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STORCH
Congenital infections that can
cause birth defects
Syphilis
• Is an infectious disease. The bacteria that
causes it spreads through broken skin or
mucous membranes. It is most often spread by
sexual contact.
• Pregnant mothers infected with the disease can
pass it to the baby developing in their womb.
This is called congenital syphilis.
• Syphilis is widespread in the United States. It
mainly involves sexually active adults between
ages 20 to 29.
Syphilis
Syphilis sore
Symptoms
• The symptoms of syphilis depend on the stage
of the disease. Many people do not have
symptoms.
• In general, painless sores and swollen lymph
nodes are symptoms of primary syphilis. Those
with secondary syphilis may also have fever,
fatigue, aches and pains, and loss of appetite,
among other symptoms. Tertiary syphilis
causes heart, brain, and nervous system
problems.
Dangers to Fetus
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Infant skin lesions
Lymph node enlargement
Multiple organ problems
Most characteristic = skeletal
abnormalities
• Vision/hearing problems
• 25% of infants die in first few months
Toxoplasmosis
• Is an infection due to the parasite Toxoplasma
gondii .
• Is found in humans worldwide, and in many
species of animals and birds. Cats are the
definitive host of the parasite.
• Human infection may result from:
• Blood transfusions or solid organ transplants
• Carelessly handling cat litter
• Eating contaminated soil
• Eating raw or undercooked meat (lamb, pork,
and beef)
Toxoplasmosis
Toxoplasmosis
• Healthy individuals do not usually display
symptoms. When symptoms do occur,
they are usually mild, resembling
infectious mononucleosis , and include the
following: enlarged lymph nodes muscle
pains fever that comes and goes general
sick feeling tired
Prevent your cats from getting
toxo
• Feed them dry or canned cat food and
keep them indoors.
• Cats can become infected by eating or
being fed raw or undercooked meat that is
infected with the parasite, or by eating
infected prey such as birds or rodents.
• Any cat that is allowed access to outdoors
should be kept off beds, pillows, or other
furniture that you also use.
Damage to Fetus
• A pregnant host has a 40-60% chance of
transmitting the infection to baby w/
serious damage
– 1st trimester=fetal death or severe impairment
– 1st or 2nd = eye abnormalities, hydrocephalus,
seizures
– 3rd = often no impairments
Other
• Viruses including varicella zoster which
causes chicken pox and shingles; polio
– Miscarriage
– Visual impairments
– Cerebral palsy
– Deaf-blindness
Chicken Pox
Chicken Pox on Adult
Chicken Pox on Infant
Rubella
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Symptoms could include:
Rash
Runny Nose
Red Rash
Swollen Lymph Nodes
Fever
Pain
Headache
Joint Pain
Malaise
Bruises
Muscle Pain
Eye Redness
Body Ache
Bruises Easily
Feels Hot to Touch
Perianal Rash
Rubella
• Most common viral cause of birth defects until 1969
when vaccination program began
• 80% risk of transmission to fetus during 1st trimester;
majority sustaining damage
• After 16th week risk of severe impairment declines; fetus
may acquire the infection without sustaining disability
• Impairments range from none to several and include;
visual impairments, hearing defects, deaf-blindness,
abnormalities of lungs and kidney, seizures, CP
• Some impairments may have later onset and include;
encephalitis and lack of motor coordination
• No effective antiviral treatment for rubella
Signs and tests
• A nasal or throat swab may be sent for
culture.
• A blood test can be done to see if a
person is protected against rubella. All
women who may become pregnant should
have this test. If the test is negative, they
will receive the vaccine.
Rubella
Rubella on infant
Rubela on infant
Cytomegalovirus
• CMV is an extremely common organism worldwide. It is
believed that about 85 percent of the adults in the United
States have been infected by CMV at some point in their
lives. CMV is found in almost all of the body's organs. It
is also found in body fluids, including semen, saliva,
urine, feces, breast milk, blood, and secretions of the
cervix (the narrow, lower section of the uterus).
• CMV is also able to cross the placenta (the organ that
provides oxygen and nutrients to the unborn baby in the
uterus). Because CMV can cross the placental barrier,
initial infection in a pregnant woman can lead to infection
of the developing baby.
CMV Symptoms
• Transmission to a fetus by a pregnant
woman can result in severe damage; 40%
risk of transmission
• Range from no symptoms to severe or
fatal
– Include organ damage, microcephaly, visual
impairments
– Asymptomatic children may develop problems
later such as hearing loss
Prevention
• Currently, there is no vaccine to prevent
CMV infection. For those who have close
contact with children, especially pregnant
women or women who might become
pregnant, hand washing is effective at
reducing the risk of infection, as are not
sharing eating utensils with young kids
and avoiding intimate contact with anyone
who has a CMV infection.
CMV Testing of Infants
• Tests that detect the virus are used to
diagnosis CMV infection at birth
(congenital CMV infection). A diagnosis of
congenital CMV infection can be made if
the virus is found in an infant’s urine,
saliva, blood, or other body tissues within
2-3 weeks after birth. Antibody tests
cannot be used to diagnose congenital
CMV; a diagnosis can only be made if the
virus is detected within 2-3 weeks of life.
Infected retina with CMV
Herpes
• Herpes simplex virus type 1 (HSV-1) is usually
associated with infections of the lips, mouth, and
face. It is the most common herpes simplex virus
and most people develop it in childhood. HSV-1
often causes lesions inside the mouth, such as
cold sores (fever blisters), or infection of the eye
(especially the conjunctiva and cornea). It can
also lead to infection of the lining of the brain
(meningoencephalitis). It is transmitted by
contact with infected saliva. By adulthood, up to
90% of people will have antibodies to HSV-1.
Herpes
More severe Herpes
Herpes Simplex
Herpes Simplex
HSV - 2
• Herpes simplex virus 2 (HSV-2) is sexually
transmitted. Symptoms include genital ulcers or
sores. In addition to oral and genital sores, the
virus can also lead to complications such as
infection of the lining of the brain and the brain
itself (meningoencephalitis) in neonatal infants
due to infection during birth. However, some
people have HSV-2 but do not show symptoms.
Up to 30% of U.S. adults have antibodies
against HSV-2. Cross-infection of type 1 and 2
viruses may occur from oral-genital contact.
Dangers to Fetus
• Range from severe impairments such as
brain inflammation, multiple organ
damage, mental retardation
• to milder forms of impairment such as
blisters
• Transmission can be prevented by Csection within 4 hours of the rupture of the
amniotic membrane
Herpes