TORCH

The acronym “TORCH” stands for Toxoplasma gondii (Toxo), Rubella, Cytomegalovirus (CMV), and Herpes Simplex-1 and -2. It was first coined to simplify the diagnostic process for these pathogens, which can cause congential, perinatal, or neonatal infection. These pathogens may cause:

  • Mild symptoms in a healthy individual
  • Severe damage and even death in the developing fetus or newborn child
  • Serious complications in the immunocompromised, such as HIV or transplant patients
    • CMV is the most common viral infection in transplant patients, affecting 20-60% of all recipients1
    • HSV infections remain an important risk for transplant recipients2

To accurately assess infection and qualify risk, screening of IgG and IgM antibodies to TORCH pathogens is widely recommended for pregnant women, neonates, and individuals with a compromised immune system.

The presence of IgM antibodies or seroconversion to IgG indicates primary, acute infection, while that of IgG indicates recent or chronic infection in the case of Toxo and HSV-1 and 2, and past infection in the case of Rubella and CMV.

Due to the complexity of the immune system, many factors may impede the detection of IgM antibodies, making IgG detection important for the consideration of any necessary medical action.

Combining the results of IgG and IgM antibody detection can suggest:

Pathogen IgG and IgM Negative IgM Positive IgG+IgM Positive IgG Positive
Toxo No infection;
Avoid vector contact (i.e. cat feces)
 Current  infection  Recent  infection  Chronic  infection
 CMV No infection;
Susceptible to infection,Vaccine eligible
 Current  infection  Recent  infection Past infection or vaccination
 Rubella No infection;
Susceptible to infection,Vaccine eligible
 Current  infection  Recent  infection  Past infection or vaccination
 HSV-1 No infection;
Avoid contact with infected personnel
 Current  infection  Recent  infection  Chronic  infection
 HSV-2 No infection;
Avoid contact with infected personnel
 Current  infection  Recent  infection  Chronic  infection

Once a diagnosis is confirmed, available treatment options and ways to minimize risk of transmission include:

  • Proper treatment with suitable antibiotics or antiviral medication
  • Fetal monitoring during pregnancy in order to assess any necessary medical attention
  • Precautions to prevent transmission of infectious agents to the immunocompromised

If neither IgG nor IgM antibodies are detected, avoiding risky behavior and pathogen vector contact will help to minimize the risk of acquiring an acute infection. In the case of a negative Rubella result, vaccination may be an important preventative action.

For more information about each of these pathogens, please click on the respective disease page.

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