1622. Increase in Congenital Toxoplasmosis and Acute Toxoplasmosis Among Pregnant Women in the US during the COVID-19 pandemic

Abstract Background During the COVID19 pandemic a rise in diverse opportunistic infections has been described Methods In this retrospective cohort study, we analyzed the trajectory of new congenital toxoplasmosis (CT) cases and cases of acute toxoplasmosis among pregnant women (AT-P) during the COVID19-pandemic (2020-2022) compared to a pre-pandemic period (2000-2019). We perused data from the Remington’s Laboratory, the National Reference Laboratory for Toxoplasmosis in the US. We calculated the yearly number of cases of CT and AT-P; the incidence rate (IR) of CT and AT-P (IR=number of cases/total number of children < 12 months or pregnant women respectively tested by the Toxoplasma IgG-Dye test). We used ARIMA time-series models to compare the trajectory slopes between the two periods. Results In the pre-pandemic period there were 196 CT cases among 8194 tested children< 12 months and 814 AT-P cases among 33,345 pregnant women. The respective numbers during the pandemic were 43 CT among 1833 tested children < 12 months and 65 AT-P among 1983 pregnant women. In 2022 we had the largest number of CT cases (21 CT in 2022 vs 6 in 2019) and similarly a high number of AT-P cases (22 AT-P in 2022 vs 16 in 2019)(Fig 1). This increase occurred, despite a drop in the total number of samples tested in the Lab ≥2020, due to programmatic changes in one major Lab client (Fig 2). The yearly IR of CT increased during the pandemic, from 1.05 cases/100 tested (6/574) in 2019 to 3.71 cases/ 100 tested (21/566) in 2022. The yearly IR of AT-P also increased during the pandemic, from 1.35 cases/ 100 tested (16/1183) in 2019 to 3.79 cases/100 tested (22/580) in 2022 (Fig 3). There was a positive trajectory-slope trend in CT and AT-P during the pandemic. This occurred after a preceding negative trajectory-slope trend in AT-P in the pre-pandemic period.Figure 1:Number of Congenital Toxoplasmosis and Acute Toxoplasmosis during Pregnancy cases: 2000-2022Figure 2:Toxoplasmosis IgG Dye tests in Pregnant Women and in Children <12 months of age: 2000-2022Figure 3:Incidence Rates of Congenital Toxoplasmosis (IR-CT)and Acute Toxoplasmosis During Pregnancy (IR-AT-P): 2000-2022 Conclusion During the pandemic, there was a rising trend in CT and AT-P cases diagnosed in the National Reference Lab for toxoplasmosis in the US. In 2022 there was a peak in the CT cases. The etiology remains unclear. A possible increase- during the lockdowns-in the contact of pregnant women with cats and/or a possible limited prenatal-preventive-guidance during the pandemic due to possible disruption in prenatal care services, could have been contributing factors. These trends need further monitoring. Disclosures All Authors: No reported disclosures