How about you change the litter box? How to respond after the reply is NO

While waiting for the vet, I decided to explore some pamphlets displayed on the office wall.  Although this was first discovered in the late 1960’s, I was unaware of the potential consequences of exposure to Toxoplasma gondii.  Toxoplasmosis, which is caused by T. gondii, is a parasitic zoonotic disease.  This rare, but serious blood infection may be of particular relevance if you are 1.) a cat owner and 2.) plan to become pregnant.  Domestic cats are a primary host of T. gondii.  Cats are infected as a result of consuming infected animals, such as rodents or birds.  Other sources of concern consist of unpasteurized milk or uncooked meat.

 The CDC has some helpful tips if you meet the above criteria:

• Avoid changing cat litter if possible. If no one else can perform the task, wear disposable gloves and wash your hands with soap and warm water afterwards.
• Ensure that the cat litter box is changed daily. The Toxoplasma parasite does not become infectious until 1 to 5 days after it is shed in a cat's feces.
• Feed your cat commercial dry or canned food, not raw or undercooked meats.
• Keep cats indoors.
• Avoid stray cats, especially kittens. Do not get a new cat while you are pregnant.
• Keep outdoor sandboxes covered.
• Wear gloves when gardening and during contact with soil or sand because it might be contaminated with cat feces that contain Toxoplasma. Wash hands with soap and warm water after gardening or contact with soil or sand.

Not surprisingly, if you have been exposed to the parasite before gestation, your immunity may protect your unborn child.  This likely plays a factor in one of the above tips, “Do not get a new cat while you are pregnant”.  Unfortunately, if you aren't immune and are exposed while pregnant, infection is likely to result.  In the U.S., it is estimated that between 1 per 1,000 and 1 per 8,000 babies are born with toxoplasmosis.  Infected offspring can be asymptomatic at birth, but might develop blindness or mental disability later, and in some cases, eye or brain impairment may exist at birth. 

As expected, IgE mediates the killing of intracellular T. gondii.  A few interesting studies have shown increased levels of IgE and cytokines, IL-5, IL-6 and very elevated levels of IL-10 among infected patients. 

Ultimately, if you are pregnant, now you have peer-reviewed evidence as to why you shouldn't change the litter box. 

References

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109627/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2685994/

http://www.cdc.gov/parasites/toxoplasmosis/gen_info/pregnant.html

http://www.americanpregnancy.org/pregnancycomplications/toxoplasmosis.html

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0018289