The world is teeming with viruses and bacteria , some good, some bad and some harmless. Some, like gut bacteria, help you stay healthy, some add flavour to your food, some make you sniff and cough, while others cause inconvenient fever and aches and pain.?A few maim and kill.
Among the most worrisome are those that routinely cause mild disease but turn deadly when they infect pregnant women and their unborn baby. The deadliest five to watch out for are:
Zika, a virus that causes mild fever, rash, pink eye and joint pain in one in five people it infects, has emerged as the newest threat to pregnant women and their unborn babies. Though there is no conclusive evidence that Zika causes microcephaly, a congenital defect that results in babies being born with small heads and brain damage, but circumstantial evidence indicates it does. Scientists in Brazil, where close to 4,000 babies have been born with microcephaly since the Zika outbreak started a year ago, have found that the virus can cross from the infected mother to the baby through the placenta. Before 2015, Brazil had less than 20 cases of microcephaly each year.
Countries with local transmission such as Brazil, Colombia and Honduras have recommended women not get pregnant this year, El Salvador has advised against pregnancy until 2018. Though the risk to pregnant women is highest during the first trimester, many countries -- including India -- have advised pregnant women against travel to affected countries.
Genetic testing for Zika virus is the only way to know if a mother has caught the infection, but with less than one in five people developing symptoms, diagnosis is often missed. Also, unlike Ebola and Hepatitis C that are present in the blood for months after infection, Zika stays in the blood for just a week, which means infected people test positive only if tested in the week-long window when the person is still ill. The upside is that once the virus clears the body, it becomes safe for women to get pregnant, but for women living in countries with local transmission, re-infection is possible.
Rubella (German measles)
Rubella is highly contagious and spreads through cough and sneezes. In healthy people, it causes mild symptoms of fever, headache, joint pains and sore throat, but can cause miscarriage, stillbirth or birth defects newborns, including heart and brain damage, hearing loss and cataracts. Babies of pregnant women who get infected during the first 20 weeks of pregnancy develop congenital rubella syndrome, for which there is no treatment.
The MMR (measles, mumps and rubella) vaccine protects against rubella infection. It is still not part of India’s universal immunisation programme, though it is included in several state-run programmes and is now recommended routinely for children. Since many women over the age of 20 in India may not have got the MMR vaccine, consider getting tested for rubella immunity. If you’re not immune, get vaccinated at least one month before conceiving. The vaccine contains a live virus that may cause rubella infection in the baby, so pregnant women must not get vaccinated.
Group B Strep
Infection by the ubiquitous Group B strep bacteria is harmless to almost everyone except pregnant women and newborns. Getting infected from the mother can make newborns very ill and may even kill them. Pregnant women must test for group B strep in the 35-37 weeks of pregnancy, and if infected, must get treated with antibiotics (usually penicillin) to prevent the bacteria from infecting the baby. Some obstetricians recommend giving all pregnant women penicillin routinely during labour to lower risk.
Cytomegalovirus (CMV) is a common, harmless virus that stays dormant in healthy people for life but can cause hearing loss in newborns and babies who get infected in the womb. There’s no cure for CMV, but drugs can help treat newborns and people with weak immune systems. The threat to the baby’s health is highest when women develop an active infection during pregnancy and infects the baby in the womb. Infected babies often appear healthy at birth, but some develop hearing, vision loss or mental disabilities many months or years after birth.
CMV spreads through body fluids such as saliva, urine, blood and semen. For pregnant women, exposure is usually through sexual activity or contact with saliva and urine of young children, who shed more virus in body fluids than adults.
Pregnant women are 10 times more likely than others to get infected with Listeria, a bacteria that causes mild symptoms of fatigue and aches but can lead to miscarriage, stillbirth, premature delivery or severe infection in newborns. Infection occurs from contaminated food, such as unpasturised milk and cheese, cold cuts, and undercooked or raw meats and fish.
Pregnant women and new mothers must avoid unpasturised and uncooked milk, dairy and seafood and get tested for listeriosis if they feel sudden fatigue and aches. If infected, getting treated with antibiotics is recommended to protect the baby. No treatment is needed if a person is infected but doesn’t have symptoms..