A study published in JAMA Pediatrics by the Karolinska Institute in Stockholm, Sweden, identified TORCH group infections as potential causes of autism and intellectual disability. These infections include Toxoplasma, syphilis, rubella, cytomegalovirus (CMV), and herpes simplex. The extent of these infections' impact on neurodevelopment within the community had not been fully quantified previously.
The research team utilized data from Sweden's national registries, tracking participants for up to 36 years. Congenital TORCH infections are rare, occurring in about 2.5 per 10,000 births, with cytomegalovirus accounting for nearly half of these cases.
Children with congenital TORCH infections still exhibited a higher risk of autism and intellectual disability compared to their unaffected siblings. According to the authors, these findings suggest the link cannot be solely explained by shared genetic factors within families.
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The strongest correlation was observed with severe forms of intellectual disability. Congenital infections were also more closely linked to autism accompanied by intellectual disability than to autism alone. Even without a diagnosis of these conditions, children exposed to TORCH at birth had lower academic scores at age 16. For rubella specifically, the difference was equivalent to a grade dropping from A to F in a subject.
The link between rubella and autism was previously established. Autism characteristics were described in children with congenital rubella syndrome, with subsequent studies showing 12-15 percent of these children met autism diagnostic criteria. In the Swedish study, rubella virtually disappeared following the implementation of a national vaccination program.
Dr. Mark Schleiss, a pediatric infectious disease expert at the University of Minnesota Medical School, commented that the findings suggest vaccination can help prevent some cases of autism spectrum disorder related to congenital infections. He authored the editorial accompanying the study.
According to the authors, the decline in rubella cases highlights the need to develop, implement, and maintain widespread vaccination programs to prevent congenital TORCH infections and their potential long-term health consequences.
Van Ha (Source: Gavi, JAMA)
