2588. Acute Toxoplasmosis among Pregnant Arab Women in Northern Israel: to Screen or Not?

BACKGROUND: The seroprevalence of toxoplasmosis among Israeli Arabs is high. Yet, the regulation of the Israeli Ministry of Health suggests not screening pregnant women for toxoplasmosis. During 2017/8 we have seen a surge in cases of acute toxoplasmosis in pregnancy in Northern Israel. We aimed to explore this surge and compare the rates of acute toxoplasmosis in pregnancy in Northern Israel among Jews and Arabs. METHODS: The database of the lab of Meuhedet HMO (Northern Israel only) was retrospectively screened for all tests for Toxoplasma serology during 2013–2017. We focused on women of childbearing age and compared rates of seropositivity in Jews and Arabs. IgG and IgM were carried out using Abbott Architect, and IgG avidity by Vidas, BioMerieux. Birth rates were retrieved from the central computer of Meuhedet HMO. RESULTS: : In 2017, Northern Israel had 1,397,833 citizens of whom 53% were Arabs. Of this population, 13% were insured by Meuhedet HMO, and of these 60% were Arabs (Muslims or Christians). During the 5-year period 16,044 Toxoplasma serology tests have been requested (both sexes), of which 26% returned IgG positive. 88% of the positive ones were of Arab citizens (P < 0.0001). Excluding duplicates, we found 118 women of childbearing age with a positive IgM test (2.8%). Of the latter, 37 had a low/medium avidity test (31.4%). 112 of the women were Arabs, while only 6 were Jews (P < 0.0001). Two-thirds of the women had a positive βHCG test at the same time. During this 5-year period there were 23,074 live births in this HMO (11,512 Arab newborns). Thus, had all these women delivered an infected newborn, the rate of congenital toxoplasmosis in the Arab population (97.2/10,000) was 19-fold higher than among the Jewish (5.2/10,000; P < 0.00001). Interview of 35 acute cases during 2017/8 revealed that most of the women had consumed raw meat called “Kibbe Niyye”—a popular dish unique to Northern Israeli Arabs (Galilee) and served on festive occasions. CONCLUSION: We found that Northern Israeli Arab women are at a high risk to contract toxoplasmosis during pregnancy due to consumption of traditional raw meat. This finding calls for awareness among women as well as doctors. We believe that the regulation not to screen pregnant women in the Arab sector should be reevaluated. DISCLOSURES: All authors: No reported disclosures.