TORCH Infection - Causes, Symptoms, and Diagnosis

Introduction:

TORCH is not a single disease, but TORCH is an acronym for Toxoplasmosis, Other agents (including HIV (Human Immunodeficiency virus), syphilis, varicella, fifth disease, and Zika), Rubella, Cytomegalovirus, and Herpes simplex virus (HSV). If the mother gets infected by TORCH during the pregnancy, she can pass it to the baby in the womb, during delivery, or after birth. TORCH infections are easily transmissible. This article explains the causes, signs and symptoms, treatment and prevention methods for TORCH infections.

What Are TORCH Infections?

Since the baby's immune system is not so developed, the baby does not have immunity to fight off infections. It may cause some serious problems for the unborn child. It will prevent organ development in the baby. It constitutes two to three percent of all congenital disorders (diseases present from birth). TORCH infection can cause miscarriage, premature birth, intrauterine growth restriction, and stillbirth.

Modes of transmission are as follows:

• Before Childbirth Through Placenta: It is transmitted through the mother's bloodstream to the baby from the placenta.

• During Childbirth Through Birth Canal: It is transmitted when the baby passes through the vaginal canal during the birthing process.

• After the Birth: It is transmitted through breast milk if the mother is breastfeeding.

What Are the Signs and Symptoms of TORCH Infection?

• Fever.

• Trouble in feeding.

• Fatigued child.

• Hearing problems.

• Patent ductus arteriosus (PDA), a developmental defect in the heart.

• Small red spots on the body (purpura)

• Bluish or purple rash (blueberry rash).

• Enlargement of the liver.

• Cataract or eye problems.

• Seizures (sudden uncontrolled movement in the body).

• Swelling of the lymph nodes.

• Difficulties in learning.

• Inflammation of the brain (meningitis).

• Loss of vision or hearing.

What Are the Causes of TORCH Infections?

TORCH is passed from pregnant women to the baby; possible causes are as follows:

1. Toxoplasmosis: It is caused by a parasite; pregnant women can be exposed to the parasite by eating undercooked meats or being exposed to cat feces.

2. Other Infections: These include:

• HIV (Human Immunodeficiency Virus): It is a viral infection with no cure. HIV is caused by sexual contact with an infected person or direct contact with needles or syringes from HIV-infected blood. Mostly infects the child in the third trimester of pregnancy or during the birthing process if the mother is not on suitable medications.

• Syphilis: It is a sexually transmitted disease. Congenital syphilis poses a high rise in babies and is passed from mother to baby during the birthing process.

• Fifth Disease: It is caused by Parvovirus B19. The transmission mode is through saliva and mucus through coughing and sneezing by an infected person. It causes a mild rash.

• Chicken Pox: It is a viral infection caused by Varicella-Zoster Virus (VZN). In most cases, lifetime immunity is acquired by vaccination.

• Zika Virus: The transmission mode is through mosquito or sexual contact with an infected person.

3. Rubella: It is a very rare disease, as most pregnant women are vaccinated against it. MMR (measles, mumps, and rubella) vaccine is given in pregnancy.

4. Cytomegalovirus (CMV):It is a viral infection transmitted through saliva and other body fluids. It is present in most adults, but immunity will suppress it; babies do not have immunity to fight this infection (CMV). Once it enters the human body, CMV will stay for life, but the immunity will take care of it.

5. Herpes Simplex Virus (HSV):There are two types HSV-1 (oral and genital) and HSV-2 (genital). It is a highly contagious virus transmitted sexually. It infects the child during vaginal birth. It is advisable to discuss with the doctor the diagnosis of Herpes simplex virus.

How to Diagnose TORCH Infections During Pregnancy?

• Blood test: Blood test will help to detect the infection.

• PCR (Polymerase Chain Reaction): Detects the viral genetic material.

• Viral Cultures or Antibody Testing: A sample of the fluid from the saliva, pee, amniotic fluid, or fluid from the skin rash or sore is collected and tested for infectious disease.

• Ultrasound Is Done During Pregnancy: To detect congenital abnormalities.

How to Diagnose TORCH Infections in Newborns?

• Physical examination at birth.

• Evaluating baby's symptoms.

• Test: Same as required for adults to diagnose TORCH infections.

• Computerized Tomography (CT): To identify any side effects of TORCH infection, especially brain lesions or swelling.

• Magnetic Resonance Imaging (MRI): To see any complications of TORCH infection.

• Eye Test: To check for vision loss.

• Hearing Test: To check for hearing loss.

What Is the Treatment Plan for TORCH Infections?

Treatment is based on the type of disease and its severity. Treatment will include antibiotics, anti-parasitic, and antiviral medication can be prescribed depending on the disease. If the TORCH infection is diagnosed in pregnancy, doctors will monitor the pregnancy very closely and can also refer to maternal-fetal medicine specialists. The doctor will decide whether the baby will need immediate medical attention or will have to stay in the NICU (neonatal intensive care unit) at birth, depending on the baby's condition. Also, a doctor's recommendation will be required on breastfeeding if the mother plans to breastfeed. Other than all measures, adequate hydration and rest should be taken for a speedy recovery. Long-term complications in the baby include developmental delays, hearing loss, eye problems, and difficulties with learning.

What Are Parents Roles?

• Pregnant mothers should stay away from sick people.

• Hand hygiene (washing hands more often) must be followed.

• Take care while traveling to more infection-prone areas.

• Avoid sharing utensils and drinks with other people.

• Meat or eggs should be fully cooked.

• A pregnant mother should not clean the cat's litter.

• Get tested for any STI (sexually transmitted infections).

• Take medicine (antiviral) as prescribed by the doctor.

Conclusion

TORCH infections are transmitted from the mother to the baby at birth and post-birth through breastfeeding. TORCH infections are treatable with medicines. Early diagnosis can lead to more treatment options for the baby. As it is known that prevention is better than cure, steps like hand hygiene during pregnancy, immunization of mothers can prevent rubella syndrome, and wearing condoms during sex can help to avoid it. Educating the mother and early in utero diagnosis is very crucial in detecting a child with a TORCH infection. Prenatal care should be followed regularly.