7. Viral Infection of the Fetus and Newborn

7. Viral Infection of the Fetus and Newborn - Viral...

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Viral Infections of the Fetus and Newborn Viral Infections of the Fetus and Newborn General considerations: • vertical transmission: intrauterine perinatal • viremia in mother required before transmission to fetus • abnormalities may be present at birth or develop years later • neonates are immundeficient - antibody levels reflect immunological experience of mother • time during pregnancy when infection occurs determines severity of disease in neonates Viral Infections of the Fetus and Newborn Intrauterine / Congenital Infections: Pregnancy effects: • disease in mother • spontaneous abortion, premature labour Fetal effects: • malformations, growth retardation, acute disease, asymptomatic infection but late neurologic sequelae, normal infant Perinatal Infections: • acute systemic disease leading to death, persistent infection with late sequelae, self limited disease, asymptomatic infection Intrauterine (Congenital) Infections TORCH Infections: TO xoplasmosis R ubella C ytomegalovirus H erpes simplex virus • Others - VZV, Parvovirus B19 Cytomegalovirus (CMV) • Herpesviridae family, DNA virus • humans are only reservoir • seroprevalence: 40 - 70% of adults are positive • acute infection is usually asymptomatic or mild; may present as “mono-like” illness and/or hepatitis • remains latent (? lymphocytes) Cytomegalovirus (CMV) Transmission: • intrauterine / perinatal • blood / blood products • close personal contact / sexual • transplantation • most infections are transmitted asymptomatically
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Cytomegalovirus (CMV) Severe disease in: • AIDS - 25% develop site or life- threatening disease - >90% infected at autopsy • Transplants - 20 - 60% develop infection • Neonates - CMV isolated in urine of 1:100 infants Cytomegalovirus (CMV)
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7. Viral Infection of the Fetus and Newborn - Viral...

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