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Billions of people around the world love cats, but kitty litter can pose a serious health problem of which most people are only vaguely aware.

Dr. E. Fuller Torrey, medical director at the Storey Research Institute, warns that cat feces may be the source of an enormous, unnoticed public health problem.

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Every year, Torrey says, cats in the USA alone produce 1.2 million tons of feces. This cat scat harbors eggs of a parasite called Toxoplasma gondii. Even where cats don't leave visible traces of toileting, each square foot of the ground in urban yards and parks tested in a sampling of locations over the United States, a recent study found, contains from 4 to 434 oocytes, parasite eggs with a tough coating that keeps them viable for several years. 

It only takes one oocyte to cause an infection with the disease called toxoplasmosis, and every single square foot of ground in urban areas offers, on average, 400 opportunities for cats, and humans, to pick up this parasitic disease. Controlling cat poop, Dr. Torrey says, needs to be a much higher priority for public health officials all over the world where cats are kept as pets, and especially in the United States.

What is toxoplasmosis?

Toxoplasmosis is an infection with the parasite Toxoplasmo gondii. a single-celled organism called a protozoan that establishes itself inside human cells.  About 1 in every 3 people around the world has a toxoplasmosis infection, usually after exposure to cat litter at some point in life, typically in childhood. It is also possible to be born with the infection. 

Toxoplasmosis can occur in humans, cats, rats, dogs, land animals, sea animals, and birds, and it is reported in every continent of the world except Antarctica--it does not affect penguins.

What are the symptoms of toxoplasmosis?

The first case of toxoplasmosis was identified in 1923 in an infant who suffered swelling of the brain (hydrocephalus), loss of vision, and seizures. Usually, however, the symptoms of the infection are much less severe. There can be swelling of the lymph nodes, usually less than 3 cm (less than about 1-1/4 inch), and the nodes are typically not tender. There can be a sore throat, mild abdominal pain, and irritation of the retina. Unless there is some kind of compromise of the immune system, even these symptoms are of only short duration.

When the immune system is compromised, however, toxoplasmosis can cause severe symptoms. In non-AIDS compromise of the immune system, toxoplasmosis results in neurological symptoms about 50% of the time. There may be seizures, and paralysis on one side of the body, similar to stroke. 

The infection can cause cough, shortness of breath, flu-like symptoms, and pneumonia. This is the reason people are asked to give up their cats before they have heart, lung, liver, or other transplants.

In people who have HIV or AIDS, the symptoms of infection are even more severe. There can be movement disorders, "cerebellar signs" (difficulty standing or sitting, tendency to fall backwards, among other problems with movement), profound weakness, alterations of vision, and psychiatric problems.

And in children who are born with the infection, about 70% will have no problems at all, but about 30% will experience some degree of vision or hearing loss if they do not get timely treatment. 

Toxoplasmosis is sometimes referred to as "crazy cat lady syndrome," and it actually is associated in some cases with eccentric behavior.

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