Other Infections of Perinatal Significance
Toxo is caused by a single celled parasite found in soil, cat litter boxes, and various kinds of uncooked meat, especially pork, lamb and venison.
60 million people in the US are probably infected but few have symptoms.
IN PREGNANCY, Toxo poses a disease threat to women who were not previously infected, as well those with compromised immune systems. Most infants who are infected while still in the womb have no symptoms at birth, but they may develop symptoms later in life, such as blindness or intellectual disabilities. A small percentage of infected newborns have serious eye or brain damage at birth.
IN PREGNANCY women may get toxo antibody titres with their prenatal labs. If you have no immunity you need to take these special measures:
- Cook whole cuts of meat to 145 degrees internal temperature, then allow it to " rest " for three minutes before eating.
- Cook ground meat to 160 degrees internal temperature.
- Cook poultry to 165 degrees internal temperature, then allow it to " rest " for three minutes before eating.
- Freeze meat for several days at sub-zero (0° F) temperatures before cooking to greatly reduce chance of infection.
- Peel or wash fruits and vegetables thoroughly before eating.
- Do not eat raw or undercooked oysters, mussels, or clams (these may be contaminated with Toxoplasma that has washed into sea water).
- Do not drink unpasteurized goat's milk.
- Wash cutting boards, dishes, counters, utensils, and hands with hot soapy water after contact with raw meat, poultry, seafood, or unwashed fruits or vegetables.
- Wear gloves when gardening and during any contact with soil or sand because it might be contaminated with cat feces that contain Toxoplasma. Wash hands with soap and warm water after gardening or contact with soil or sand.
- Teach children the importance of washing hands to prevent infection.
Varicella, aka chicken Pox Virus
This is the common virus that causes Chicken Pox and later in life, shingles. Most people get it in childhood and in most cases it does not cause any lasting problems. However, IN PREGNANCY, there are special concerns. Below is the very precise and concise CDC mention on the subject so I will simply quote:
“ Pregnant women who get varicella are at risk for serious complications; they are at increased risk for developing pneumonia, and in some cases, may die as a result of varicella.
If a pregnant woman gets varicella in her 1st or early 2nd trimester, her baby has a small risk (0.4 – 2.0 percent) of being born with congenital varicella syndrome. The baby may have scarring on the skin, abnormalities in limbs, brain, and eyes, and low birth weight.
If a woman develops varicella rash from 5 days before to 2 days after delivery, the newborn will be at risk for neonatal varicella. In the absence of treatment, up to 30% of these newborns may develop severe neonatal varicella infection.”
If you have a clear cut history of chicken pox as a child, you need not worry. If you do not, then even so, you are most probably immune. However, you may be advised to have a varicella antibody panel drawn to confirm your immunity. This can be a part of your prenatal lab panel. Women are pregnant and have no immunity to chicken pox must stay away from people with or exposed to chicken pox. They must also stay away from persons with shingles, which is reactivated chicken pox. It takes from 10-21 days after contact with an infected person for someone to develop chickenpox. A person with chickenpox is contagious 1-2 days before the rash appears and until all blisters have formed scabs.
Non pregnant non-immune women should get vaccinated against chicken pox at least 30 days from becoming pregnant. Please vaccinate your children against varicella. The child you will protect may not be your own, but may well be a child fighting cancer who is not eligible for the vaccine. Herd immunity helps.
Influenza, aka flu
Influenza is not the same as the common cold or a gastrointestinal virus. It is caused by a group of specific viruses which are especially dangerous IN PREGNANCY. Here is the CDC ( Center for Disease Control ) statement on influenza in pregnancy.
" Pregnant and postpartum women are at higher risk for severe illness and complications from influenza than women who are not pregnant because of changes in the immune system, heart, and lungs during pregnancy (367). Vaccination during pregnancy has been shown to protect infants from influenza (170,368), including infants aged <6 months, for whom no influenza vaccines are currently licensed (368–370). The ACIP and American College of Obstetricians and Gynecologists (ACOG) recommends that all women who are pregnant or who might be pregnant in the upcoming influenza season receive IIV because of this increased risk for serious illness and complications from influenza (371). Influenza vaccination can be administered at any time during pregnancy, before and during the influenza season. "
Flu vaccines have proven to be safe and effective in pregnancy with a very low incidence of side effects.
Pertussis, aka Whooping Cough
Pertussis, a respiratory illness commonly known as whooping cough, is a very contagious disease caused by a bacteria. The bacteria attach to the lining of the respiratory tract and secrete inflammatory toxins. People with pertussis usually spread the disease by coughing or sneezing while in close contact with others, who then breathe in the pertussis bacteria.
History of Pertussis:
Before the availability of pertussis vaccine in the 1940s, more than 200,000 cases of pertussis were reported annually. Since widespread use of the vaccine began, incidence has decreased more than 80% compared with the pre-vaccine era. However, since the 1980s there's been an increase in the number of reported cases of pertussis, from increased detection due to better tests and better reporting, but also due to failure to vaccinate.
Differing symptoms in adults and infants:
In adults, pertussis starts like a common cold, first with a runny nose. Then a cough develops, intermittent at first, then paroxysmal, i.e in long worsening bouts. In infants, the cough may be minimal or absent, and apnea, lack of breathing, may be the only symptom.
Unvaccinated or incompletely vaccinated infants younger than 12 months of age have the highest risk for severe and life-threatening complications and death. About half of infants younger than 1 year old who get pertussis are hospitalized, and 1 or 2 in 100 hospitalized infants die.
Vaccinating Pregnant women, family and friends:
This is why we vaccinate all women IN PREGNANCY between 27-36 weeks. The whooping cough vaccine is recommended during your third trimester so that your body can create antibodies and pass them to your baby before birth. In the first few weeks after you are vaccinated, you have the most antibodies. These antibodies will help protect your baby when he is most vulnerable to serious complications from this disease. The vaccine you get will help protect your baby as soon as he is born and until he is able to start getting his own whooping cough vaccines at 2 months of age. We repeat the vaccine for each pregnancy, so each baby gets a boost of antibodies from their newly vaccinated mom to protect them during the first two months of life.
It is also necessary to make sure everyone around the infant is immunized. This includes parents, siblings, grandparents (including those 65 years and older), other family members, babysitters, etc. They should be up-to-date with the age-appropriate vaccine (DTaP or Tdap) at least two weeks before coming into close contact with the infant. Unless pregnant, only one dose of Tdap is recommended in a lifetime. Pertussis vaccination has changed a great deal compared to when I was a child. It is far more effective, and unlike the early versions, has only the side effects of a sore arm.
If there is any suspicion that Pertussis is present, obtain prompt consultation with your doctor or pediatrician.
Fifth disease, aka, Parvovirus B19
Fifth disease is a mild rash illness caused by parvovirus B19. This disease is usually not a problem for pregnant women and their babies.
About 50% of pregnant women are immune to parvovirus B19. So, these women and their babies are usually protected from getting the virus and fifth disease.
Pregnant women who are not immune usually do not have serious complications after they are exposed to others with fifth disease. They usually have only mild illness. Also, their babies usually do not have any problems. However, sometimes if a mother's initial infection is IN PREGNANCY, a baby will develop severe anemia, and the woman may have a miscarriage. But, this is not common. It happens in less than 5% of all pregnant women with parvovirus B19 infection and more commonly during the first half of pregnancy.
Pregnant women who are not immune and are not currently infected with parvovirus B19 may want to stay away from people with fifth disease.
Herpes simplex 1 and 2
These viruses can produce genital and oral herpes.
In the United States, about one out of every six people aged 14 to 49 years have genital herpes.
Most people who have herpes have no, or very mild symptoms. This is why it can be passed so easily.
Herpes is passed through secretions and thus is passed by any form of sex.
In some cases, the first outbreak is severe, making painful blister like sores the affected area, aches, fevers, and swollen glands. Subsequent infections are usually less severe.
IN PREGNANCY, herpes infection can be passed from you to your unborn child and cause a potentially deadly infection (neonatal herpes). Sometimes genital herpes infection can lead to miscarriage. It can also make it more likely for you to deliver your baby too early. It is important that you avoid getting a primary ( initial) herpes infection during pregnancy.
If you are pregnant and already have genital herpes, you may be offered medicine (acyclovir or valcyclovir) towards the end of your pregnancy to reduce the risk of having any symptoms and passing the disease to your baby. At the time of delivery your doctor should carefully examine you for symptoms. If you have herpes symptoms at delivery, a ‘C-section’ is usually performed to reduce the risk of transmission to the baby.
Bacterial Vaginosis (BV)
Bacterial vaginosis is the most common vaginal infection in women ages 15-44.
Bacterial vaginosis (BV) is an infection caused when too much of certain bacteria change the normal balance of bacteria in the vagina.
Any woman can get bacterial vaginosis, even a woman who has never had sex. However, we do know that having a new sex partner or multiple sex partners and douching can upset the balance of bacteria in the vagina and put women at increased risk for getting BV.
Having bacterial vaginosis can increase your chance of getting an STD.
- Not having sex;
- Limiting your number of sex partners; and
- Not douching.
Symptoms of BV: From none to a thin white or gray vaginal discharge, odor, pain, itching, or burning in the vagina, a strong fish-like odor, especially after sex, burning when urinating; itching around the outside of the vagina, or both.
Treatment is easily accomplished with a variety of different antibiotics.
IN PREGNANCY, treatment of BV is especially important. BV puts pregnant women at risk for miscarriage, premature delivery or low birth-weight babies.
Content in these pages is excerpted and remixed from the CDC.gov