Types of Congenital Infections - Health Education - DesiMD Healthcare - India
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Types of Congenital Infections

Dr.Surya Rao Poodipeddi profile Authored by Dr.Surya Rao Poodipeddi on 20 Nov 2014 - 12:24.

Congenital infections in the infants are far too many. Only the important ones are mentioned here. Only some of the important congenital infections that can affect a new born are:

Rubella: This condition affecting a newborn is termed as congenital rubella syndrome mostly seen in early pregnancy. 90% of infants are affected before 11 weeks of gestation in the mother. Around 25% of infants are affected at 16 weeks of gestation. This syndrome usually does not occur due to infection in the mother after the first trimester.

The commonest manifestation is intrauterine growth retardation. Other manifestations include cataracts often associated with microopthalmia (small sized eyes), myocarditis (inflammation of the muscles of the heart) with or without structural cardiac defects such as PDA (Patent Ductus Arteriosus), pulmonary artery stenosis (narrowing of the artery), sensorineural deafness and mental retardation.

HIV: Exposure to this deadly and incurable infection is primarily due to unprotected sexual intercourse with multiple partners besides transmission of blood from infected persons and use of contaminated needles. Transmission from an infected mother is always due to delivery through normal birth canal. More than 25 to 30% are seen in the world other than Europe, America and Africa, including India. Infection occurs during delivery or breastfeeding. Risk of transmission can be achieved to a large extent with latest drugs available in the market and avoiding vaginal delivery and breastfeeding the infant.

CMV: (CytoMegaloVirus): This is the commonest congenital infection .About 1 to 4 % of women acquire it even in developed countries. CMV infection in pregnancy may be without symptoms or produce symptoms similar to a condition called infectious mononucleosis. Symptoms in the newborns are noticed in about 5 to 15% of these cases. Around 80% of those who show symptoms may develop neurological symptoms including mental impairment and hearing loss. Intravenous ganciclovir can reduce hearing loss in severely infected infants.

Herpes Zoster: This infection is seen one in every 2000 pregnancies. The infection can pass on to the infant if the mother has this infection 5 days before delivery. This infection is associated with up to 30% of neonatal mortality (death in an infant after birth). Babies of mothers developing perinatal (during pregnancy) chickenpox should receive VZIG (Varicella-Zoster Immune Globulin) injections.

Hepatitis B: In Africa and Asia the percentage of women found positive for Hepatitis B is around 25%. Those who are found negative for Hepatitis B still carry a risk of transmission where as those who are positive, the risk of transmission is to the extent of  70 to 90%. Transmission can be minimized or even reduced by active immunization with Hepatitis B vaccine using hepatitis B immunoglobulin within 12 hours of birth.

Hepatitis C: Hepatitis C infection is seen either alone or along with HIV infection.  Risk of infection increases to about 25% if the mother is also positive for HIV. The infected infant has the risk of chronic hepatitis.

Streptococcal Infection: About 10 to 25% of pregnant women are found to have Group B Streptococci especially in the urine. The fetus is vulnerable for infection if the delivery is preterm or when there is ascending infection after the rupture of membrane. Neonatal sepsis associated with mortality in about 6% of prevalence is seen in one to three per every 1000 live births. This alarming occurrence can be prevented with intrapartum penicillin in high risk cases.

Listeria moncytogenes: This infection passes through the placenta. Seen mostly during 24 weeks of pregnancy it may end up in an abortion. Infants born after 24 weeks are either stillborn or end up in premature delivery. Some of the live infants may exhibit a phenomenon called granulomatosisinfantiseptica (Septicemia in infants with granuloma) which is seen covering the baby and the placenta. The infant may also develop pneumonia without any granuloma. Meningitis is another possibility. Higher antibiotics like ampicillin in combination with amino glycosides are the drugs of choice to check infection.

Syphilis: This infection belongs to a group of diseases called STD (Sexually Transmitted Diseases). This avoidable disease in the mother is always due to unprotected sexual intercourse with someone before marriage or after marriage. Even if detected it becomes necessary for both the partners to get treated simultaneously and abstain from sexual inter course till both declared free from the disease. From this it becomes clear that the innocent infant becomes a victim to this infection which is transmitted through the placenta during delivery.

It is alarming to note that the transmission through placenta occurs in about 90% of untreated women. At birth the disease manifests as neonatal rhinitis (inflammation of nose at birth) osteitis (inflammation in bones) and bullous lesions over the skin. Usually detected during antenatal screening of pregnancy it is treated with benzyl penicillin. If only the parent(s) exercise care in their premarital and extramarital sexual relationships especially without any protection, every child can be saved from this dangerous infection.

Chlamydia Trachomatis:This condition seen in about 5 to 7 percent of pregnant women is usually and luckily asymptomatic.The main symptom in the infant is conjunctivitis which can be treated with local and if necessary systemic antibiotics.

Gonorrhea: This condition in the mother is again due to transmission through sexual intercourse with those other than the spouse or with the spouse who is infected but doesn’t reveal it. Once again the infant is the victim if born to a mother who has gonorrhea during pregnancy. Unfortunately the mother is asymptomatic during pregnancy and therefore it is left undiagnosed.  However, fortunately it only causes opthalmianeonatorum (conjunctivitis in the infant) with pus like discharge and sticky eyes. Antibiotic eye drops are the drug of choice. Every child at birth is appliedargerol eye drops (silver nitrate eye drops) to the eyes of the infant immediately after birth, to avoid any eye infection to the infant.

Toxoplasmosis: This is a protozoal infection that causes serious illness in fetuses and in those who have reduced power of immunity. Those who come in contact with cats and those who eat raw or undercooked meat have greater risk to this deadly disease. The infection is caused by protozoa called toxoplasmosis gondii.

The parasite initially infects a cat and the cysts (dormant stages) of the parasite are excreted in the feces of the infected cat. Those who handle the litter of the cat or those who fondle the cat as a pet are more susceptible to get infected. The ignorant mother unaware of such a possibility passes on the infection to her infant during delivery and the baby who gets it, will be an unfortunate victim of this deadly disease with different forms of presentation and serious sequel like blindness in one or both eyes. Those with reduced immunity like in cases of HIV are more susceptible to infection with toxoplasmosis.

If the mother is infected during pregnancy roughly 1/3rd infants are prone to get infected with toxoplasmosis. The risk increases two fold if the mother is infected during later part of her pregnancy. Toxoplasmosis presents in different forms which include:

  • Systemic diseases of the infant like rash, jaundice, thrombocytopenic purport (presenting with rose colored angry looking spots), hepatosplenomegaly (enlargement of liver and spleen), pneumonia and progressive uveitis (inflammation of the uvia of the eyes).
  • Neurological diseases: like hydrocephalus (accumulation of water in the coverings of brain), microcephaly (small sized head), microptholmia (small eyes), retinochoroiditis (inflammation of the retina and choroids) and cerebral calcification (thickening of the brain like a stone).
  • Mild disease: isolated occurrence of retinochoroiditis or mild cerebral calcification without any signs of injury to the brain.
  • Sub clinical: Seen in 70% of the infected babies.
  • Relapsing: Its effects in the eyes as a flare-up at any age and in most cases, retina which was previously intact may get involved.

Prevention is the easiest option to avoid the infection in an infant. However, those who have anyway got it, the treatment is also simple which includes use of a drug called pyrimethamine and sulfadiazine.

Most of the infections mentioned below are preventable. Even those which have surfaced can be cured. Few of these are not fully curable and some of the very few infections cannot be cured. For example blindness due to toxoplasmosis remains permanent.

From the brief coverage of the important congenital infections in the infants it becomes amply clear that every mother should be aware of the causes of these avoidable infections and how to prevent them from affecting their innocent offspring.

It also becomes clear that mothers who indulge in various inappropriate activities like modern life styles, exposure to the risk of sexually transmitted diseases due to unprotected sexual intercourse with those other than the spouse, pre & extra marital sex, illegal relationships with others and a fancy for pets without realizing the risks in maintaining them are wholly and solely responsible to gift their infant with congenital infections which can be avoided.

This article aims at educating to- be-mothers, about the causes and  prevention measures against congenital infections in their infants so that it helps them to stay clear from such infections.

*Disclaimer
*Disclaimer: This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.