TORCH Agents Research Articles

Molecular Biology for Diagnosis of Congenital and Neonatal Infections in the Cerebrospinal Fluid of Newborns from a Brazilian Tertiary Hospital

The risk of infection transmission from mother to fetus depends on the pathogen. TORCH agents cause some neuroinfections, including Toxoplasmosis, rubella, Cytomegalovirus, herpes simplex 1 and 2, and others (Varicella Zoster, Parvovirus B-19, Epstein–Barr virus, and Zika virus). The consequences can be stillbirth, prematurity, uterine growth restriction, and congenital malformations. The detection of DNA/RNA from CSF by molecular methods is a marker of the involvement of congenital infection in the central nervous system. This study aimed to identify the frequency of these pathogens in CSF samples from newborns (1 to 28 days old) at a tertiary hospital, using PCR, and determine the clinical consequences. Methods: This was a prospective descriptive study involving the molecular analysis of 151 CSF samples from neonates, collected for cytological and biochemical diagnosis from 2017 to 2021. After the results and consent from the participants’ caregivers were obtained, the leftover material was sent to the University’s Virology Laboratory and submitted for DNA/RNA extraction and Nested-PCR/RT-PCR. A review of the patients’ medical records and descriptive statistics was performed. This work was approved by the Ethics Committee (CAAE: 86760218.3.0000.5404). Results: A total of 151 CSF samples were obtained, 16 of which were positive (10.6% [95% CI%: 6.18–16.63%]). Two of these were PCR-positive for HSV-1 (1.3%), four for VZV (2.6%), one for CMV (0.67%), two for Toxoplasmosis (1.3%), four for Parvovirus B-19 (2.6%), and four for Zika (2.6%). The proportion of positive PCR results was higher in the group that presented with malformations (25.0% vs. 8.4%, p = 0.040). Conclusions: The pathogens identified by PCR were mostly Zika virus, VZV, and B-19, and these were mainly found in newborns with malformations.

Seroprevalence of ToRCH Pathogens among Children Admitted to a Tertiary Care Hospital in Eastern India for Cataract Surgery and Cochlear Transplantation.

The study aims to investigate the presence of TORCH infections in a child with bilateral cataracts and deafness and report the ToRCH-serology screening profile (Toxoplasma gondii (TOX), rubella (RV), cytomegalovirus (CMV), and herpes simplex virus (HSV-I/II)) in pediatric cataract and deafness. Cases that had a clear clinical history of congenital cataracts and congenital deafness were included in the study. The study population consisted of 18 bilateral cataracts and 12 bilateral deafness child who was admitted to AIIMS Bhubaneswar for cataract surgery and cochlear implantation, respectively. Sera of all children were tested qualitatively and quantitatively for IgG/IgM-antibodies against ToRCH agents in a sequential manner. Anti-IgG antibodies against the torch panel were detected in all cataract and deafness patients. Anti-CMV IgG was detected in 17 of 18 bilateral cataract children and 11 of 12 bilateral deaf children. The rates of anti-CMV IgG antibody positivity were significantly higher. In the cataract group, 94.44% and in the deafness group, 91.66% of the patient was Anti-CMV IgG positive. Besides this, 77.7 % of the patient from the cataract group and 75% from the deafness group was anti- RV IgG antibody positive. In bilateral cataract patients, IgG-alone seropositive cases were mostly attributed to CMV (94.44%; 17/18), followed by RV (77.70%; 14/18), HSV-I (27.70%; 5/18), TOX (27.70%; 5/18), and HSV-II (16.60%; 3/18). In bilateral deafness patients, the spectrum of IgG alone seropositive cases was almost the same except for TOX (0/12). The current study recommends interpreting ToRCH-screening in pediatric cataracts and deafness with caution. Interpretation should include both serial qualitative and quantitative assays in tandem with clinical correlation to minimize diagnostic errors. The sero-clinical-positivity needs to be tested in older children who might pose a threat to the spread of infection.

Serum antibodies against ToRCH agents in pregnant women presenting at a tertiary hospital in Port Harcourt, Nigeria.

ToRCH infections pose a great risk to the fetus and neonates if the mother is actively infected during pregnancy. This may lead to miscarriage, stillbirth, delayed fetal growth and maturation (intrauterine growth retardation), or pre-term delivery. This study aimed to evaluate the prevalence of ToRCH infections in pregnant women in Port Harcourt. Sera from 84 pregnant women between the ages of 16 and 45 were analysed for detectable ToRCH IgM antibodies using the Dia-Pro ToRCH IgM kit. The results from the study showed an IgM seroprevalence rate of 82.1%, with the highest rate of seropositivity obtained among married women (91.0%), Civil servants (92.3%) and women within the age group 25-34 years (92.9%). There was significant relationship between the ToRCH IgM seropositivity and age, marital status and occupational status. The seropositivity of ToRCH agents among pregnant women in Port Harcourt is high, suggesting an acute infection which may adversely affect fetal health. This underscores the need for preventive antenatal screening and universal immunization schemes.

An examination of the seroprevalence of torch infections and their correlation with adverse reproductive outcomes in females exhibiting a bad obstetric history

: The term TORCH infections refer to a group of diseases including Toxoplasma, Other (syphilis, varicella-zoster, parvovirus B19), Rubella, Cytomegalovirus (CMV), and Herpes infections. These are a set of pathogens capable of traversing the placental barrier, subsequently causing congenital infections. Often these infections are asymptomatic initially and pose significant diagnostic challenges during gestation, potentially leading to undesirable obstetric outcomes. This research intends to explore the correlation between TORCH infections and perinatal outcomes within pregnancies deemed high-risk.: We examined 143 high-risk pregnant patients aged 18-46 from the Obstetrics and Gynecology Department at the Baghdad Gynecology and Obstetrics Hospital. Hundreds of normal pregnancy group were also included. The high-risk group encompassed women with recurring pregnancy loss, fetal congenital anomalies, intrauterine fetal death, and low birth weight intrauterine neonatal death. The presence of IgG and IgM antibodies against TORCH agents in patients’ serum control serum were assessed using ELISA kits. We compared perinatal outcomes between TORCH seropositive and seronegative high-risk pregnant women.: Among the 143 high-risk pregnancies, a significant proportion of young, low-parity women from diverse residences were co-seropositive for Toxoplasma gondii, rubella virus, Cytomegalovirus, and Herpes Simplex infections. Of these, 55 cases (48.4%) were seropositive for all the four TORCH agents compared to 88 cases (38%) were seropositive for antibodies to one to three of the TORCH agents. IgG seropositivity was 74.5%, while IgM seropositivity was 31.8% for Toxoplasma gondii, 3.6% for CMV and 0% for RV infections, respectively. Significantly, high-risk pregnancies with TORCH seropositivities exhibited a clearly strong correlation with Habitual abortions outcomes.: High-risk manifestations demonstrated for Toxoplasma gondii, Rubella virus, Cytomegalovirus and Herpes Simplex infections strongly associated with habitual abortions compare to high but less significant association in those seropositive to one, two or three of the TORCH agents

Seroprevalence of Infections with TORCH Agents in Romania: A Systematic Review.

Maternal-fetal infectious pathology-notably the TORCH panel (Toxoplasma gondii, rubella, Cytomegalovirus, and herpes simplex viruses)-critically impacts maternal and neonatal health. This review collates data on the seroprevalence of IgG and IgM antibodies against TORCH agents in Romanian women, aiming to discern regional and population differences and identify risk factors. Twenty studies were included in the review, revealing variable seroprevalence rates across the country. Regions such as Moldavia and Banat showed higher anti-T. gondii IgG seroprevalence rates than Bihor, with notable declines in Banat. Rural, older, and multiparous women showed elevated T. gondii IgG rates. Anti-rubella vaccine introduction significantly reduced the prevalence of anti-rubella IgG antibodies, but recent vaccination coverage decreases raise concerns. CMV and HSV seroprevalence varied geographically, with rural areas generally showing higher CMV rates and HSV influenced by factors like education level and number of sexual partners. Concurrent seroprevalence of multiple TORCH components in some cases underscores potential common risk factors. This study highlights the importance of continuous monitoring and preventive measures such as vaccinations and awareness campaigns to mitigate the health impact on the pregnant population.

Seroprevalence of TORCH Agents in Women with Spontaneous Miscarriage in Jizan, Saudi Arabia

Seroprevalence of TORCH Agents in Women with Spontaneous Miscarriage in Jizan, Saudi Arabia

Study of some microbial infections of recurrent miscarriage in women

Background: some microbial infections can be passed to the fetus before or during birth and damage the fetus or cause a miscarriage, like infection with ToRCH agents and salmonella enterica. The current study aims to investigate the extent of the involvement of salmonella enteria serovars, proteus spp. and Brucella spp. in recurrent miscarriage in women during first trimester. Material and method: The 50 blood samples were collected from women age rage (19-39), who had repeated miscarriages during the first trimester during periods extended from October 2021 to February 2022,. The study control includes the 20 fertile women with no miscarried history. Two tests were conducted which are ToRCH IgM and febril antigen slid test for identification infectious agents associated with pregnancy loss. Results: The present results showed that the most frequent recurrent miscarriage (RM) was in the age group 35-39 years at a percentage 34%, while the lowest abortion rate was 18% at the age group of 25-29 years.

Microcephaly caused by or associated with congenital infections in the last 20 years in Brazil: a systematic review.

ABSTRACTThis systematic review aimed to identify the pathogens causing or associated with congenital microcephaly in Brazil in the last 20 years due to the lack of official information by the Health Authorities and, as a consequence the uncertainty on the real infectious etiology of congenital microcephaly. A review protocol was prepared according to the PRISMA recommendation, using the PubMed, SciELO and LILACS databases to search for references presenting original data on microcephaly caused by or associated with congenital infectious in Brazil, using the descriptors “MICROCEPHALY AND INFECTION”. The search ended on 30/Jun/2020. All selected titles were read in full and analyzed independently by the three reviewers. After searching the databases, 2,389 articles were selected for title review. Of these, 109 were excluded due to duplicates and 2,236 according to the criteria defined in the review. Only 44 met the eligibility criteria and were therefore read in full. Data extraction was performed on 10 articles, all published after 2015. Seven studies were literature reviews or case series, only two were case-control, and one was a cross-sectional study. As the studies focused on the period of the ZIKV epidemic in Brazil, the cases of congenital microcephaly between 2015 and 2017 were attributed to maternal infection by this virus when it was not possible to prove the presence of other etiological agents. Among the TORCH agents, a predominance of syphilis was observed. The analyzed studies did not add consistent information about the infectious causes or association of microcephaly in Brazil outside the period of ZIKV epidemic, revealing the need for more studies on the subject.

Prevalence of Serum Specific Antibodies to TORCH Agents in a Cohort of Children Using DiaSorin "Flash" Chemiluminescence Technology.

Our study was undertaken to detect the prevalence of serum specific antibodies to TORCH agents in children by establishing the presence of the specific IgM antibodies with DiaSorin "Flash" chemiluminescence technology. A total of 804 blood samples were collected for the detection of the Toxoplasma IgM; 2,048 cases were collected for CMV IgM, and 337 cases were collected for HSV-1/2 IgM, over a period of 9 months (from January 2019 to September 2019). In our cohort, a total of 103 samples (12.8%) were found to be seropositive for Toxoplasma, 1,551 samples (75.7%) were positive for CMV and 174 samples (51.6%) were positive for the HSV-1/2 infections. The perinatal CMV infection was observed in 11.9% of the patients with positive serology for CMV. The routine antenatal screening with chemiluminescence technology should be recommended in general population to avoid congenital malformations, as long as the prevalence of serum specific antibodies to TORCH agents is high and seropositivity rate increases with age.

Increase in Percentage of Seronegative Toxoplasma gondii and Cytomegalovirus in Pregnant Women: An Improvement in Hygienic Conditions in Certain Areas?

(1) Background: Toxoplasma gondii and cytomegalovirus belong to a group of pathogens entities called TORCH agents. TORCH represents an acronym which derives from the name of a series of certain pathogenic agents (Toxoplasma gondii, Other agents, Rubella virus, Cytomegalovirus, Herpes virus). They could cross the placenta barrier and cause serious damage to the fetus if a primary infection occurs in a pregnant woman. Immunized women are relatively protected against a reinfection and the risk of a materno-fetal infection in these categories of pregnant women is considered low. (2) Aim of the study: To analyze changes in the percentage of pregnant women seronegative to Toxoplasma gondii and cytomegalovirus along a period of ten years, from 2008 to 2018. (3) Material and Methods: We studied the changes in percentage of seronegative Toxoplasma gondii and Cytomegalovirus pregnant women along two periods: 2008–2010 and 2015–2018. Only pregnant women with declared medium of provenience and unequivocal results were enrolled in the study. (4) Results: In urban areas, we found an increase in the percentage of pregnant women seronegative to Toxoplasma gondii (RR = 1.488, p < 0.0001), respectively to cytomegalovirus (RR = 1.985, p < 0.0001), from 2008–2010 to 2015–2018. A similar increasing trend was found also in rural areas: Toxoplasma gondii (RR = 1.136, p < 0.0322), respectively cytomegalovirus (RR = 1.088, p < 0.8265) but it did not reach a significant threshold for cytomegalovirus. (5) Conclusion: Our study showed that the percentage of women seronegative to Toxoplasma gondii and cytomegalovirus antibodies increases along a period of ten years, from 2008–2010 to 2015–2018, in both urban and rural areas. Probably, the main cause of this trend is represented by the improvement in hygienic condition and food quality control. These results present an argument for continuing the TORCH screening of pregnant women.

Human Neural Stem Cell Systems to Explore Pathogen-Related Neurodevelopmental and Neurodegenerative Disorders.

Building and functioning of the human brain requires the precise orchestration and execution of myriad molecular and cellular processes, across a multitude of cell types and over an extended period of time. Dysregulation of these processes affects structure and function of the brain and can lead to neurodevelopmental, neurological, or psychiatric disorders. Multiple environmental stimuli affect neural stem cells (NSCs) at several levels, thus impairing the normal human neurodevelopmental program. In this review article, we will delineate the main mechanisms of infection adopted by several neurotropic pathogens, and the selective NSC vulnerability. In particular, TORCH agents, i.e., Toxoplasma gondii, others (including Zika virus and Coxsackie virus), Rubella virus, Cytomegalovirus, and Herpes simplex virus, will be considered for their devastating effects on NSC self-renewal with the consequent neural progenitor depletion, the cellular substrate of microcephaly. Moreover, new evidence suggests that some of these agents may also affect the NSC progeny, producing long-term effects in the neuronal lineage. This is evident in the paradigmatic example of the neurodegeneration occurring in Alzheimer’s disease.

ToRCH-screening in pediatric cataract revisited: A North Indian tertiary care centre study.

Purpose:To analyze and report ToRCH-serology screening profile (Toxoplasma gondii [TOX], rubella [RV], cytomegalovirus [CMV], and herpes simplex virus [HSV-I/II]) in pediatric cataract.Methods:In this prospective analytical study, 1,026 consecutive children were screened, of which 46 children with clinically diagnosed congenital (n = 26) and developmental cataract (n = 20) were included. Post-traumatic and familial cataracts were excluded. Sera of all children were tested both qualitatively and quantitatively for IgG/IgM-antibodies against ToRCH agents in a sequential manner.Results:Overall, IgM/IgG-seropositivity against ≥1 ToRCH agent was reported in 91.3% (42/46) children. IgM (±IgG) positivity against ≥1 ToRCH agent was reported in 26.08% (12/46) children (nine congenital and three developmental cataract; P = 0.18), which included 8.7% (4/46) children reported positive against ≥2 agents. Finally, 13% (6/46) children were reported to be sero-clinical-positive (three were infants and three were >1 year age, P = 0.55; five congenital and one developmental cataract, P = 0.21). Either alone or combined, RV attributed to the majority (50%; 6/12) of the IgM (±IgG) and sero-clinical-positive (50%; 3/6) children. None of the children were HSV-II IgM-positive. Laboratory-confirmed congenital rubella syndrome was reported in 4.3% (2/46) children. One sero-clinical-positive infant with rare coexisting bilateral persistent fetal vasculature was also reported. IgG-alone positivity was reported highest with CMV in 67.4% (31/46) children, whereas 43.4% (20/46) children were found nonimmune to RV.Conclusion:The current study emphasizes the need to interpret ToRCH-screening in pediatric cataract with caution. Interpretation should include both serial qualitative and quantitative assays in tandem with clinical correlation to minimize the diagnostic errors. Clinicians should remain vigilant regarding sero-clinical-positivity in older children too who might pose a threat to the spread of infection.

TORCH screening used appropriately in China?\u2500three years results from a teaching hospital in northwest China

ObjectivesTORCH infections caused by Toxoplasma gondii (TOX), rubella virus (RV), cytomegalovirus (CMV) and herpes simplex virus 1,2 (HSV-1,2) are associated with congenital anomalies. The study aimed to analyze the characteristics of TORCH screening in reproductive age women.MethodsA total of 18,104 women (2015–2017) from a teaching hospital in Xi’an, China, were enrolled in the study. The characteristics of TORCH screening, i.e., the application of TORCH test, the seroprevalence, the impact of age, periods of gestation and woman with bad obstetric history (BOH) on the serological data were investigated.ResultsIn the study, 319 women (1.76%) performed dynamic TORCH test. 51.66, 20.44 and 3.83% of the population did the test in the pre-gestation period, the first and third trimester, respectively. Quite a few pre-gestation women (29.74%) ignored screening of IgG antibodies. The overall IgG/IgM seropositvity of TOX, RV, CMV, HSV-1 and HSV-2 was 4.35%/0.35, 90%/0.63, 96.79%/0.97, 81.11%/0.14 and 6.1%/0.19%, respectively. The age-specific distributions and periods of gestation had no significant effect on the seroprevalence of TORCH agents, p>0.05. However, BOH was significantly associated with higher seropositvity of IgM (RV, CMV, HSV-1 and HSV-2) and IgG (CMV and HSV-1) antibodies, p < 0.05.ConclusionIn Xi’an region, more attentions should be paid to TOX, CMV, HSV-2 and the women with BOH for TORCH screening. Meanwhile, a greater emphasis needs to be placed on TORCH test used inappropriately in China.

The ‘Dangerous Cocktail’: an epidemiological survey on the attitude of a population of pregnant women towards some pregnancy risk factors

Many investigations have shown the important role played by risk factors such as tobacco and alcohol and infectious agents (especially Rubella) in the development of congenital anomalies (CAs). Through the administration of a questionnaire, we evaluated the attitude of a population of pregnant women towards some risk factors in pregnancy (smoking and alcohol habit and risk of contracting one of TORCH agents). 14% of the women continued to smoke despite pregnancy; the majority of these were 34–35 years old, divorced, workers and with a high educational level. The 4.3% who identified as moderate drinkers; were mainly younger and married. Concerning the TORCH agents, it a high percentage were negative to the Rubella antibodies (62.8%). In order to improve the awareness of pregnant women on these risk factors, health education campaigns represent a public health cornerstone.Impact statementWhat is already known on this subject? Several investigations have shown an association between congenital anomalies (CAs) and various exogenous factors such as air pollutants, pesticides, metals, radiations and others present in the environmental matrices. Moreover, an important role is played by some risk factors linked to the lifestyles (i.e. tobacco and alcohol).What do the results of this study add? Our study shows that the awareness of the women about the importance of these risk factors is still rather poor, especially concerning the avoidable risks associated with smoke and alcohol and the preventable risk associated with rubella infection.What are the implications of these findings for clinical practice and/or further research? Our results highlight the importance of continuous health education both about the risk to smoke and drink during pregnancy and about the risk not to have had contract the rubella infection before the pregnancy. Particularly, about the latter issue, it appears necessary to increase the pre-conceptional diagnosis and, eventually, to vaccinate the women resulted negative in order to eliminate congenital rubella.

Small head circumference at birth: an 8-year retrospective cohort study in China

ObjectiveHead circumference is considered a reliable assessment of the volume of the underlying brain. We sought to identify risk factors (maternal factors or antenatal antecedents) for microcephaly and to assess...

Seroprevalence of TORCH Infections in Children

Background : The acronym “TORCH” was introduced to highlight a group of pathogens that cause a congenital and perinatal infections: Toxoplasma gondi, rubella virus, Cytomegalovirus (CMV) and Herpes Simplex Virus (HSV). These pathogens are often associated with congenital anomalies. Congenital malformations have a direct impact on the family. This study was undertaken to detect the serological evidence of TORCH infections in children, by establishing the presence of specific IgM antibodies.&#x0D; Methods: During the period 1st June 2016 to 30th May 2017, 58 suspected TORCH infection cases were included from Paediatrics Department of CMOSH for TORCH antibody detection. The children were in the age of 0 day to 1 year with an average age of 3.3±2.59 months. The serum samples were tested forIgM and IgG antibodies against TORCH agents by using enzyme linked immunoassay method (ELISA).&#x0D; Results: Among the 58 children, seropositivity was found in 55 (94.82%) cases. Of the 55 seropositive cases serological evidence for combination of IgM and IgG with any one of the TORCH agents was detected in 25 (43.10%) and IgG alone was detected in 30 (51.72%) children. IgM/IgG antibody positivity to Toxoplasma, Rubella, CMV and HSV was 21(36.21%), 50(86.21%), 52(89.66%) and 8(13.79%) respectively. IgM anti-CMV were observed in highest number of cases 19(32.76%), followed by IgM anti-rubella 7(12.07%). IgM against HSV and Toxoplasma were found in equal number of cases, 3(5.17%) each.&#x0D; Conclusions: Awareness amongst clinicians and mothers about TORCH infections and their consequences should be developed.&#x0D; Chatt Maa Shi Hosp Med Coll J; Vol.17 (1); Jan 2018; Page 13-16

Congenital Zika virus syndrome\u2026what else? Two case reports of severe combined fetal pathologies

BackgroundZika virus (ZIKV) has recently emerged as a teratogenic infectious agent associated with severe fetal cerebral anomalies. Other microorganisms (TORCH agents) as well as genetic disorders and toxic agents may lead to similar anomalies. In case of fetal anomalies, the exact etiology might be difficult to establish, especially in ZIKV endemic countries. As the risks associated with maternal infection remain unclear adequate parental counseling is difficult.Case presentationWe present two cases of severe fetal pathologies managed in our multidisciplinary center during the ZIKV outbreak in Martinique, a French Caribbean Island. Both fetuses had congenital ZIKV infection confirmed by RT-PCR. While one case presented with significant cerebral anomalies, the other one presented with hydrops fetalis. A complete analysis revealed that the fetal lesions observed resulted from a combination of ZIKV congenital infection and a genetic disorder (trisomy 18) in case 1 or congenital Parvovirus B19 infection in case 2.ConclusionsWe highlight the difficulties related to adequate diagnosis in case of suspected ZIKV congenital syndrome. Additional factors may contribute to or cause fetal pathology, even in the presence of a confirmed ZIKV fetal infection. An exact diagnosis is mandatory to draw definitive conclusions. We further emphasize that, similarly to other congenital infections, it is very likely that not all infected fetuses will become symptomatic.

SEROLOGICAL COMPARISON STUDY FOR DIAGNOSIS OF TORCH PROFILE AGENTS OF PREGNANT WOMEN IN IRAQ

This study reports the prevalence of Toxoplasma gondii (T.gondii), Rubella virus, Cytomegalovirus (CMV), and Herpes simplex virus (HSV), infections in 1500 serum samples from women with Bad Obstetric History (BOH) like abortion and dead fetuses from Mosul and Baghdad hospitals. These Samples taken as serum, to used it in ELISA (IgM ,IgG) , EUROLINE immunoblot (IgM, IgG) and the indirect immunofluorescence test for BIOCHIPs TORCH-Profile IgG to detect the presence of the TORCH agents, for two years. Three hundred positive samples demonstrating the presence of immunoglobulin IgM and IgG antibodies using ELISA test. IgM antibodies were positive in 44 patients (14.7%) T.gondii, 146 (48.7%) CMV, 37 (12.3%) Rubella, and 177 (59%) HSV II and IgG antibodies were positive in 75 patients (25%) T.gondii, 189 (63%) for CMV, 60 (20%) Rubella, and 232 (77.3%) HSV II. We were selected 30 samples from the 300 which had been shown the presence of IgM antibodies in ELISA kits, to used it in EUROLINE immunoblot. IgM antibodies were positive in 2 patients (6.7%) for CMV, Rubella &amp; HSV I and Nil for T.gondii and HSV II. IgG antibodies were positive in 4 patients (13.3%) for T.gondii, 29 (96.7%) CMV and HSV I, 28 (93.3%) Rubella, 2 (6.7%) HSV II. Also 45 samples were selected from the 300 samples were used in the indirect immunofluorescence test for BIOCHIPs TORCH-Profile IgG positive in 21 patients (46.7%) T.gondii, 45 (100 %) CMV, 31(68.9%) Rubella and 44 (97.8%) HSV I and II.

TORCH infection in antenatal women: A 5-year hospital-based study

Objectives: The diagnosis of acute TORCH infection in pregnant women being pertinent for the management of such infections prompted the current study due to lack of published data from India describing the seroprevalence of specific IgM antibodies to TORCH agents in this part of Northern India. Material and Methods: Blood samples of a total of 240 high-risk pregnant women attending the antenatal clinic of our tertiary care hospital during a 5-year period (2005–2009) were analyzed for specific IgM antibodies to Toxoplasma gondii, rubella, Cytomegalovirus (CMV), and combined herpes simplex virus (HSV) 1 and 2 by capture enzyme-linked immunosorbent assay. Results: Overall, seropositivity to TORCH infection in the present study was 98.8%. Seropositivity to T. gondii was 24.2%, rubella 9.2%, CMV 53.8%, and 11.7% were positive for combined HSV-1 and 2 infections. The average age of the study population was 27.5 years. Overall, 15.4% of women were seropositive for coinfections. Conclusion: The high seropositivity of 98.8% and presence of multiple infections seen in the present study communicate to all health authorities to screen routinely all pregnant women for TORCH infections for appropriate intervention in the proper management of these patients.

Is Zika Virus an Emerging TORCH Agent? An Invited Commentary.

Zika virus (ZIKV) is a mosquito-borne arbovirus from the family Flaviviridae, which had caused some epidemics since its discovery in 1947 without any significant impacts on public health. In 2015, however, a 20-fold increase in congenital microcephaly cases in northeastern Brazil was attributed to prenatally acquired ZIKV infection. Traditionally, TORCH agents have 4 common characteristics including causing a mild illness in infected mother, vertical transmission to fetus, developing several anomalies in the affected fetus, and in some instances, maternal therapy may not ameliorate fetal prognosis. Prenatal ZIKV infection has shown the aforementioned characteristics during the recent epidemics in South America and the Caribbean region; therefore, it should be considered as an emerging TORCH agent that may seriously threaten public health. Fetal ultrasound can be used as a safe, inexpensive, and easy-to-access imaging modality for detecting suspicious cases of congenital Zika syndrome in utero and suggesting confirmatory diagnostic examinations to these patients.