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
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