TORCH Infections

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

TORCH is an acronym that stands for the following conditions:

• T: Toxoplasmosis
• O: Other infections like HIV, syphilis, parvovirus B19 (fifth disease), varicella (chickenpox) and Zika
• R: Rubella
• C: Cytomegalovirus (CMV)
• H: Herpes simplex virus (HSV)

Since your baby’s immune system isn’t fully developed yet, they have a harder time fighting infections on their own. TORCH infections can sometimes lead to complications, like problems with growth or organ development. Your healthcare team will monitor you and your baby closely to help reduce these risks.

How does my baby get a TORCH infection?

TORCH infections can spread from you to your baby in three ways:

• Through the placenta: Certain diseases can pass through the placenta to the fetus during pregnancy.
• During childbirth: Your baby can catch a TORCH infection during a vaginal delivery.
• After birth: You can pass an infection to your baby through breastmilk.

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”
• Enlarged liver
• Microcephaly

After age 2, signs of TORCH infection may include:

• Vision loss
• Hearing loss
• Seizures
• Learning disabilities

TORCH infections causes

The causes of TORCH infections depend on which virus or disease it is.

Toxoplasmosis

Toxoplasmosis is a disease caused by parasites. 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 diseases like:

• HIV: A virus spread through sexual contact or from sharing needles with an infected person.
• Syphilis: Bacteria cause this sexually transmitted infection (STI). You can get it from direct contact with syphilis sores.
• Fifth disease: Parvovirus B19 causes this rash. It spreads through saliva and mucus when an infected person coughs or sneezes.
• Chickenpox: The varicella-zoster virus (VZV) causes this highly contagious disease.
• Zika virus: An infected mosquito spreads this virus in areas where it’s common. It can also be passed through sex with an infected person.
• Listeria: You can get this infection from eating contaminated food, like soft cheeses and deli meat.

Rubella (or German measles)

The RuV virus causes rubella. Many people are vaccinated against it. It spreads when an infected person coughs or sneezes.

Cytomegalovirus (CMV)

CMV is a type of herpes virus. It’s spread through saliva and other bodily fluids. Babies and newborns don’t have the immunity to fight CMV.

Herpes simplex virus (HSV)

Herpes is a highly contagious STI. It spreads through sexual or direct contact with an infected person. HSV most commonly infects a newborn during vaginal childbirth.

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

Be sure to share your medical history with your healthcare provider, including vaccinations you got 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.
• Eat fully cooked meat and eggs.
• Have someone else clean litter boxes during pregnancy.
• Wear condoms during sex.
• Get tested for STIs before pregnancy.

Complications of TORCH infections

TORCH infections can cause pregnancy complications, like:

• Premature birth
• Intrauterine growth restriction
• Miscarriage
• Stillbirth

Babies born with TORCH infections may have long-term side effects. Identifying and treating infections as soon as possible leads to the best results for you and your baby. Some long-term complications include:

• Learning disabilities
• Vision or hearing problems
• Developmental delays

How doctors diagnose them

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. PCR tests work by detecting the genetic material of a virus in a fluid sample.

Your healthcare provider can see congenital disorders, growth problems and issues with major organ development on a prenatal ultrasound before birth.

How are they 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.

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.

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. 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

If you’re pregnant, it’s a good idea to let your provider know if you plan on traveling. They can let you know if TORCH diseases are common.