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      An Overview of Tickborne Infections in Pregnancy and Outcomes in the Newborn: The Need for Prospective Studies

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          Tick-borne infections are an ever-increasing issue internationally, many factors contribute to this including a changing climate. Pregnant women represent the single largest vulnerable group in populations due to a relative immune deficiency status. Infections in pregnant women have the added gravity of potential infection in the developing fetus which may have catastrophic consequences including death in-utero or lifelong debilitation. Currently there is a paucity of data surrounding tick-borne infections in pregnancy and long-term outcomes for mother and infant for conditions like Lyme disease and co-infections. At present there are no established international surveillance systems to identify and gain understanding of these infections in pregnancy. Furthermore, the removal of Congenital Lyme Disease from ICD-11 codes hampers dialogue and characterization of borreliosis in pregnancy and stifles future developments of this understudied domain. This review makes the case for further study and re-opening a dialogue of tick-borne infections in pregnancy.

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          Pregnancy and infection.

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              Rocky Mountain spotted fever.

              Rocky Mountain spotted fever (RMSF) is a life-threatening disease caused by Rickettsia rickettsii, an obligately intracellular bacterium that is spread to human beings by ticks. More than a century after its first clinical description, this disease is still among the most virulent human infections identified, being potentially fatal even in previously healthy young people. The diagnosis of RMSF is based on the patient's history and a physical examination, and often presents a dilemma for clinicians because of the non-specific presentation of the disease in its early course. Early empirical treatment is essential to prevent severe complications or a fatal outcome, and treatment should be initiated even in unconfirmed cases. Because there is no vaccine available against RMSF, avoidance of tick-infested areas is still the best way to prevent the infection.

                Author and article information

                Front Med (Lausanne)
                Front Med (Lausanne)
                Front. Med.
                Frontiers in Medicine
                Frontiers Media S.A.
                06 March 2020
                : 7
                1Infectious Diseases Department, Mater Misericordiae University Hospital , Dublin, Ireland
                2Infectious Diseases Department, Rotunda Maternity Hospital , Dublin, Ireland
                3School of Medicine, University College Dublin , Dublin, Ireland
                Author notes

                Edited by: Arie Hendrik Havelaar, University of Florida, United States

                Reviewed by: Delbert Abi Abdallah, Thiel College, United States; Ana Afonso, University of São Paulo, Brazil

                *Correspondence: John S. Lambert jlambert@ 123456mater.ie

                This article was submitted to Infectious Diseases Surveillance, Prevention and Treatment, a section of the journal Frontiers in Medicine

                Copyright © 2020 Lambert.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 46, Pages: 7, Words: 5703


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