Prevention of prenatal toxoplasmosis by serological screening of pregnant women in Austria.

In 1975 Austria introduced an obligatory serological screening of pregnant women for toxoplasmosis. Every woman is tested for antibodies at the beginning of her pregnancy and, in case of seronegativity, again in the second and third trimester. Basic tests are--alternatively--Dye test (SFT) and Indirect Fluorescent Antibody test IFAT); for further clarification, complement fixation test (CFT) and, particularly, various tests for detection of specific IgM and IgA antibodies and, in certain cases, for circulating antigen are carried out. If a primary Toxoplasma gondii infection of the pregnant woman is suspected, immediate therapy--with spiramycin before the 16th week of gestation and with pyrimethamin plus sulfadiazin after the 15th week of gestation--is carried out. Before the introduction of the screening programme, the incidence of prenatal toxoplasma infections was 50-70 per 10,000 births, presently it is below 1 per 10,000 births. Seropositivity among pregnant woman has decreased from almost 50% at the end of the seventies, to 36.7% in recent years (1989-1991). The percentage of suspected primary infection during pregnancy has, however, in the same period increased from less than 0.4% to 0.83%.