病毒CDC报道说，，也可以使用这些药物治疗，直到其病情改善为止，尽管有些人需要以较低剂量或替代药物进行终身治疗。（（6)

Other drug combinations may also be used in these situations, such as pyrimethamine plus克林霉素。

孕妇在妊娠中期或初期早期通常接受螺旋霉素治疗，而在妊娠中期或第三个中期的孕妇通常用乙胺胺和磺胺嘧啶加氟维氏蛋白治疗。

新生儿通常用乙胺胺和磺胺胺和白细胞素治疗。这些是一般指南，将根据每个患者的特定需求和风险因素进行定制。（5）

预防弓形虫病

为了防止食物感染弓形虫病，CDC建议采用以下准则：

使用食物温度计来确保肉类和家禽煮熟至安全温度。

根据the U.S. Department of Agriculture (USDA), whole cuts of meat should be cooked to an internal temperature of least 145 degrees F; ground meat should be cooked to at least 160 degrees F; and poultry should be cooked to at least 165 degrees F.

Peel or thoroughly wash fruit and vegetables before consuming.

彻底清洗与生肉或家禽，海鲜和未洗的农产品接触的切割板，餐具，器皿和表面。

Do not consume unpasteurized goat milk.

避免吃生或未煮熟的牡蛎，贻贝和蛤。

To prevent infection from cats, cat owners should change the litter box daily, avoid feeding their pet raw or undercooked meat, and keep their cat indoors to reduce the risk of infection. Pregnant women should not clean the litter box if possible, or if there is no one else able to, should wear disposable gloves and wash their hands after.

每个人都应该避免喝未经处理的水，并在园艺或与土壤或沙子接触时戴上手套。请记住，随后总是洗手，因为这些区域可能会因猫粪便污染。（7）

If you get toxoplasmosis while pregnant, you may pass it on to your unborn baby (congenital toxoplasmosis), even if you don't experience any symptoms.

But if you had the disease before becoming pregnant, your child is not at risk for toxoplasmosis — your immune system confers protection.

据疾病预防控制中心（CDC）称，有时建议至少在感染后六个月等待怀孕之前等待。

“当孕妇在怀孕而不是免疫时首次感染时，可以将弓形虫病在胎盘上传播给未出生的孩子。”医学博士Rima McLeod，芝加哥大学的教授和医学主任University of Chicago Medicine Toxoplasmosis Center。“未出生的孩子在免疫学上不成熟，因此感染可能对他们的眼睛，大脑和一般幸福感特别有害。这种损害可以反复出现并表现出终生。”

Toxoplasmosis during pregnancy can also result in流产, stillbirth, or a child born with signs of the disease, such as an abnormal head size.

此外，有可能从T. Gondii，通常如果您天生患有弓形虫病。该疾病会引起炎症性视网膜病变和疤痕，从而导致眼睛疼痛，光敏，撕裂和视力模糊。（（8)

一些研究表明T. Gondii会影响人格和行为，包括引起神经质，精神分裂症,沮丧， 和自杀tendencies. A June 2015 study published in the journal精神分裂症研究, for example, concluded that cat ownership in childhood is significantly more common in families in which the child later becomes “seriously mentally ill.” The mechanism, researchers hypothesize, could be toxoplasmosis. (9)

The theory, though, is that when the parasite gets into the brain, “depending on where it lodges, it can cause chronic inflammation. This can slowly damage the brain in that area, leading to neurological or psychological problems depending on the area involved,” Edwards explains.

但是，在上述研究中，研究人员只观察到儿童猫的所有权与未来之间的相关联系mental illness; more studies are needed before researchers can definitively say that one causes the other. What’s more, a February 2016 study published in thePLoS One在先前的研究中指出了缺陷，并得出结论，几乎没有科学证据表明T. Gondiiis related to increased risk of psychiatric disorder.（（10)

An estimated 40 million people in the United States may be infected withT. Gondii根据疾病预防控制中心，但大多数人没有症状，因为免疫系统通常会阻止寄生虫引起疾病。（11）

What's more, up to 60 percent of some populations across the globe are infected by the parasite, the CDC reports. (3)

最喜欢的组织以获取有关弓形虫病的信息

American Veterinary Medical Association (AVMA)

The American Veterinary Medical Association is the nation’s leading advocacy organization for veterinarians. Stay informed on the most up-to-date info on how toxoplasmosis affects cats and tips on how you can help keep your pet and family safe.

弓形虫病研究所和中心

This Chicago-based nonprofit performs and promotes research on toxoplasmosis and optimal care for those affected. Learn about the organization’s latest research findings or read personal stories from families impacted by toxoplasmosis on the center’s website.

The Companion Animal Parasite Council (CAPC)

伴侣动物寄生虫理事会是兽医，兽医寄生虫学家和其他动物医疗保健专业人员的独立理事会，旨在为威胁宠物及其所有者健康的最佳寄生虫创建准则。除了有关弓形虫病的信息外，CAPC还提供有关宠物被其他寄生虫感染的有用，可书签的资源，包括tick虫，跳蚤，tap虫和耳螨。