TORCH Infections

What are TORCH infections?

TORCH infections (or TORCH syndrome) are a group of infectious diseases that affect a developing baby (fetus) or newborn baby. If you get a TORCH infection, you can pass it to your baby during pregnancy, during delivery or after birth.

Since your baby lacks immunity to fight off diseases, TORCH infections can cause complications to the pregnancy or prevent your baby’s organs from developing properly. How sick your baby gets depends on the type of infection and how far along they are in development when they're infected. Typically, infections that occur early in the pregnancy result in worse outcomes. Prompt medical treatment is needed to reduce the risk of complications.

What are the TORCH diseases?

TORCH infection is an acronym that stands for the following conditions:

• Toxoplasmosis.
• Other infections like HIV, syphilis, parvovirus B19 (fifth disease), varicella (chickenpox) and (Zika).
• Rubella.
• Cytomegalovirus (CMV).
• Herpes simplex virus (HSV).

How does my baby get a TORCH infection?

Your baby can get a TORCH infection in three ways:

• Through the placenta: Certain diseases are carried through your bloodstream to your baby's blood through the placenta during pregnancy. The placenta provides your baby with oxygen, nutrients and blood.
• During childbirth: Your baby can catch a TORCH infection while passing through the birth canal during a vaginal birth.
• After birth: You can pass an infection to your baby through your breastmilk if you are breastfeeding (chestfeeding).

How common are TORCH infections?

TORCH infections account for approximately 2% to 3% of all congenital disorders (conditions you’re born with).

Can TORCH infection cause a miscarriage?

Yes, TORCH infections can cause pregnancy complications such as premature birth, intrauterine growth restriction or miscarriage. It can also cause stillbirth, which is the loss of pregnancy after 20 weeks of gestation.

What are the signs and symptoms of TORCH infections?

The exact symptoms vary depending on the specific underlying infection, but TORCH infections share these symptoms:

• Fever, sluggishness and trouble feeding.
• Jaundice.
• Low birth weight.
• Hearing impairment.
• Patent ductus arteriosus (PDA).
• Small red or brown spots (purpura).
• Bluish or purplish spots called “blueberry rash.”
• Hepatosplenomegaly (enlarged liver).
• Cataracts.
• Microcephaly (a small head).

After age 2, signs of TORCH infection may include:

• Loss of vision.
• Loss of hearing.
• Seizures.
• Learning disabilities.

What causes TORCH infections?

How a pregnant person develops a TORCH infection depends on the type of disease.

Toxoplasmosis

Toxoplasmosis is a disease caused by a parasite. You can get it from eating undercooked meats or from being exposed to cat feces.

Other infections

The “O” in TORCH stands for other and includes a group of diseases.

• HIV: A virus spread through sexual contact or direct contact with HIV-infected blood (like from sharing needles). Most HIV infections in children occur in the third trimester, during or after delivery when the birthing parent isn't on the appropriate medications.
• Syphilis: A sexually transmitted infection caused by bacteria. You can get it from direct contact with syphilis sores during anal, vaginal or oral sex. Congenital syphilis is on the rise and babies are getting the infection in the birth canal.
• Fifth disease: A mild rash caused by parvovirus B19. It spreads through saliva and mucus when an infected person coughs or sneezes.
• Chickenpox: A highly contagious disease caused by the varicella-zoster virus (VZV). In most cases, getting chickenpox once in your lifetime (usually as a child) or getting vaccinated against the disease gives you immunity for life.
• Zika virus: A virus spread by an infected mosquito in areas where the virus is common. It can also be passed through sex with an infected person.

Rubella (or German measles)

Most pregnant people are vaccinated against rubella, so this disease is rare. However, if you didn't get the MMR vaccine (measles, mumps and rubella) as a child and are considering getting pregnant in the future, you should talk to your healthcare provider about getting the vaccine.

Cytomegalovirus (CMV)

CMV is a type of herpes virus. It’s spread through saliva and other bodily fluids. Most adults will have CMV and never know because their immune system fights it. However, developing babies and newborns don’t have the immunity to fight CMV. Once you have CMV, it stays in your system for life, but your immune system suppresses it.

Herpes simplex virus (HSV)

Herpes is a highly contagious sexually transmitted infection. There are two types of HSV infection: HSV-1 (oral and genital) and HSV-2 (mostly genital). It's most commonly spread through sexual or direct contact with an infected person. HSV most commonly infects a newborn during a vaginal childbirth, so it's important to discuss an HSV diagnosis with your healthcare provider during pregnancy.

Are TORCH infections contagious?

Yes, TORCH infections are contagious and spread easily.

How are TORCH infections diagnosed during pregnancy?

TORCH infections are diagnosed through blood tests, PCR (polymerase chain reaction) tests and viral cultures. A viral culture is when your healthcare provider takes a sample of fluid, cells or tissue from your body and tests it for infectious diseases. Common areas include saliva from your mouth, mucus from your nose, blood, pee, amniotic fluid or fluid from a skin rash or sore. PCR tests work by detecting the genetic material of a virus in a fluid sample.

Some congenital disorders, growth problems or issues with major organ development can be seen on prenatal ultrasound and diagnosed before birth.

How are TORCH infections diagnosed in newborns?

After you’ve been diagnosed with a TORCH infection, your healthcare provider will take steps to identify a TORCH infection in your baby. Not all TORCH infections are passed to your baby during pregnancy, and just because you have an infection doesn’t mean your baby will get it.

Healthcare providers diagnose TORCH infection in newborns:

• During a physical exam at birth.
• After evaluating your baby's symptoms.
• With ultrasound or other imaging tools during pregnancy.

Healthcare providers use the same tests to diagnose TORCH infections in newborns as they do for adults. Your child's healthcare provider may take a small blood sample from their heel or finger or obtain a fluid sample to test for viral infections.

Additional tests like computed tomography (CT) scans or magnetic resonance imaging (MRI) can help identify complications or side effects of TORCH infections.

How are TORCH infections treated?

Treatment for TORCH infections depends on the disease, when the infection occurred and the severity of symptoms. It may include antibiotics, antiparasitics or antiviral medications. Some TORCH infections are viruses and don't have treatment other than rest and hydration.

If you're diagnosed with a TORCH infection, your provider will monitor your pregnancy and consult with maternal-fetal medicine specialists. Depending on the condition, your baby may need immediate medical attention or care in a neonatal intensive care unit (NICU) at birth.

Talk to your healthcare provider if you're breastfeeding or plan to breastfeed and have one of the TORCH infections during pregnancy.

How can I lower my risk for TORCH infections during pregnancy?

Be sure to share your medical history with your healthcare provider, including which vaccinations you received as a child. Some other things you can do to reduce your chances of TORCH infection are:

• Avoid contact with people who are sick.
• Wash your hands often.
• Don’t share drinks or utensils with other people.
• Avoid traveling to parts of the world where certain infectious diseases are prevalent.
• Eat fully-cooked meat and eggs.
• Have someone else clean litter boxes during pregnancy.
• Wear condoms during sex.
• Get tested for STIs before pregnancy.
• Take antiviral medications as directed by your provider.

What are the long-term complications of TORCH infections?

Babies born with TORCH infections may have long-term side effects. The outlook is better when your baby is treated as soon as possible for TORCH infections. Some long-term complications include:

• Learning disabilities.
• Vision or hearing problems.
• Developmental delays.

Most TORCH infections are treatable with medication. It's important to discuss any symptoms you have during pregnancy with your healthcare provider. Identifying and treating infections as soon as possible leads to the best results for you and your baby.

When should I see my healthcare provider?

Contact your healthcare provider immediately if you're pregnant and think you have one of the TORCH infections. Symptoms vary depending on the condition, but some things to look for include:

• Fever.
• Unexplained rashes or skin lesions.
• Swollen lymph nodes in your neck or groin area.
• Sore throat.
• Body or muscle ache.
• Cold cores or blisters on your genitals or around your mouth.

A note from Cleveland Clinic

TORCH infections refer to a group of infectious diseases that affect a fetus or newborn baby. They can be passed to your baby during pregnancy, childbirth or shortly after birth in breastmilk. The best way to prevent TORCH infection is to practice good hygiene during pregnancy and wear condoms during sex. TORCH infections are rare but can have serious implications for your baby because they don't have a strong immune system. Be sure to tell your doctor your full medical and vaccination history, including if you've been treated for sexually transmitted infections. Discuss any concerns you have with your provider. In most cases, babies with TORCH infections make a full recovery.