Hygiene and infections

An infection can have bad consequences for yourself and for your unborn baby. Our midwives have established a few simple rules and measures that help you prevent infections.

  • Always wash your hands before and after cooking food, visiting the bathroom, changing diapers and gardening;
  • Cook meat, fish and shellfish until they are well done;
  • Do not eat raw meat products such as raw beef sausage and steak tartare;
  • Do not drink raw, unpasteurized milk;
  • Do not eat cheese made of raw milk (‘au lait cru’);
  • Make sure your fridge is cold (2-7 ° C) and clean it daily;
  • Clean fresh products such as fruit and vegetables (also pre-washed lettuce) thoroughly using running water;
  • Use gloves when gardening and avoid contact with sand in sandpits. This reduces the chance of ingesting sand or soil contaminated with Toxoplasma or Listeria;
  • Do not clean the cat litter box, as Toxoplasma can be found in cats’ stools. If you do clean the cat litter, do it daily, because Toxoplasma’s “eggs” are only dangerous after one day. Wear gloves;
  • Avoid direct contact with goats and sheep that have just given birth and always wash your hands after touching animals at a farm or petting zoo.

What do you have to be mindful of during the pregnancy?

Unfortunately, not all infections are completely unavoidable, but unfortunately not all infections are dangerous. A cold doesn’t hurt, for instance. Some infections can have severe consequences, though. Measles during pregnancy can lead to a miscarriage or premature birth, and rubella can cause birth defects.

Pathogens

An infectious disease is caused by bacteria, viruses, parasites or fungi. Among these pathogens, there are a few that can cause problems during pregnancy. Below are the most common infections and infant diseases. If you have any doubts or questions, please contact our practice!

Mumps is an infection caused by the Paramyxovirus. Mumps is spread from person to person through infected droplets that infect the upper respiratory tract. Symptoms include mild to high fever, facial pain, swelling of the pancreas and the temples or jaws. The infection is transferable six days before to nine days after the swelling has become visible in the face. The symptoms usually disappear within 1-2 weeks.

Mumps is part of the Dutch immunization program since 1976. The current program offers a combined vaccine against mumps, rubella and measles at the ages of 14 months and 9 years.

Women suffering from mumps during pregnancy until the third month have a slightly elevated risk of miscarriage. It’s unclear if mumps during pregnancy poses a threat to the unborn child.

If you were not vaccinated and never suffered from mumps, we advise avoiding contact with patients. In case you have been in contact with someone who is suffering from mumps or has suffered from it in the past, please contact our practice.

Het cytomegalovirus (CMV) is een virus dat via contact met anderen overgedragen kan worden, met name via direct en indirect contact met lichaamsvloeistoffen zoals speeksel, urine en bloed en door seksueel contact. Meer dan de helft van de mensen heeft een CMV-infectie doorgemaakt, maar omdat het meestal zonder klachten verloopt, wordt het bijna nooit opgemerkt. Sommige mensen hebben kortdurend last van vermoeidheid of koorts. Als je het virus hebt gehad, blijft het in je lichaam aanwezig.

Vooral jonge kinderen scheiden CMV in hoge mate uit in urine en speeksel. In de thuissituatie met jonge kinderen is overdracht van CMV moeilijk te vermijden, maar met goede handhygiëne kan besmetting vaak voorkomen worden. Daarom is het belangrijk om goed handen te wassen, bijvoorbeeld na het verschonen van een luier en om contact met speeksel van jonge kinderen te vermijden door geen voedsel, bestek en bekers te delen.

Een CMV-infectie in de zwangerschap kan afwijkingen veroorzaken. Echter, omdat veel vrouwen al eens  een CMV-infectie hebben doorgemaakt is de kans hierop klein, omdat je dan antistoffen bij je draagt.  Indien je niet weet of je ooit een CMV-infectie hebt gehad en in aanraking komt met iemand met een CMV-infectie neem dan contact met ons op.

Pertussis, or whooping cough, is a highly contagious bacterial respiratory disease and is caused by Bordetella pertussis. Pertussis is contagious during the first 3-4 weeks of the disease; its incubation period is 7 to 14 days. In the beginning, pertussis is like a common cold with sneezing, mild fever and coughing. Suddenly, severe coughing fits will occur, accompanied by a whooping sound and coughing up phlegm.Pertussis is highly dangerous to young infants who have yet to be vaccinated. When someone in the family has pertussis and there is a newborn baby in the family, or someone in the family has been pregnant for more than 34 weeks, please contact our practice.From December 2019, women are offered pertussis vaccination during pregnancy. As a result, newborns are better protected against whooping cough from birth. The vaccination is included in the National Immunization Program. You can read more in this folder of RIVM.

Listeria is a bacterium that occurs in raw, unpasteurized milk, chicken, meat, fish and shellfish, especially if kept for (too) long. Because Listeria is found in soil, the bacterium is also found on vegetables and fruits. An infection with Listeria may cause premature birth or stillbirth. Listeria is not resistant to heating. If you observe the hygiene measures, the risk of infection is small.

Measles is caused by the measles virus, and is a highly contagious and serious disease. It spreads through moisture droplets and through direct contact with nasal and throat secretion. Measles can be transferred from six to three days before, up to about one week after skin rash appear.

The symptoms resemble those of a heavy cold: a runny nose, coughing, sneezing, inflamed eyes, sore throat and high fever. On the fourth or fifth day, the first rash will appear, after which it will decrease again. After a week, all symptoms have usually disappeared.

Measles is part of the Dutch immunization program since 1976. The current program offers a combined vaccine against mumps, rubella and measles at the ages of 14 months and 9 years.

Most babies are protected because the mother has been vaccinated or has had measles herself. If you have never been vaccinated or have never had measles, avoid contact with patients who may have measles. The passage of measles during pregnancy is not associated with an increased risk of congenital abnormalities. Very rarely, an infection leads to a miscarriage or premature birth.

Q fever is a disease caused by the Coxiella burnetii. Goats and sheep who have just given birth can spread the bacteria. The passage of Q fever during pregnancy gives an increased chance of miscarriage, premature birth or stillbirth. Avoid contact with these animals during the lambing/kidding period (February to May). Pay attention to complaints such as fever with headaches and coughs and contact our practice if you think you may have Q fever.

Rubella is caused by the Rubella virus. Rubella is contagious and is transmitted by coughing, sneezing or even talking. It can also be transmitted via hands, cutlery, cups or toys. After infection, it takes two to three weeks before symptoms develop. Rubella often starts with a cold, followed by a sudden rising rash, first in the face, later throughout the body. The spots have a pale pink color and are not itchy. In addition, fever may occur, pain and swelling in the joints and swollen glands. Rubella is contagious from ten days before to seven days after the spots have appeared. The spots disappear spontaneously after a few days and rarely does high fever occur.

Rubella is part of the Dutch immunization program since 1976. The current program offers a combined vaccine against mumps, rubella and measles at the ages of 14 months and 9 years.

Scarlet fever is caused by bacteria and can occur at any age. It starts with severe fever and sore throat. Tonsils and adenoids are swollen and inflamed. After a few days small red dots appear in the neck and armpits, that gradually spread throughout the body. Very typical is the thick, strawberry red tongue. After one to three weeks, swelling of the palms and soles of the feet occurs. The disease cures spontaneously after a few days. Scarlet fever can only cause a problem with the unborn child in a very serious infection. If you have symptoms of scarlet fever, please contact our practice.

Toxoplasmosis is caused by a parasite that can be found in feces of (especially young) cats, in the soil contaminated with cat feces, and in raw or insufficiently cooked meat. Toxoplasmosis can lead to birth defects in the unborn child. Toxoplasmosis is not resistant to heating. If you observe the hygiene measures, the risk of infection is small.

Chickenpox is caused by the initial infection with varicella zoster virus. It is an airborne disease that spreads easily through the coughs and sneezes of an infected person. It may also spread through contact with the blisters. Skin rashes are the first symptoms of the disease. From one day before the blisters appear up until the blisters have dried out, chickenpox is highly contagious. Chickenpox generally takes approximately 10 days to heal and heals by itself.

Almost everyone gets chickenpox during their childhood. Anyone who has had the disease is immune for the rest of their lives. In case you are sure you’ve had chickenpox in your youth, there’s no reason to worry about contact with people or children with chickenpox during pregnancy. If you’re unsure whether you’ve had it, it is possible you will be infected during pregnancy. The chance that the fetus will be infected too is small, but not impossible, and will cause abnormalities in the child. If you have been in contact with a patient, please contact the practice.

Fifth disease is caused by a virus and is mildly contagious. Fifth disease is transmitted primarily by respiratory secretions (saliva, mucus, etc.) but can also be spread by contact with infected blood. After the initial infection, it takes approximately two weeks for the rash to appear. However, the disease is already contagious a week before the rash appears. Once the rash has appeared, chance of transmission is small.

Fifth disease primarily occurs in children of 4 to 10 years old, usually in spring or early summer. Some of the symptoms are red cheeks, with a bright pink-red rash. This rash will spread to the torso, the buttocks, arms and legs. The rash disappears after approximately ten days.

Many adults have had fifth disease in their youth, which makes them immune for the rest of their lives. With pregnant women who have not had the disease in their youth and become infected, the fetus too can be infected. Early in the pregnancy this can lead to miscarriage, and later in the pregnancy it can lead to anemia in the baby. However, there have been no indications that fifth disease can lead to abnormalities in the child.

If you’re unsure if you’ve had fifth disease in your youth, please avoid contact with patients. In case you have come in touch with fifth disease, please contact us.

Roseola is also caused by a virus and only occurs in children of 6 months to 3 years of age. The child will suddenly get a high fever, up to 40 degrees Celsius. Sometimes the glands in the neck and behind the ears are swollen. After three to five days the temperature will fall quickly. That’s when small, non-itchy spots will appear in the face, neck and later the torso. The rash will disappear within one to two days. There has been no indication that roseola causes complications in a pregnancy.