Abnormal Development - TORCH Infections
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|Educational Use Only - Embryology is an educational resource for learning concepts in embryological development, no clinical information is provided and content should not be used for any other purpose.|
Infections, collectively grouped under the acronym TORCH for Toxoplasmosis, Other organisms (parvovirus, HIV, Epstein-Barr, herpes 6 and 8, varicella, syphilis, enterovirus) , Rubella, Cytomegalovirus and Hepatitis. (some of these infections have additional pages and also see related pages on maternal hyperthermia and bacterial infections}.
Materal effects should really be called environmental (in contrast to genetic) removing the association of mother with the deleterious agent. Accepting this caveat, there are several maternal effects from lifestyle, environment and nutrition that can be prevented or decreased by change which is not an option for genetic effects.
Finally, when studying this topic remember the concept of "critical periods" of development that will affect the overall impact of the above listed factors. This can be extended to the potential differences between prenatal and postnatal effects, for example with infections and outcomes.
|Viral Links: TORCH Infections | Cytomegalovirus | Hepatitis Virus | HIV | Parvovirus | Polio Virus | Rubella Virus | Chickenpox | Lymphocytic Choriomeningitis Virus | Zika Virus | Vaccination | Environmental|
Some Recent Findings
|More recent papers|
This table shows an automated computer PubMed search using the listed sub-heading term.
References listed on the rest of the content page and the associated discussion page (listed under the publication year sub-headings) do include some editorial selection based upon both relevance and availability.
A Morand, C Zandotti, R Charrel, P Minodier, A Fabre, B Chabrol, X De Lamballerie [From TORCH to TORCHZ: Zika virus infection highlights infectious fetopathies]. [De TORCH à TORCHZ : fœtopathies infectieuses à virus Zika et autres.] Arch Pediatr: 2017; PubMed 28870816
Michael M Espiritu, Sean Bailey, Elena V Wachtel, Pradeep V Mally Utility of routine urine CMV PCR and total serum IgM testing of small for gestational age infants: a single center review. J Perinat Med: 2017; PubMed 28803228
Ashis Patnaik, Sudhansu Sekhar Mishra, Srikanta Das Extensive intracranial calcification of pseudo-TORCH syndrome with features of Dandy-Walker malformation. Asian J Neurosurg: 2017, 12(3);541-543 PubMed 28761539
Nathalie Auger, Caroline Quach, Jessica Healy-Profitós, Anne-Marie Lowe, Laura Arbour Congenital microcephaly in Quebec: baseline prevalence, risk factors and outcomes in a large cohort of neonates. Arch. Dis. Child. Fetal Neonatal Ed.: 2017; PubMed 28676560
Mohammad Zare Mehrjardi Is Zika Virus an Emerging TORCH Agent? An Invited Commentary. Virology (Auckl): 2017, 8;1178122X17708993 PubMed 28579764
The causal agent of Toxoplasmosis is the protist Toxoplasma gondii. This unicellular eukaryote is a member of the phylum Apicomplexa which includes other parasites responsible for a variety of diseases (malaria, cryptosporidiosis). The diagnosis and timing of an infection are diagnostically based on serological tests.
|Toxoplasmosis lifecycle||Toxoplasma tachyzoites|
Recent findings suggest that pre-pregnancy immunization against toxoplasmosis may not protect against reinfection by atypical strains.
- Links: Toxoplasmosis
A general term covering a ranges of viruses: parvovirus, HIV, Epstein-Barr, herpes 6 and 8, varicella, syphilis, enterovirus.
Susan B Brogly, Mark J Abzug, D Heather Watts, Coleen K Cunningham, Paige L Williams, James Oleske, Daniel Conway, Rhoda S Sperling, Hans Spiegel, Russell B Van Dyke Birth defects among children born to human immunodeficiency virus-infected women: pediatric AIDS clinical trials protocols 219 and 219C. Pediatr. Infect. Dis. J.: 2010, 29(8);721-7 PubMed 20539252
Rubella virus (Latin, rubella = little red) is also known as "German Measles" due to early citation in German medical literature. Infection during pregnancy can cause congenital rubella syndrome (CRS) with serious malformations of the developing fetus. This association between infection and abnormal development was first identified in 1941.The type and degree of abnormality relates to the time of maternal infection.
|Infant rubella virus||Rubella virus (electron micrograph|
- Links: Rubella Virus
Human cytomegalovirus (HCMV, Greek, cyto = "cell", megalo = "large") or Human Herpesvirus 5 (HHV-5) is a member of the herpes virus family. A viral infection that causes systemic infection and extensive brain damage and cell death by necrosis. HCMV infection is ranked as one of the most common infections in adults, with the seropositive rates ranging from 60–99% globally. In Western countries, adults with advanced AIDS prior to the introduction of highly active antiretroviral therapy (HAART) this virus also a cause of blindness (CMV retinitis) and death in patients.
Estimated annual number of United States children with long-term sequelae caused by various disease conditions.
Congenital cytomegalovirus data are from a literature review, with varying collection periods spanning multiple years.
Assumes 4 million live births per year and 20 million children less than 5 years of age. Where applicable, numbers represent means of published estimates. All estimates should be considered useful for rough comparisons only since surveillance methodology, time periods, and diagnostic accuracy varied by study.
| Hepatitis (inflammation of the liver) is caused in humans by one of 7 viruses (A, B, C, D, E) with the 2 additional F has not been confirmed as a distinct genotype; and G is a newly described flavivirus.
"All of these viruses can cause an acute disease with symptoms lasting several weeks including yellowing of the skin and eyes (jaundice); dark urine; extreme fatigue; nausea; vomiting and abdominal pain. It can take several months to a year to feel fit again." (CDC text).
Virus particles measure 42nm in overall diameter and contain a 27nm diameter DNA-based core.
Hepatitis Transmission Risk to the Fetus
- Hepatitis A - Fetal transmission of virus occurs with extreme rarity.
- Hepatitis B - Can occur as a consequence of intrapartum exposure, transplacental transmission, and breastfeeding.
20%–30% of HBsAg-positive/HbeAg-negative women will transmit virus to their infants. 90% of HBsAg- and HBeAg-positive women will transmit virus to their infants. Immunoprophylaxis at birth with both HBIG and Hepatitis B vaccine within 12 hours of birth decreases the risk of transmission. Passive (HBIG) and active immunization is 85%–95% effective in preventing neonatal HBV infection.
- Hepatitis C - The overall risk of transmission is approximately 5%–10% with unknown maternal viral titers.
All pregnant women with HCV should have viral titers performed.
Data: Hepatitis and reproduction
- Links: Hepatitis Virus
- Tatjana Vilibic-Cavlek, Suncanica Ljubin-Sternak, Mirela Ban, Branko Kolaric, Mario Sviben, Gordana Mlinaric-Galinovic Seroprevalence of TORCH infections in women of childbearing age in Croatia. J. Matern. Fetal. Neonatal. Med.: 2011, 24(2);280-3 PubMed 20476874
- S van der Weiden, S J Steggerda, A B Te Pas, A C T M Vossen, F J Walther, E Lopriore Routine TORCH screening is not warranted in neonates with subependymal cysts. Early Hum. Dev.: 2010, 86(4);203-7 PubMed 20227842
- N M Gregg Congenital cataract following German measles in the mother. 1941. Epidemiol. Infect.: 1991, 107(1);iii-xiv; discussion xiii-xiv PubMed 1879476
- Centers for Disease Control and Prevention, Congenital CMV Infection Trends and Statistics http://www.cdc.gov/cmv/trends-stats.html, viewed 6 November 2012 (EST).
- Practice Committee of American Society for Reproductive Medicine Hepatitis and reproduction. Fertil. Steril.: 2008, 90(5 Suppl);S226-35 PubMed 19007636
Joshua P Nickerson, Beat Richner, Ky Santy, Maarten H Lequin, Andrea Poretti, Christopher G Filippi, Thierry A G M Huisman Neuroimaging of pediatric intracranial infection--part 2: TORCH, viral, fungal, and parasitic infections. J Neuroimaging: 2012, 22(2);e52-63 PubMed 22309611
Sidra Ishaque, Mohammad Yawar Yakoob, Aamer Imdad, Robert L Goldenberg, Thomas P Eisele, Zulfiqar A Bhutta Effectiveness of interventions to screen and manage infections during pregnancy on reducing stillbirths: a review. BMC Public Health: 2011, 11 Suppl 3;S3 PubMed 21501448
Barbara J Stegmann, J Christopher Carey TORCH Infections. Toxoplasmosis, Other (syphilis, varicella-zoster, parvovirus B19), Rubella, Cytomegalovirus (CMV), and Herpes infections. Curr Womens Health Rep: 2002, 2(4);253-8 PubMed 12150751
A Helfgott TORCH testing in HIV-infected women. Clin Obstet Gynecol: 1999, 42(1);149-62; quiz 174-5 PubMed 10073308
E R Newton Diagnosis of perinatal TORCH infections. Clin Obstet Gynecol: 1999, 42(1);59-70; quiz 174-5 PubMed 10073301
A Greenough The TORCH screen and intrauterine infections. Arch. Dis. Child. Fetal Neonatal Ed.: 1994, 70(3);F163-5 PubMed 8198407
TORCH syndrome and TORCH screening. Lancet: 1990, 335(8705);1559-61 PubMed 1972489
Tatjana Vilibic-Cavlek, Suncanica Ljubin-Sternak, Mirela Ban, Branko Kolaric, Mario Sviben, Gordana Mlinaric-Galinovic Seroprevalence of TORCH infections in women of childbearing age in Croatia. J. Matern. Fetal. Neonatal. Med.: 2011, 24(2);280-3 PubMed 20476874
Marawan A Abu-Madi, Jerzy M Behnke, Haydee A Dabritz Toxoplasma gondii seropositivity and co-infection with TORCH pathogens in high-risk patients from Qatar. Am. J. Trop. Med. Hyg.: 2010, 82(4);626-33 PubMed 20348511
Jan M Kriebs Breaking the cycle of infection: TORCH and other infections in women's health. J Midwifery Womens Health: 2008, 53(3);173-4 PubMed 18455090
S Singh Prevalence of torch infections in Indian pregnant women. Indian J Med Microbiol: 2007, 20(1);57-8 PubMed 17657031
Sherif A Abdel-Fattah, Abha Bhat, Sebastian Illanes, Jose L Bartha, David Carrington TORCH test for fetal medicine indications: only CMV is necessary in the United Kingdom. Prenat. Diagn.: 2005, 25(11);1028-31 PubMed 16231309
June 2010 "TORCH Infections" All (183) Review (37) Free Full Text (18)
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Cite this page: Hill, M.A. 2017 Embryology Abnormal Development - TORCH Infections. Retrieved September 26, 2017, from https://embryology.med.unsw.edu.au/embryology/index.php/Abnormal_Development_-_TORCH_Infections
- © Dr Mark Hill 2017, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G