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The indirect immunofluorescence test (IIFT) was used for screening to detect specific antibodies of all immunoglobulin classes. In case of seropositivity (titre ��1:16) a second specimen collected >2?weeks later was checked for any titre rise. If the titre increased or if it was ��1:64 already in the first test, an IgM test (VIDAS TOXO IgM) was performed, and if this IgM test was not clearly negative, an IgG avidity test (VIDAS TOXO IgG AVIDITY) was carried out. A negative result for IgM or positive IgM but high avidity index was assumed to rule out acute infection Histone demethylase (all tests from bioM��rieux, Marcy-l��Etoile, France; before October 2004 an in-house IIFT test was used). A case was regarded as a ��suspected case�� if the test constellation was: IIFT positive, IgM positive and avidity low. If seroconversion or a more than fourfold titre rise in IIFT during pregnancy had occurred, we classified the case as a ��certain case��. Based on these definitions, suspected cases included also certain cases. We used locally weighted regression to visualize the changes in weekly incidence of toxoplasmosis over time and to estimate the seasonal trend during a calendar year. Since the overall number of examinations did not change over the studied period, we used Poisson distribution selleck chemicals llc to model the incidence of toxoplasmosis cases. The analysis was conducted with R-library gam [7]. In total, there were 191 suspected cases, including 51 certain cases of acute toxoplasmosis infections in our study population. In 45 of the 51 certain cases seroconversion was observed. There was substantial variability across time in the weekly incidence of suspected cases, with a higher incidence during the winter months (Fig.?1). This was confirmed in the seasonal trend analysis, with a more than two times higher incidence of toxoplasmosis during the winter months (Fig.?2, p-value Enzalutamide cost borderline evidence supporting higher incidence in every second year (Fig.?1). The results were similar when the analysis was restricted only to certain cases (data not shown). In the cases when seroconversions (n?=?45) were documented, the mean duration between the last seronegative and the first seropositive result was 102?days (range 30�C181?days). Our findings confirm the seasonality in diagnosis of acute toxoplasmosis infections during pregnancy observed by Logar et?al. [6] in Slovenia using an independent sample from Upper Austria.