Meduni Vienna: Toxoplasmosis-Screening at the MedUni Wien significantly reduces infection rate

22 years ago, the globally unique Toxoplasmosis Register was established at the MedUni Wien, where all pregnant women in Austria suffering from acute toxoplasma infection and children who acquired the infection in the womb are recorded. With the aid of this screening and the associated preventive measures, the cases of congenital toxoplasma infection have since been considerably reduced: While there were 78 infections per 10,000 live births in the past, only one in 10,000 infants is affected by this disease today.

This track record at the University Clinic for Children and Juvenile Medicine at the MedUni Wien (Toxoplasmosis laboratory and after care centre) has now been compiled and published by Andrea-Romana Prusa and David Kasper in a study in the top journal "Clinical Infectious Diseases".

"The efficiency of the Austrian therapy scheme could also be verified", says Prusa. "The anti-parasitic therapy for pregnant women and children is well tolerated. The child therapy allowed the occurrence of the classic triad of retina infection, cerebral calcification and hydrocephalus to become a rarity. Furthermore, it also worked as an effective prevention strategy." Serious cases of Toxoplasmosis have, in the meantime, become much rarer in Austria.
Another positive factor: "The register provides us with an overview of all infections during pregnancy and the outcome of the children since 1992."

Single cell parasite as pathogen
Antibodies are formed in the blood of women who once had a toxoplasma infection. They are therefore practically immune to infection and the foetus is protected. However, the initial infection of the mother during pregnancy can lead to considerable harm to the unborn child - even causing a miscarriage. Every fourth infected child has a mental and/or physical impairment.

The pathogen of toxoplasmosis is a single-cell parasite (toxoplasma gondii), which is spread worldwide and can infect many vertebrates as well as human beings. So-called final hosts of the parasite are domestic cats, who excrete the eggs of the parasite with their faeces. Through the soil, the eggs also reach livestock, where - among other symptoms - they form tissue cysts in the muscles. People can either become infected through oocysts in cat faeces and thus contaminated soil, or through cysts in raw or medium-cooked meat.

A healthy adult is normally unaware of the infection. Rare cases develop a swelling of the lymph nodes, joint and muscle aches as well as flu-like symptoms. However, the infection can lead to life-threatening symptoms for people with an immune system deficiency. The infection is diagnosed by a blood test. In Austria, each pregnant woman is examined for a toxoplasma infection in the context of the mother-child pass. The first examination ideally occurs prior to the 9th week of pregnancy. Women who are not infected should be tested regularly throughout the pregnancy.

Service: Clinical Infectious Diseases
The Austrian Toxoplasmosis Register, 1992-2008. Prusa AR, Kasper DC, Pollak A, Gleiss A, Waldhoer T, Hayde M. Clin Infect Dis. 2014;pii:ciu724.

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