Wayne Smith was sick. Again. Just four years old, he’d already had a hair-raising helter-skelter ride with his health: flu symptoms, lung infections, stomach aches, a sore throat and skin rashes. Despite several visits to the doctor and course after course of antibiotics, it seemed his immune system was giving up the fight.

It’s no wonder his parents Yolandie and Stephen Smith and his granny, Liana Olivier, were feeling sick too – out of sheer concern.

“We were frantic,” says Liana, who had to return from Qatar, where her husband works as a shift co-ordinator, to support the family. “No one could tell us what was really wrong and we had no idea what to do next.”

When strange lumps appeared on Wayne’s side and under his right armpit, another trip to the doctor and more antibiotics followed. But the little boy didn’t improve.

“In one year Wayne missed six months of preschool. Every three weeks he developed a respiratory tract infection, for which antibiotics were prescribed,” Liana says. “He had no energy, cried all the time and was really ill. When a paediatrician finally referred us to a surgeon we started to fear the worst.

With the appearance of the lumps the possibility of cancer was mentioned and they were removed. As the family waited for the test results, Wayne’s condition deteriorated.

Finally, the results came back: Wayne had toxoplasmosis.

What is toxoplasmosis?

Toxoplasmosis is an infection caused by a single-cell parasite called Toxoplasma gondii, which is spread by cats. While most domestic animals – including dogs, hamsters and birds – can carry the disease, only cats shed the infection-causing eggs in their droppings. People are exposed to the eggs when they come into contact with cat faeces – for instance when cleaning litter boxes or playing in sandpits in which cats might have buried their business.

Cats such as Wayne’s Tom and Micky.

Once the diagnosis was made, it was easy for the family to trace the origin of Wayne’s infection: Tom and Micky regularly went hunting on a nearby golf course. They would return with their prey, often rats, to present to their owners with pride.

“They often ate the rats in the house during the night and we’d find the evidence in the lounge in the morning,” Yolandie explains. “As far as we know Wayne never went near the rats but the cats often slept on his bed.”

Small animals are often infected with toxoplasmosis. Then they, the hunted, pass on the parasite to the hunters, in this case Tom and Micky.

When it comes to a child’s health a faceless foe is terrifying for a parent. But because toxoplasmosis is fully treatable with the correct antibiotics, Wayne was soon on his way to a clean bill of health when the parasite was revealed and the problem identified.

Bye-bye Kitty?

So does the risk of toxoplasmosis mean you should start looking for a new home for your cat?

“No,” says Dr Andrew Whitelaw, a medical microbiologist. “If care is taken to avoid contact with cat faeces, Kitty definitely doesn’t have to be given the boot.”

Rough statistics show an average of about one in four people is thought to be exposed to toxoplasmosis but most become naturally immune. This means your immune system keeps the parasite from making you ill and very few people have any symptoms at all.

The implication? Not every child or adult who comes into contact with an infected pet will contract the disease. But if your immune system is compromised, you’re at risk of infection. And that’s exactly what happened to Wayne.

Repeated respiratory tract infections, sore throats and colds had weakened the boy’s immune system, making him a prime target for toxoplasmosis. As to where the infection originated, that is as impossible to answer as the old chicken-or-egg conundrum.

How to identify toxoplasmosis

Many people are infected with toxoplasmosis and simply don’t know it. Dr Whitelaw stresses the symptoms are very easily confused with those of flu and therefore often go unrecognised. That said – and although the condition is rare – don’t ignore nasty, nagging colds and flu symptoms that won’t respond to antibiotics or other medication.

If you can add exposure to cats to the puzzle, it might be time to consider a toxoplasmosis test.

People such as Wayne who are immune-compromised experience severe symptoms, including fever, headache, confusion, sleepiness, weakness or numbness in parts of the body, seizures, poor coordination and changes in vision. In the most rare and severe cases, these symptoms can progress to coma and even death unless the infection is diagnosed and treated in time.

So what’s a perplexed parent to do? And how do you ensure a timely diagnosis?

It’s simple: your doctor will recommend a blood test to identify the presence of the antibodies that kill the parasite. A positive result doesn’t necessarily indicate an active infection – but it does show that you’ve been infected by the toxoplasmosis parasite in the past and could be at risk in the future.

On the other hand a negative test result indicates you’re at very low risk of developing the infection. Four-year-old Wayne was finally diagnosed by a positive test.

How to live in health and harmony with your cat

    • Make sure the litter box is cleaned daily by someone who is neither pregnant nor immune compromised. Wear gloves and wash your hands thoroughly with soap and water afterwards.

    • Keep the litter box away from the main living areas – preferably outside or in an area accessible to the cat but not to toddlers or young children. Install a cat flap in the door leading to a veranda where the litter box can be kept.

    • Cover sandpits when not in use. Sand and soil are where young children are most likely to come into contact with cat faeces.

    • Cats can become infected with toxoplasmosis when they catch and eat small animals. So try to keep your cat indoors at night to prevent it from hunting – a natural nocturnal instinct.

    • Feed your cat only cat food or cook meat thoroughly before giving it to your cat. Raw or undercooked meat could harbour the parasite.

    • When acquiring a cat, choose one that’s healthy and at least a year old. A screening test can be done to find out if the cat has antibodies to the toxoplasmosis parasite. A negative result means the cat hasn’t been exposed to the organism. Avoid stray cats and kittens as they’re more likely to be infected.

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