Toxoplasmosis (Hansard, 22 January 1992)

§ Mr. Ashley
To ask the Secretary of State for Health what is the estimated cost of toxoplasmosis disabilities to the national health service.

§ Mrs. Virginia Bottomley
The cost has not been estimated. It would be difficult to disaggregate the cost of toxoplasmosis from other costs involved in health care activities.

§ Mr. Ashley
To ask the Secretary of State for Health which health authorities in England provide(a) information on infectious disease during pregnancy and (b) specific information about the prevention of toxoplasmosis to pregnant women; which health authorities routinely test pregnant women for toxoplasmosis; which test pregnant women on demand for toxoplasmosis; and if he will require those authorities which do not screen to do so.

§ Mrs. Virginia Bottomley
All pregnant women seen at antenatal clinics receive a copy of the Department of Health's leaflet entitled "While you are Pregnant" and also a copy of the Health Education Authority's pregnancy book, both of which provide advice on the dangers of toxoplasmosis, and other infections, and on how to avoid catching this infection. Copies of both booklets are available in the Library.
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Health authorities do not routinely offer antenatal tests for toxoplasmosis. It is not known how many offer such a test on demand.
We have no plans to introduce screening of pregnant women for toxoplasmosis. The Department keeps this policy under review, and has sought the advice of experts. Their view is that there is no available evidence that the benefits conferred by screening clearly outweigh any risks involved.

§ Mr. Ashley
To ask the Secretary of State for Health what is the cost of the screening blood test for toxoplasmosis.

§ Mrs. Virginia Bottomley
The most commonly used screen for toxoplasmosis is the latex agglutination test. The cost of purchasing a commercial kit for this test is of the order of £35 per 20 tests; this cost does not take account of clinic, transport, laboratory and reporting costs. Should this test give a positive result there is then a need for confirmatory testing. Additional costs for such confirmatory testing could be of the order of £20 per patient.

§ Mr. Ashley
To ask the Secretary of State for Health (1) what action the Government are taking to improve the knowledge of health professionals, and especially general practitioners and midwives, about the prevention, treatment and diagnosis of toxoplasmosis;

(2) if he will implement a campaign to educate pregnant women and their health carers about toxoplasmosis and its prevention in England;

(3) if he will conduct a survey into the amount and quality of counselling provided in each health authority to pregnant women infected with toxoplasmosis;

(4) what information his Department has provided to general practitioners regarding the implications of a toxoplasmosis infection for pregnant women.

§ Mrs. Virginia Bottomley
The Department recently published a new leaflet designed to encourage pregnant women to take precautions when handling and consuming food and to ensure safe contact with animals. The leaflet entitled "While you are pregnant: safe eating and how to avoid infection from food and animals" gives advice on toxoplasmosis and other infections. Women will be given copies as soon as their pregnancy is confirmed. The leaflet is available from antenatal clinics, maternity units and GP practices. Doctors and midwives may also give the leaflet to women who are planning to become mothers. Copies of the leaflet are available in the Library.
The Royal College of Obstetricians and Gynaecologists has convened a working party which includes representatives from other Royal Colleges and professional associations, and which will be producing guidance on toxoplasmosis for professionals. We have no intention therefore to conduct a survey into existing counselling activities within health authorities.

§ Mr. Ashley
To ask the Secretary of State for Health what is his estimate of(a) the number of women who suffer an infection of toxoplasmosis during pregnancy and (b) the number of of babies born with an infection of toxoplasmosis; and on what information these estimates are based.

§ Mrs. Virginia Bottomley
A recent review of studies conducted in the 1970s and 1980s in a number of localities230W suggested an incidence of toxoplasmosis infection in two of every 1,000 pregnancies. However, this information may not apply nationally in the 1990s: there has been some evidence from Britain and Europe that there may be a downward trend in the incidence of toxoplasmosis in the population generally. A review by the Public Health Laboratory Service of laboratory reports for 1988 identified 13 possible cases of congenital toxoplasmosis in new born babies. A PHLS/British paediatric surveillance unit study between June 1989 and May 1990 suggests that approximately 14 babies present in the first year of life with symptomatic congenital toxoplasmosis. The number of asymptomatic infants with congenital toxoplasmosis born each year is unknown at present.

§ Mr. Ashley
To ask the Secretary of State for Health if he will list the disabilities known to occur, either immediately or at some later stage of life, in babies born with a toxoplasmosis infection.

§ Mrs. Virginia Bottomley
In most healthy individuals newly acquired toxoplasmosis infection is asymptomatic or presents with non-specific signs or symptoms. When acquired in pregnancy, toxoplasmosis can cause fetal infection. In most cases the condition is not severe, but in rare instances it can cause potentially serious damage to the newborn infant. Such damage can range from hydrocephalus, severely impaired vision and neurological impairment, to small size for gestational age, deafness, epilepsy and physical disability.

§ Mr. Ashley
To ask the Secretary of State for Health what is the total expenditure on health education regarding toxoplasmosis; and if he will give a breakdown of the expenditure.

§ Mrs. Virginia Bottomley
The Department produces the booklet "While you are Pregnant" and the Health Education Authority produces the pregnancy book, copies of which are available in the Library, both of which are given to women attending on their first visit to an antenatal clinic. Both publications contain guidance on how to avoid toxoplasmosis. Advice from doctors and nurses is available to women at the GP's surgery and at antenatal clinics where posters about toxoplasmosis are displayed. It is not possible to disaggregate costs associated with health education regarding toxoplasmosis from other health education costs.
The Department also funds the Toxoplasmosis Trust for its activities in advising the public on the risks associated with the disease. The sum of £10,000 has been granted to the trust in each of the years 1991–92, 1992–93 and 1993–94.

§ Mr. Ashley
To ask the Secretary of State for Health what plans his Department has for a multi-centred study to examine the rates of pre-pregnancy immunity to toxoplasmosis, the prevalence of sero-conversion during pregnancy, and the numbers of babies born infected each year.

§ Mrs. Virginia Bottomley
Information on how many severely affected infants are born each year in this country is being gathered under the British Paediatric Association surveillance scheme. Consideration is also being given to priorities for research or screening for a variety of conditions including toxoplasmosis. There are no plans at present to start any other surveys or information collection exercises.
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§ Mr. Ashley
To ask the Secretary of State for Health what research into toxoplasmosis is supported by his Department; and what financial support is provided by his Department to the Toxoplasmosis Trust.

§ Mrs. Virginia Bottomley
The main agency through which the Government support biomedical and clinical research in the United Kingdom is the Medical Research Council which receives its grant-in-aid from the Department of Education and Science. The Public Health Laboratory Service, which is funded by the Department of Health, is conducting research to improve tests for the diagnosis of toxoplasmosis infection.
The Toxoplasmosis Trust has been awarded a grant by the Department of Health of £10,000 per annum for 1991–92, 1992–93 and 1993–94.