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In California, rate of diagnosed congenital toxoplasmosis low
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From 1998 to 2012, only two cases of clinically identified congenital toxoplasmosis were seen in children born in California, according to recent findings.
“Although we found a low rate of diagnosed congenital toxoplasmosis in northern California, population-based studies to evaluate rates of the disease in other geographic areas would be beneficial,” the researchers wrote in Emerging Infectious Diseases.
Although congenital toxoplasmosis is found throughout the United States, there are little data on the rates of diagnosed disease. To quantify the rates, the researchers gathered 15 years of data on children aged from birth to 2 years within the Northern California Kaiser Permanente Medical Care Program (KPNC), which provides care for more than 3.2 million people.
Using the KPNC electronic medical records database, the researchers evaluated potential toxoplasmosis cases, identifying 2,010 infants younger than 24 months who had undergone at least one test for toxoplasmosis. Ten infants met the potential case criteria: ICD 9-CM codes related to toxoplasmosis or congenital infection.
A review of the electronic and paper medical records confirmed two cases of congenital toxoplasmosis from 1998 to 2012, putting the 15-year rate of diagnosed congenital toxoplasmosis at 3.8 per million live births (95% CI, 1.5-9.2).
Both patients with diagnosed toxoplasmosis were girls; one was diagnosed in 2003 and the other in 2011. The records showed that both girls had immunoglobulin G persistently detected after age 1 year. They were monitored for retinochoroiditis, the researchers wrote.
There was no information on maternal exposure or risk factors. No infant deaths were attributed to toxoplasmosis. The investigators could not study fetal death rates because the corresponding cause-of-death codes were not available.
These findings should be considered only a minimum estimate of congenital infection because they could only identify clinically apparent cases, according to the researchers.
“The small number of cases makes the rate of diagnosed congenital toxoplasmosis somewhat imprecise; a few missed cases would increase the rate considerably,” they wrote.
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