Thank you very much. Thank you for joining me to, to have a little look at Toxoplasma gondii, which, has perhaps been a little bit out of the limelight recently in veterinary circles. There's been a lot of discussion about flea and worm control, but of plasma is one of those parasites that isn't really ever that far from the public's mind and the pet owner's mind, both metaphorically, hopefully not literally, but possibly, because it's just had a very high public profile for a very long time.
And you know, we were just discussing before the webinar started that, you know, some of that may be due to our concerns about the effects that toxoplasma will have on cats, but from pet owners' point of view, it's very much associated with the zoonotic risk and the effects that it might have on them through exposure. So we're going to consider that a little bit. I'm not going to dwell too heavily on sheep aspects.
It's a long time since I've seen a sheep, other than a field. I know a little bit about toxoplasma's activities in sheep, but it's not really in the scope of this webinar. If anyone has a burning sheep toxoplasma question at the end, I'll, I'll happily try and answer it.
So just a little refresher, a little reminder, Toxoplasma gondii is a coccidian, sometimes called apicomplexum parasite, part of a wide group of parasites that include some vector-borne parasites, some waterborne parasites that affect people like Cryptosporidium. But in this case, as a sort of life cycle that incorporates a very, very wide range of warm blooded animals, and, you know, brace yourselves, we'll have a little look at the life cycle in, in a moment, but you know, when you boil it down, more straightforward than it first appears, it has a worldwide distribution. It has been staggeringly successful in its ability and to parasitize life.
Numbers of hosts, and it's not only a wide range of species, but also at a very, very high prevalence. And that's actually reflected in the number of people who have zero prevalence, so sero converted have antibodies to the parasite. So, if we stop and consider this figure for a moment, 30 to 50% of humans globally are estimated to be positive for toxoplasma.
Now, Granted, the figure is much higher in the Americas, in many developing countries, largely because of, culinary habits. We'll talk a little bit about that later. But even so, in the Western world, it's not unusual to see figures in developing countries of maybe 1015, 20%, depending on the study and the country involved.
So it's an awful lot of people being exposed to toxoplasma. And one of the reasons it has such a high profile is the potential for this wide range of outcomes from human infection. And that tends to get into the press.
So we'll talk about the different types of effects it can have on people. Traditionally, people have been worried about its effect on pregnancy, but much more recently, there have been headlines about toxoplasma rewiring the brain, about its effects on things like schizophrenia, suicidal risk, risk taking. So naturally these headlines are going to worry the public, and a large number of the public are pet owners, and because of the association with cats, they are very likely to bring these concerns to you.
So, you know, as a result, we need to be ready to answer their questions, to put their mind at rest, but also to give what preventative advice we can, which is within our remit, rather than giving medical advice. It does need to be mentioned, but yes, it does also have potential economic impacts from abortion, from sheep, and if cats, you know, get onto farm and shed oocysts, which we'll talk about in a moment, there is some overlap there between some small animal aspects and the large animal aspects. But again, you know, for a small animal practitioners, the sheep aspect of this, you know, isn't something that we'll be involved with day to day.
It can have potential health impacts on cats. Pretty uncommonly, if we compare it with the number of cats that are exposed to infection, actually very few cats develop clinical disease. But even if it's a very small percentage, it's very likely that small animal practitioners at some point will see a case of toxoplasmosis in cats.
You know, in first opinion practise, so we need to be ready, to diagnose and treat that as best we can. So human aspects, veterinary aspects, and we're going to consider both. So this, this is just to show you the latest headline.
You know, it's not just, you know, headlines haven't just happened traditionally, I, I would say they're in the press. Every week in some corner of the press. This is the latest take.
I just wanted to show you this because sometimes there's suggestion that toxoplasma may actually have positive benefits. So in this case, they're suggesting that business tycoons take the risks they do, and that they're not risk averse because their brains are affected by toxoplasma. So, You know, an awful lot of information out there that the members of the public will be getting, and then they're going to bring that to you.
So let's begin with the life cycle. So toxoplasma life cycle is one of those that you look at and you just think, oh crikey, like, you know, what, what is going on there? But actually it's very, very straightforward because lots of the animals that get infected by toxoplasma get infected incidentally.
Toxoplasma is really a parasite of cats and That the animals that cats predate upon. So small rodents, birds are most important to the parasite itself in terms of its propagation and continuing. So what we have is cats as the definitive host.
So only cats can produce the sexual stage of the parasite, which are these os. So when they're passed, they're, they're passed in a, in a non-infective way, so they're initially non-infective, and then they need time to mature and develop in the environment before they then become infective. Under the right conditions, this can happen very, very rapidly, it can happen in days.
So you know, it likes moist, warm, humid conditions, spread them out very easily by moisture. So it's spread in the faeces initially, and very easily get into waterways, dispersed as the sort of faecal pack breaks down, and then can get into contaminate fruit, vegetables, local water sources, all sorts of different ways that animals might be exposed to those os. So that's one way that infection is passed on.
It's actually a very, very brief opportunity for the parasites. So these oocysts are only produced shortly after the cat is infected for the first time, because after that, Immunity kicks in, and the parasite has to hide away. But initially it's in the guts, it's reproducing in the guts, and that's when these oocysts are reproduced.
So what happens is that you get cats get infected, and they will then produce, Just huge numbers of these oys in one go, but it will happen very, very briefly and then they're done. So after that time, once those oocysts have been spread into the environment, the parasite is then relying on them being eaten and then getting into other animals that will act as intermediate hosts. So those animals could be almost any warm-blooded animal.
So you know, even outside of that sphere, some cold-blooded animals will act as intermediate hosts, but from our point of view, birds, small rodents, livestock, and crucially, people, can act as reservoirs for the infection. So after the oocyst has been ingested, you get rapid proliferation of the parasite and the parasite will then spread throughout the body to various muscles, organs, and there it will form, . Sort of asexual form of the parasites.
So initially rapidly dividing tachyzooites. So these are sort of rapidly dividing asexual form, they'll reproduce themselves many, many, many times in the tissues until the immune system starts. To get a handle on what's going on.
So, if you become clinically sick, whether you're a cat, whether you're a person, you're gonna get clinically sick from toxoplasmosis. It tends to be why, while these tachyzooytes are rapidly dividing in the tissues. And hopefully if you're immune competent, you get on top of that infection and then these tachyzooites will hide away in cysts in the body, and they will form Bradyzooites that are much slower reproductive forms.
So that's the sort of process where it can then hide from the immune system and wait essentially either to reactivate if the immune system drops or to get eaten, and then reactivate that way. So infection can also occur through eating the tissues of infected hosts with bradyzooites. So it can carry on without useless production through one asexual intermediate host, eating another and, you know, getting infected that way.
The other trick that it has up its sleeve is that it can be passed on congenitally, so it's extremely good at vertical transmission and especially in rodents, which one of its favoured hosts, you know, the reproductive capability of rodents is huge, so it will Reproduce itself many, many, many times and actually with quite a good success rate being passed on from one generation to the next. So it can sustain itself really well in this way, and then essentially it's just using the ESIS to top up its numbers every so often. So we need to remember that the cat is this sort of primary source of the EIS, which is one of the concerns that surrounds cats and potential human exposure, but we can also be infected and cats can also be infected by predation or, you know, eating infected tissues.
There's a lot of flexibility in its life cycle. So the eis when they're initially shed contain just sort of an amorphous mass in the middle, and then as they mature like a fine wine, you get a couple of little sporozoites inside, and then if it's then ingested, you'll subsequently get infected and it will form tachyzooites and start reproducing. In the way that I've described.
As far as we know, these osis are only produced by felets. So wild elids as well, but domestic cats in our day to day lives are going to produce these oys that other pets and animals may then be infected by, or humans. Tacky so white it's, these rapidly dividing asexual stages can be found in pretty much all vertebrate hosts.
So, you know, we have this very, very wide range, and that's important because, you know, it means that almost anything that cats predate, they'll get infected. And almost any sort of, meat or a tissues that we eat raw, we might get infected as well. So yeah, it's very important to bear in mind.
Occasionally dogs will get infected, and become sick as well by eating infected tissues. And then the brandyzooites are these very slow dividing insisted stages, and they're found again in invertebrate hosts, and they will just hide from the immune system and just bide their time for predation or immune suppression to occur. Clinical toxoplasmosis is when the body's immune system reacts badly to these rapidly dividing tachyzooytes.
You get local inflammation responses, gra granulosis inflammation, that starts to cause organ damage, can lead to a variety of effects in the bodies, sort of immune mediated or inflammatory. It's multi-systemic, it tends to affect multiple organs and can affect almost any organ as these tachyoites rapidly divide, . It tends to be when they get out of hand.
So most animals when they're initially infected by toxoplasma, if their immune competence, may develop a little bit of a fever and may get lymphadenopathy, and humans often describe sort of flu type symptoms, but then your immune system should kick in, the bradyzoys form, and you know, you, you start to feel better, you know, you sort of feel OK. And the same is true for cats as well. It's most commonly seen when there's some sort of issue with the immune system.
So this is a disease really of adult cats. It's not something that we tend to see in groups of kittens. So, with Neospre, it's very closely related protozoa of dogs.
It's passed congenitally, and we tend to see disease in young groups of puppies. We tend to see disease very rarely in adult dogs. Here, Sort of congenital transmission in cats is, is pretty rare.
It's pretty unusual given that, you know, it's so good at being passed congenitally in other species, but it means that we're not going to see infection and clinical disease in groups of kittens very often. We're tending to see it in adult cats that have other health issues. So when we see relevant clinical signs, we want to consider it as a differential, but We also want to consider what other the disease processes might be going on.
So one of the most common ones would be FELV FIV infection, the general other systemic disease, so, . Sort of, you know, if you have malignancies, if you have other immune-mediated disease going on, it makes it more likely, that you're going to develop secondary toxoplasmosis and because many, many cats are infected, they've just got the infection under control. So the sort of signs that we'd be looking out for where we'd want to consider toxoplasma as a differential, are, lymphadenopathy, Clinical signs associated with lymph nodes, so lymphadenitis, neurological signs are quite common.
So encephalitis, sort of, if, if you get clinical disease is quite a common outcome in cats, pneumonia is seen quite often and heart complications. So myocarditis and toxoplasma would definitely be a differential. You can also get issues with the eye, which you see in people as well.
So changes in the retina, you would also want to consider toxoplasma as a differential. Particularly with initial infection, but then ongoing, if you have got immune compromised cats, you'll get prolonged fevers, you'll get associated weight loss and lethargy. These cats will just seem systemically unwell and at that point, you know, you want to be investigating whether toxoplasma is in play, but also whether we do have a combination of factors that are leading to the chronic disease.
What is absolutely crucial to say is that cats that are clinically ill with toxoplasma actually very, very rarely shedoosis in their faeces. So you can imagine that, you know, you've got a clinically sick cat, you diagnose toxoplasma because of, you know, public knowledge of the parasite, the first thing that pet owners are going to think is that that's going to put them at risk. That they're going to be at increased risk of infection because the cat is clinically unwell.
And that is absolutely not the case. So the oocysts that we are likely to ingest and then catch, clinical toxoplasmosis are only shared after initial infection. That's when reproduction is going on in the gut, and then these oocysts are being passed.
Clinical disease in cats is associated with multi-systemic infection. So, you know, the action is taking place away from the gut, and oocysts at that point are almost never formed. And this is especially true if it is secondary to other disease.
If you've got long standing toxoplasma infection in a cat, you can pretty much guaranteed that it isn't going to shed cysts. Diagnosis is tricky. So there's a few different ways we could go about it, but the first thing that you have to consider is why you're going after the diagnosis.
So, you know, are we screening cats because we're concerned that they might be a risk, to their owners, particularly, say, pregnant owners, or are we trying to diagnose clinical toxoplasmosis in the cat? So there's a test that you would use there are very different. So we can look for this.
Now, as we've just described, that isn't going to be very much use for the clinically affected cats, but absolutely, you know, it's intuitive that you'd think, well, we're worried about this possibly being a risk to an owner. We should probably see if there are osis in the faeces. There are a number of issues we do in this, but the first is that they are very small.
So 10 micrometres by 12 micrometres means in standard observations of sort of direct smears or floats, they are very, very easily missed. And you may well see them on a direct smear if they're being shared because there'll be very large numbers of them, but those will be concentrated by centrifugal flotation. So as you know, if you're doing part, doing it as part of a general parasite screen, floatation will just increase that rate, that chance of you finding new cysts in the faeces.
The shedding though only takes place in a very short period of time. So really, that the odds of you ever seeing them are quite low. Even if you do flotation, even if there are significant numbers there, they can be missed.
So if you get a negative results, it's very difficult to be able to go back to clients and say, well, your cat's definitely not shedding. And even if they are shedding, you've got a very small window of time in which to find these eysts, and then confirm infection, that doesn't mean it's not worth looking. I think you just have to sort of limit expectations in terms of what you're likely to find.
So most diagnosis is done through antibody assays, and this is really most useful if you're looking at clinical infection, and we want to know if infection is recent, and if it's escalating, and therefore might be causing the clinical signs that we're seeing. So we may look for IGG or we might look for IGM. So IGM titers develop in around 80% of cats, 1 to 4 weeks after initial infection.
So if we think our cat's just been infected, it's got acute signs, we think that it's immune competence, then this is useful to look for initially. Those IGM titers are normally gone by about 16 weeks after infection. So for chronically infected cats, we're looking at IgG, which in a normally detectable 3 to 4 weeks after infection, and it's gonna peak at around about 2 to 4 weeks after you've initially detected them.
Just finding them doesn't really tell you a lot. Tells you that the cat's been exposed, titers stay for a long time. So, you know, it tells you that exposures taking place, but it doesn't really tell you whether your clinical signs are due to toxoplasmosis or not.
So to do that, we really need to do have quantitative analysis. And we're looking at a sort of 4-fold increase in IGG. If we take two, readings.
2 to 4 weeks apart, a 4-fold increase in that time is going to tell you that you have got escalating infection, and that, you know, the clinical signs probably are due, at least in part, to toxoplasma infection. So, from that point of view, antibodies are useful, but only if they're used in the correct way. What they absolutely don't do is tell you anything about UI shedding.
So if a client comes to you and they say, oh yeah I'm really worried, that you know, my cat might be shedding OIS, there is no correlation between antibody titis and likelihood to shed. So as a screen for that risk, it's not terribly useful. I mean, it is fair to say that, you know, if a cat's antibody negative, that means that it's susceptible to infection and therefore may get infected in the future.
But a positive antibody titer probably doesn't tell you a lot, in terms of where the shedding has taken place or is likely to take place. And then finally, we have a relatively new sort of diagnostic technique on the scene, which is PCR testing of faeces. Now this has become commercially available.
There are in-house testers that will look at toxoplasma PCR and faeces. It's still very early days in terms of what it tells us in terms of correlation. With us this shedding, which is probably where it's going to be most useful, and PCR is going to be much, much easier to detect in the faeces than the UI themselves.
So if over time with research, we find there is a strong correlation between the two, and I think this is going to be much more useful screen than looking for the UI themselves. Once we've established that clinical toxoplasmosis is present, whether it's primary or whether it is associated with another condition, you know, it makes sense to then go on and try and treat it. I would say in in adult cats, particularly ones where we suspect they're chronically infected, it eats.
You know, absolutely fine to try treatments, but I think we need to manage expectations, as sometimes outcomes are not very good. And you know, it's a real shame, cats often will have been compensating, you know, perhaps coping with another chronic condition, you know, there may have been, FIV or FELV positive, you know, being kept at home, but when clinical toxoplasmosis comes into play, it is a very, very serious complication. There isn't any licenced treatments, so there's a few different combinations that people have used over the years.
Clindamycin has limited efficacy, but you do have to go to very high doses, for it to work and for quite a long time. So some cats' guts won't tolerate those high doses, but you know, it's certainly worth a try, and there is some efficacy there. Pyra pyromethane all we said, plus a sulfonamide, in combination.
I, I've never tried this in, in combination, but in the literature there is, efficacy there, so worth considering. I think perhaps the one that we've used. The most, certainly the one that I've used the most is trimeroprim sulfonamide combination.
That's used at a rate of 15 migs per kg twice a day for around 4 weeks, has reasonable efficacy at clearing parasites. Often though, the prognosis isn't associated with which of these treatments you're using, I mean, all of them have, you know, reasonable efficacy of bringing the parasite back under control. The issue is it's very difficult to clear the parasite from the body and the existing condition is still going to be there.
So sometimes you don't get a clinical response to treatment and sometimes even if you do, it relapses are common. As we said at the beginning, one of the sort of biggest concerns that your clients are going to have is the risk to themselves. And that's completely understandable given how high profile this parasite is.
. We've said, it occurs worldwide. There has been some suggestion that some strains of toxoplasma, particularly strain in South America, may be more virulent, maybe be more likely to cause clinical signs than the ones we have in Europe and in North America. It's varying amounts of literature on this, but it's really more the chronic effects of infection that we're really, really concerned about.
So people get infected either by the consumption of osis, and that's through environmental contamination. So, you know, waterways can become infected if cats defecate near them, get into water supplies and sometimes can get into mains water supply. There'll be sort of local, toxoplasma outbreaks, through treated water, you know, where, where it hasn't been treated effectively.
But mostly it's from taking water from rivers, streams, ponds, without treating it adequately. It can also contaminate, very easy to contaminate, fruit and vegetables that are grown in allotments or fields, simply because cats love, love, absolutely love to come and have a #2 on top of them, and have a little dig around. Have a poo on your courgettes.
And I mean, there are many sort of different zoonotic, parasites that might be transmitted that way. But toxoplasma is quite persistent in the environment. It can survive a range of conditions.
So once they uses are passed, they have no problem sitting around on your, your lovely fruit and veg until you come along and decide you're going to eat them without washing them thoroughly or cooking. So that's another major route. They can, develop just in the immediate environment, if cats are defecated and it's warm and moist, so don't necessarily need a medium to get onto, but they do need to mature first.
But say, you know, if litter trays weren't cleaned for days. Or if faeces got into a sort of home, outbuilding environment, it's cattery runs, say, breeding establishments, then, you know, it's quite easy for these UI to develop, and become a potential risk. The other way that people get infected, and probably far more common way that people get infected is through the consumption of tissue cysts in undercooked or raw meat, .
Certainly the cause of such a high prevalence globally. And in some countries such as France, and the prevalence has come down, and although this hasn't been conclusively proven, cooking practises of meat are thought to be involved. So that is a big part of how people get infected, and you know, when giving advice, when medical people give advice, To, to any member of the public that's worried about toxoplasma and toxoplasma and pregnancy, that raw or undercooked food consumption is, is probably, you know, a more likely route of infection than your cat.
We're still looking at maybe, as we said with those figures, 3 or 5 of the world being infected. It has to be said that the vast, the vast majority of people, as far as we know, are going to be absolutely fine. So they may develop this bit of a fever, they might develop a lymphadenopathy, but unless they're immune suppressed.
You know, they're, they're gonna get better, you know, they're going to recover and they're going to be OK. What has emerged though in recent years and has concerned people is the possible chronic effects on our cognitive function and on our decision making. So some of these cysts inevitably end up in the brain, and there's been a lot of studies and a lot of debates about how Much of an effect it might be having there.
Now, we know that it has a profound effect on rats. It's genius plan on the part of the parasite that it makes rats seek out cat urine, makes cat urine irresistible to rats and other rodents. So they go and seek it out where they're much more likely to get eaten, and then for the life cycle to propagate itself.
Now there's no, as far as I know, there's no concrete evidence that it makes, small mammal, er or cat urine, more desirable for us, but it has been shown to have correlatory effects, infection with various types of chronic condition and behaviour. So over the years, it's been identified as a risk factor for schizophrenia, for bipolar disorders, for epilepsy, chronic migraines, the strength of these relationships have been contested. I mean, a risk factor is just that, to what degree the risk is, it is, you know, open to a lot of debates.
It is important though, if members of the public are worried to stress, but these are risk factors, you know, if you test positive for toxoplasma, it doesn't definitely mean that you're going to get one of these conditions. It just means that if you take a group of people that are positive, they're more likely to get them than a group of people who are negative. There have also been links to increased, suicide risk and increased risk taking, whether that be beneficial risk taking, if you're the head of a top company, or whether, you know, if you're gambling, it's, it's sort of poor risk making decisions.
There have been, these links, that have been made. Again, the strength of them varies from study to study. You can imagine there are a lot of confounding factors there, you know, it's correlation, you know, there may be other factors, sort of common factors such as, say, cat ownership, or your diet.
Habits, you know, that are linked into these factors. But, you know, nevertheless, it's there. There's a sort of proposed mechanism by which it occurs, you know, not having toxoplasma is probably the better choice, you know, on, on balance.
It is an important take-home message that individuals are relatively unlikely to be infected by their own individual cat. So if we consider, sort of, you know, cat osis, which is the risk, and like, you know, people aren't going to eat their cats, so cat uses are the way that you're going to get infected from your cats, and the shedding takes place from a relatively short period of time, albeit large numbers that are going to persist in the environment, but still a short period of time. You know, most cats, but all Almost all of their life aren't going to be shedding.
So if we compare that with the, you know, much higher risk of contracting infection through eating, undercooked food, then, you know, we have to keep those two risks in perspective. Now, it has to be said that that risk is going to climb if you work with lots of cats. So, you know, if you're working with lots of cats, Cats every day and different cats every day.
So, say in a cattery environment, or, you know, in a, breeding establishment, then, you know, that risk is going to go up and you might want to take preventative measures, sort of good hygiene measures for that, but an individual cat is going to pro, is going to provide a very, very small risk. Congenital toxoplasmosis is probably the one that, you know, a lot of people are worried about, particularly if they're planning to get pregnant, if they're already pregnant. Now, you know, we absolutely can't give medical advice in that regard, but I mean, it, it is, you know, fair to say if people ask, it's important that we know that, you know, it can cause, you know, fatal, severe complications, with children infected in utero.
You can get ocular or cerebral complications or you can have issues throughout the whole body. It's severity depends on the trimester when infections are required. So in the first trimester normally results in miscarriage or abortion.
Second trimester, you know, you may have children that survive at birth, but with severe deficits, and then in the third trimester, it tends to be less severe, but you may have, lifetime complications and deficits. So, you know, being infected at any stage during pregnancy is a concern, but the stage does matter. Any detailed questions about the medical aspects of toxoplasmosis, though, you should always defer, to, you know, local health authorities, their GP or their nurse, you know, we really, the advice that we give has to be limited to, basic preventative advice.
We do need to be aware that if any of our owners are immune suppressed, they are going to be at higher risk. So opportunistic infections can be very severe in, sort of either children or adults. So, you know, so it'd be very severe in immune-compromised patients.
So those suffering from HIV, perhaps people undergoing chemotherapy, transplant patients, those are, who are on immune suppressives for immune mediated. Disease are going to be more likely to develop severe clinical toxoplasmosis as a result. So if they're not already infected, it may be worth considering sort of extra, you know, particularly good hygiene measures to try and ensure that infection doesn't occur.
So how can we advise clients and how much advice can we give? Well, we are going to get questions about it. I've actually in no capacity to my, you know, deep love of parasites.
I've had a couple of questions about toxoplasma in the past couple of weeks, and that really isn't unusual. It's high profile, clients are generally worried about pregnancy. That's what my two queries involved.
They had, a kitten and an adult cat, respectively. They were pregnant and they were worried about the relative risks of interacting with the cat and cleaning out the litter trays. In the press, cats are often painted as the villain, but as we've described, you know, it's relatively low risk and there's no reason why people and why pregnant people can't have a continued loving relationship.
With their cats, they do need to be more careful because although the risks are low, there are risks, but they absolutely don't need to put the cat out of the house, or ostracise their cats. They just need to be taking, you know, sensible measures. We can't give medical advice.
If people have specific medical concerns, then they absolutely need to go and seek advice from a human medical professional. But what we can do is put the risk in perspective. We can give very simple advice to reduce exposure risk.
And yeah, I think that that is completely reasonable. What I would advise though, because even within, I mean, I work in a, in a pretty small practise, but even in a small practise, different members of staff have been asked about toxoplasma, and it's well worth sitting down and making sure that the advice is being given and how much advice is being given is consistent across the whole practise. So what advice can we give?
Well, it's, it's 4 stages really, 4 key points that are gonna help to keep people toxoplasma free. So the first is thorough cleaning of litter trays. You want to get those litter trays cleaned as soon as that poo hits that tray, because then the uses aren't going to have time to develop if they're present.
So, you know, daily cleaning is just going to break that cycle and it's going to eliminate risk. Now, I mean, I think it's common sense to say that, you know, if you're pregnant and someone else can clean the litter tray out for you, they should, and that's certainly what we should be advising. If, you know, it's a pregnant person on their own, you know, they have no choice but to clean out the litter tray themselves, and it's a case of, you know, gloving up excellent hand hygiene.
If the tray is being cleaned out very regularly, then the risks from it are going to be very, very small. Good hand hygiene generally is just brilliant for reducing the risk of all sorts of faecal oral parasites, not just toxoplasma, but in this case, it is going to significantly reduce the risk of oocyst ingestion if we thoroughly wash our hands after handling cat faeces, if we've been around the bottom of cats, or, . So you know, if we're just sort of, you know, about to prepare food, you know, good hand hygiene, brilliant.
So that was just win-win. Thorough washing of fruit and vegetables intended for raw consumption. I mean, you know, it is just a wonderful thing if you're on the allotments and you've grown your lovely spring onion, just pull it out of the ground and think maybe I'll just have a little nibble, just have a try.
But it can be so difficult to know whether a cat has pooed on that area just Maybe a few days before. I mean, in which case, you know, you may have toxicara eggs there, and you may have toxoplasmarosis. So just thorough washing again can make a huge difference.
I mean, unless you're going to cook them. Cooking of meat is just, you know, a brilliant way of killing the tissue cysts that we're going to consume. And this is also true in terms of limiting, infection for cats.
So, you know, a lot of cats are going to get positive by going out and hunting, and it can be very, very difficult to prevent that from happening. But, you know, when we're feeding them their own food, at least, especially say if it's an indoor cat, then we can limit exposure by simply feeding them a cook to diet. Now, this feeds into the whole sort of raw debates, the transmission of parasites through raw diets.
You know, you don't have to cook meat to deactivate, tissue cysts. You just need to freeze them adequately first. So, you know, if you have a conversation about sort of raw diets, and people are very pro raw diets, maybe you're very poor at pro raw diet, and the cyst can be inactivated, by freezing to at least 20 degrees C for at least 2 days.
Now that isn't necessarily going to do for other parasite life stages, like tapeworms, Sort of, you know, in raw meat or offle, you need to freeze it for longer for those purposes, maybe minus 18 for 7 to 10 days, depends on the study you read, but just very cold for, you know, a reasonable length of time, at least 48 hours in the case of toxoplasma is going to kill those cysts. Be a little bit cautious about saying, particularly to pregnant women, well, you know, jobs are good and, you know, you can just freeze it, that'll kill the toxoplasma, and you're good to give it to your pet, because, you know, there are bacterial loads that are associated with raw diets as well. So this is where we have to be very cautious in terms of giving medical advice.
But in general, the transmission of toxoplasma, that adequate freezing before feeding is going to do the job. So in summary, toxoplasma gondii is everywhere. As coccidium protozoa makes it very adaptable, and it can infect a wide range, wide range of animals.
Cats though are the key in terms of being the definitive host, so they're the only host that's going to be shedding toxoplasma in their faeces, and that's going to be osis. And actually, disease syndromes in cats are uncommon, although, you know, pretty severe in the immune suppressed and just due to the sheer number of positive cats we're going to see in our careers, we are going to see a positive case at some point, so we should be aware of the possibility. Toxoplasma is a zoonosis with a really high public profile, one that's got there really without very much effort.
Although, you know, it should be said that the NHS and public health providers do a very good job of promoting simple precautions, and explaining the risks, to pregnant women that are coming into clinics. Human health risks can absolutely be minimised by very simple control measures, and any risks should be kept in perspective, but you know, while giving practical control advice to clients, but never, ever, ever give medical advice, however much anybody wants to show you their rash or they think they might already have toxoplasma, just don't go there. And then finally, I always like to give SAP UK and Ireland a plug, no non for profit company, and we give lots of parasite control advice, including toxoplasma, which we do get regular queries about.
So we have, toxoplasma fact sheets, information about toxoplasma is also in, guideline 6, our intestinal protozoa guideline. There are modular guidelines that you can go and have a look at for general parasite advice, but crucially, if you have any questions about toxoplasma or any other parasite, you can drop an email, an advice request into the SCAP UK and Ireland website, and we will do our very best to answer. So, thank you very much.
Thank you for listening. Thank you, Ian, for an informative session, so yeah, I did find it also interesting to know about the shedding process and the PCR testing available, and also the sensible measures, to be taken for exposure risk. We haven't had any questions this evening, but like as Ian has said, more than happy for anyone who does have questions at a later date, to pop on to the website www.SCAP.org.uk.
So, that will end tonight's webinar. We hope you all, enjoyed that session and thank you for joining us. I keep listening.