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During my last pregnancy, my obstetrician gave me strict instructions not to clean the kitty litter box until after the blessed event. This was a no-brainer for me, since I didn't own a cat, and I certainly didn't plan to volunteer to clean anyone else's litter box at the time. But for many women with a feline family member, being taken off litter box duty for nine long months can present something of a problem.

There's a good reason to avoid kitty litter during pregnancy. You could contract toxoplasmosis, a condition also known as litter box disease. The illness is caused by the organism Toxplasma gondii, a parasite that multiplies in cat intestines and is excreted via feces into cat litter.

Cats who are kept indoors and fed strict diets of commercial cat chow usually don't become infected with the organism. But cats that are allowed to roam outside may get infected when they snack on rodents, birds and other prey. You and your cat can also acquire the illness if you partake of non-pasteurized dairy products or raw or undercooked meat, especially pork and lamb.

Toxoplasmosis can infect virtually any type of warm-blooded animal. Despite being one of the most common infections in the world, it usually doesn't cause significant illness in any species. But it can be devastating -- even deadly -- for an unborn fetus.

Although many people with toxoplasmosis don't even know that they're ill, some folks may feel as if they've come down with a mild case of the flu. Signs and symptoms of toxoplasmosis can include any combination of swollen lymph glands, rash, fever, headache, cough, sore throat and nasal congestion.

The illness typically passes in a matter of days, and normally doesn't create any long-term complications.

But the disease is of special concern to pregnant women because it can cause miscarriage, premature births or birth defects in unborn children.

Problems usually arise only when a woman is infected just before or during her pregnancy. If a mother-to-be contracts the disease early in her pregnancy, she's less likely to transmit it to her fetus. But if she does, it's much more likely to cause serious injury to her unborn child.

An infected fetus can suffer serious birth defects, including vision or hearing loss, mental retardation, and even death. Toxoplasmosis is more easily transmitted to the fetus in the last stages of pregnancy, but at this point, the infection isn't likely to cause any real harm.

If an infection with toxoplasma is suspected during your pregnancy, your doctor can perform several types of tests to make the diagnosis. Samples of fetal blood or amniotic fluid may be analyzed, and ultrasound studies of the unborn baby can often detect signs of fetal involvement.

If the diagnosis of toxoplasmosis is confirmed, antibiotics may be prescribed to reduce the chances of complications.

According to the American College of Obstetricians and Gynecologists, infection with the toxoplasma organism during pregnancy is relatively rare, affecting around one in 1,000 expectant women.

Fortunately, about a third of all adult American women have protective antibodies against toxplasmosis as a result of a previous exposure, which lessens their chances of acquiring the disease during pregnancy. The percentage of immune women is probably even higher among cat owners.

If you contracted toxoplasmosis more than six months before getting pregnant, you're probably home free. Once the infection passes, you should be immune for life. You're unlikely to transmit the disease to anyone, including your unborn baby.

Since it's always better to be safe than sorry, women should take a few extra precautions during pregnancy. To avoid acquiring the parasite that causes toxoplasmosis, expectant mothers who are also cat owners should take a 9-month sabbatical from litter box duty.

Even avoiding direct contact with kitty litter doesn't totally guarantee against infection. The Toxoplasma gondii organism remains active for weeks after it is excreted in cat feces, and it may be transmitted in an airborne form, which can be inhaled. For this reason, it's a good idea to put the litter box in the garage or another isolated area.

Mothers-to-be should also avoid playing in sandboxes and working in gardens that cats may have used for litter boxes. Washing up with plenty of soap and warm water after petting cats and kittens is a good habit to acquire.

Becoming pregnant doesn't mean you that have to banish your feline friends from the family; you just have to make a few healthy adjustments.

Dr. Rallie McAllister is a family physician in Kingsport, Tenn. Her column appears three times a month on this page.

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