title: Newborn screening for congenital Toxoplasma infection: five years experience in Massachusetts, USA.
abstract: Since 1986, all Massachusetts newborn filter paper blood specimens, and some from New Hampshire, have been screened for the presence of IgM antibodies to Toxoplasma gondii using an enzyme-linked IgM capture assay. Among approximately 530,000 infants screened, 40 had serologically confirmed congenital toxoplasma infection, and 4 additional infants had borderline serologies, for an overall identification and treatment rate of 1:12,000. False positive results from the newborn's filter paper specimen occurred in 22 infants (1/24,000); these were clarified by tests for IgM and IgG in serum specimens obtained 2-3 weeks later from the infant and mother. The screening program would have failed to detect 3 infants with severe infection who were diagnosed on clinical grounds prenatally or at birth and lacked IgM. No infants with a later diagnosis of congenital toxoplasmosis that was missed by screening are known to our statewide network of pediatric infectious disease consultants. Follow-up studies are in progress to evaluate more completely the sensitivity of the IgM assay in newborns and the efficacy of treatment.
authors.affiliation: New England Regional Newborn Screening Program, Massachusetts State Laboratory Institute, Boston 02130.
authors.forename: H W
authors.initials: HW
authors.lastname: Hsu
authors.forename: G F
authors.initials: GF
authors.lastname: Grady
authors.forename: J H
authors.initials: JH
authors.lastname: Maguire
authors.forename: B J
authors.initials: BJ
authors.lastname: Weiblen
authors.forename: R
authors.initials: R
authors.lastname: Hoff
mesh_terms: D000913:Antibodies, Protozoan / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005189:False Positive Reactions; D006801:Humans; D007231:Infant, Newborn; D008404:Massachusetts; D015997:Neonatal Screening / Q000379:methods*; D014125:Toxoplasmosis, Congenital / Q000175:diagnosis*
chemical_list: D000913:Antibodies, Protozoan