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Listeriosis in pregnant women

Listeriosis in pregnant women: What do we talk about?
Listeriosis is an infection caused by a bacterium, Listeria monocytogenes. In most healthy individuals, listeriosis unnoticed, sometimes it causes flu-like symptoms (fever, headache) and more rarely gastroenteritis.
In contrast, patients whose immune system is deficient in people over 60 years, clinical symptoms may be more severe (bacteremia, septicemia, meningitis), resulting in hospitalization almost systematic.
In pregnant women, listeriosis, sometimes inapparent, complicated pregnancy and causes damage to the fetus up until his death in utero.

It is a notifiable disease.

Listeriosis in pregnancy: what are the health issues?
Anyone can contract listeriosis, especially that there is no sustainable immunization, unlike toxoplasmosis: the fact of having listeriosis are not protected against reinfection. Healthy carriers exist, they excrete the bacteria but are not sick. Bacterium little dangerous to healthy adults, the disease is rare - less than 4 cases per million inhabitants - it is still fatal in 20 to 30% of cases (figures Institut Pasteur, Paris).

The incidence in the general population reported by the Epidemiological EPIBAC network of invasive Listeria monocytogenes increased in 2009 (0.60 cases per 100 000) compared to 2008 (0.46 cases per 100 000) (p <10-2 ) and thus returns to the level observed in 2007 (0.53 cases per 100 000) (p = 0.2).

The total number of cases maternal and newborn was 43 in 2010 (figures InVS) including 4 fetal deaths and 10 stillbirths. Evening 5.2 cases per 100 000 births. These figures are stable thanks to information campaigns on listeriosis in pregnant women.

Listeriosis in pregnancy: what are the mechanisms?
Listeriosis is primarily transmitted through contaminated food: cheese sold grated, raw milk, soft cheese, sausage, meat, fruits, vegetables and seafood, especially raw fish. The bacteria passes through the intestinal barrier and spreads throughout the body via the bloodstream with a particular tropism for the nervous system, meningitis, encephalitis ...

The incubation period between the consumption of contaminated food and developing listeriosis mother from a few days to two months.

During pregnancy, listeria through the placenta to the fetus it infects the nervous system and especially the lungs. It causes placental and amniotic miscarriages and death in utero, increasingly frequent with advancing pregnancy.

Another way of transmitting the infection to baby during birth by natural means: passage through the vagina infected breast.

What are the symptoms of listeriosis during pregnancy?
A pregnant woman, the symptoms of listeriosis are often very pronounced: digestive disorders common wave ILI. Any low-grade fever (slight elevation of body temperature around 38 ° C) must alert. Like any flu, with headaches to muscle or abdominal pain with vomiting, nausea states or fatigue for no clear reason justifies an immediate consultation of a general practitioner, gynecologist or midwife.
Sometimes no discomfort does make the diagnosis is revealed only after the birth months of insidious infection. The birth heals mother of his latent infection.

Contractions and a miscarriage in the early months of pregnancy should always evoke. In the second quarter, miscarriage condemns child, often stillborn. Later preterm birth reveals a seriously ill newborn sepsis, respiratory distress and / or neurological disorders (meningitis).

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