Adapted with permission from the Middlesex-London Health Unit

While the information contained in the materials is believed to be accurate and true, no responsibility is assumed by MLHU and mother of twins for its use.

Infections During Pregnancy – A Quick Reference Guide – Always check with your Dr if you have a medical condition.

Chickenpox (Varicella)-Highly contagious virus.-Incubation period, 10-21 days.-Person-to-person by direct contact, droplet or airborne, and by indirect contact with articles freshly soiled with discharges from vessicles (blisters).-Contagious before rash appears, and continuing until all lesions have crusted over.

-Once acquired, immunity is lifelong.
-Mild fever followed in a day or two by a rash, which may be very itchy. Red spots soon turn into fluid filled vessicles.

-More severe disease in people over 12 years old.
-If not previously infected with chicken pox should consider a blood test to determine immunity.-Non-immune women should highly consider varicella vaccine. Two doses at least 4 weeks apart required.

Should NOT become pregnant for one month after second needle.
-If immune, no precautions are necessary.

If not immune and aware of chickenpox cases in community avoid contact with these individuals.

-DO NOT VACCINATE if pregnant.
-If exposed and unsure of immune status, consult physician immediately. A blood test to determine immunity should be done. If a woman is susceptible, an injection of varicella-zoster immune globulin (VZIG) may be given within 96 hours to help prevent severe infection.

-Medications may be recommended for the pregnant woman in her 2nd or 3rd trimester.
Fifth Disease (Parvovirus B19-spread through secretions of the mouth and nose (i.e., sneezing and coughing, touching used facial tissue)-transmission from mother to fetus is possible.

-Contagious before rash appears.
-Mild illness. Rash in children ‘slapped cheek’, lace-like rash on trunk and extremeties.-Rash is not typical or absent in adults.

-Adults may develop joint pain, which can last for days to months to years.

-25% or more may have no symptoms.
-At least 50% of young adults have developed immunity-No vaccine available.

-If concerned can undergo blood testing to determine immunity.
-Good handwashing is very important.-Cover nose and mouth while sneezing and coughing, and carefully dispose of used facial tissues.-Do not share eating utensils.

-Outbreaks in child care and schools indicates wider spread in the community, therefore, exclusion from childcare settings is not recommended as this only slightly decreases the risk of exposure.
-Consult physician. May want to consider blood testing to determine immunity.-No vaccine or drug treatment available.-Even if infected, unlikely to be passed on to fetus.

-If infection occurs in first half of pregnancy, less than 10% risk of fetal hydrops and fetal death.
Influenza-Droplet, direct or indirect contact, airborne.

-Contagious one day before onset of symptoms to 3-5 days after onset of symptoms in adults, 7 days after onset in children.
-Fever, headaches, muscle pain, extreme fatigue, sore throat, runny nose, and cough.-Pregnancy can increase the risks of complications and hospitalization from Influenza.-Should get vaccinated if planning a pregnancy during Influenza season (Oct – April)

-Inactive vaccine is approx. 70-80% effective in healthy adults.
-Good handwashing is very important.

-Vaccination is considered safe during any stage of pregnancy.
-Usually self-limiting. If symptoms are severe, and you are concerned, consult physician.-The medication Tamiflu is not recommeded for pregnant women.

-Be cautious with over-the-counter medications, and always consult physician or pharmacist before taking any over-the-counter medications.
Toxoplasmosis-A parasite, which can infect all mammals, but is commonly carried in cats and excreted in their feces. -From eating raw or undercooked infected meat (pork or mutton).-Pregnant women may pass on to fetus through placenta.

-Not spread from person to person.
-Usually is no symptoms are present, but may experience malaise, fever, sore throat, and muscle pain. Swollen lymph nodes are the most common sign.

-May also experience a mononucleosis-like illness.
-Daily changing of cat litter is a good idea, as the toxoplasma parasite does not become infectious for 1-2 days after passage.

-No vaccine available.
-Good handwashing is very important.-Avoid activities which expose you to cat feces (litter boxes, gardening), or at the least, wear gloves and wash hands thoroughly after removing the gloves.

-Cook meat thoroughly, wash fruits and vegetables, wash hands and clean surfaces properly.
-Consult physician. Blood testing of the fetus or detection of the parasite in fetal blood or amniotic fluid can determine if infection of the fetus has occurred. -If the mother is infected, treatment is recommended.-Babies born infected usually have no symptoms at birth but can develop impairments in childhood.
Rubella (German Measles)-Through droplet or direct contact with the nose and throat secretions of an infected person.-Communicable from a week before to 7 days after onset of rash.-Immunity is lifelong after natural infection and usually lifelong after vaccination.

Infants born to immune mothers are protected for 6 –9 months after birth.
-In adults, is usually a mild disease characterized by a rash, swollen lymph nodes, and slight fever.

-Up to 50% of infections have no symptoms.
-Prenatal screening for Rubella immunity is highly recommended, as immunity from childhood vaccination may decrease over time.

-Non immune women should strongly consider vaccination with MMR. If planning to become pregnant, should wait 1 month after receiving MMR.
-Always practice good handwashing. --DO NOT VACCINATE if pregnant.

-Immunizing susceptible children in the household does not pose a risk to the pregnant woman.
-Greatest risks to fetus if infection occurs during the 1st trimester of pregnancy.

-If exposed early in pregnancy and susceptible, consult physician immediately. Immunoglobulin (IG) may be given to suppress symptoms, but IG may not prevent infection.
Listeriosis (Listeria monocytogenes)-Distributed widely in environment, especially in food.-Unpasturized milk, soft cheeses, prepared meats (hot dogs, pate), undercooked poultry, unwashed raw vegetables.

-Can multiply in contaminated refrigerated foods.
-Maternal infection is associated with an influenza-like illness, fever, malaise, headache, gastrointestinal symptoms, and back pain.-Always make sure to wash raw vegetables before eating. Keep uncooked meats separate from ready to eat foods, and avoid unpasteurized dairy products.-Good handwashing after handling uncooked foods.-As well as washing raw vegetables and keeping raw meats and vegetables separate, avoid unpasteurized dairy, soft cheeses (feta, brie, camembert, and blue-veined cheeses), and smoked fish.-Leftover or ready-to-eat foods (hot dogs) should be reheated until steaming hot (74oC).-May choose to avoid cold cuts although the risk from cold cuts is relatively low.

-If infection is diagnosed during pregnancy, medications are recommended to prevent infection in the fetus which can cause abortion, stillbirth, infection at birth, or menningitis in the infant even if the mother has no symptoms at delivery.


-Useful website from Health Canada on Food recalls,

National Geography Multiples DVD

Twins Related Books