In Germany, National Reference Centers (NRC) and so-called Consulting Laboratories (CL) are appointed by the Robert Koch Institute (RKI) for defined infectious diseases or pathogens. The catalog of tasks focuses on advisory skills, epidemiological investigations and diagnostic services that go beyond routine.
The German Consulting Laboratory for Toxoplasma (CL-Toxo) answers an annual number of 250-300 medical requests and provides specialized diagnosis for 800-900 clinical samples. Requests and clinical samples come from all regions of Germany. Questions regarding the management of pregnancy-relevant Toxoplasma infections are currently in the focus of medical requests. They have become the basis for the creation of corresponding recommendations and guidelines established by the CL-Toxo together with the RKI and the Working Group for Obstetrics and Prenatal Diagnostics.
Surveys and epidemiological studies performed by the CL-Toxo together with partners (e.g. RKI, ToxoNet, DGHM) show that (i) seroprevalence rates are higher in East-German states, (ii) genotype II of Toxoplasma gondii predominates, and (iii) congenital infections are rare with fewer than 20 cases discovered annually in Germany. In addition, therapy initiated early can significantly reduce transmission from the mother to the child and symptomatic progression (<20% versus 70%). Amniocentesis and PCR detection of T. gondii only play a minor role in Germany.
In order to improve diagnostics, the CL-Toxo has developed, for example, the CGMC test to improve the detection of prenatally acquired infections, as well as recombinant antigens (e.g. SUB1) for general serological diagnosis.
In keeping with the network idea, besides the above-mentioned partners the CL-Toxo is currently involved in activities of the German Maternity Protection Committee and the Toxoplasma working group of the Paul-Ehrlich-Society.