TORCH 5 in 1 Test

Product Information

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<title>TORCH 5 in 1 STD test</title>
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<h3>Rapid combination test for toxoplasmosis, cytomegalovirus, rubella,
and herpes types 1 and 2.</h3>
 
The DiagLineTM One Step Torch 5 in 1 Panel is a rapid test  IgG
and IgM antibodies to Toxoplasma gondii (TOXO), Cytomegalo- 
virus (CMV), Rubella Virus (RV), and Herpes Simplex virus types 1 and 2
(HSV-1 and HSV-2) in human blood.  A drop of blood is obtained by
using the thumb prick device and the dropper provided to place the
blood sample into the well of the cassette. 
 
Introduction 
The conception of the TORCH infections was to group five infections,
including Toxoplasmosis (TOXO),Rubella Virus (RV), Cytomegalovirus
(CMV) , Herpes simplex virus (HSV-1 and HSV-2). Infections acquired in
utero or during the birth process are a significant cause of fetal and
neonatal mortality and an important contributor to early and later
childhood morbidity. Thus, routine screening of pregnant women at the
first prenatal visit for TORCH titers is commonplace in many parts of
the world. 
 
SUMMARY AND CLINICAL SIGNIFICANCE for
TOXO: 
T. gondii is an obligate intracellular protozoan parasite with a
worldwide distribution (1,2).  Serological data indicate that
approximately 30% of the population of most industrialized nations is
chronically infected with the organism (3). When a seronegative woman
become infected T. gondii during pregnancy, the organism is often
transmitted across the placenta to the fetus (1,4). The severity of
infection in the fetus varies with the trimester during which the
infection was acquired. Infection during the trimester may lead to
spontaneous abortion, stillbirth or overt disease in the neonate.
Approximately 75% of congenitally infected newborns are symptomatic.
However, nearly all children born with subclinical toxoplasmosis will
develop adverse ocular or neurologic sequelae later in life (4,7).
Approximately 80-85% develops chorioretinitis and some may also
experience blindness or mental retardation. A variety of serologic
tests for antibodies to T. gondii have been used as an aid in diagnosis
of acute infection and to assess previous exposure to the organism. The
more widely used test include the Sabin-Feldman dye test, direct
agglutination, indirect hemagglutination, latex agglutination, indirect
immunofluorenscence, and ELISA. 
 
SUMMARY AND EXPLANATION OF THE TEST for CMV: 
Cytomegalovirus is a herpes virus and a leading biological factor
causing congenital abnormalities and complications among those who
receive massive blood transfusions and immunosuppressive therapy. About
half of pregnant women who contract a primary infection spread the
disease to their fetus. When acquired inutero, the infection may cause
mental retardation, blindness, and/or deafness.  Serological tests
for detecting the presence of antibody to CMV can provide valuable
information regarding the history of previous infection, diagnosis of
active or recent infection, as well as in screening blood for
transfusions in newborns and immunocompromised recipients. 
 
SUMMARY AND EXPLANATION OF THE TEST for Rubella Virus (RV): 
Rubella is a herpes virus. Generally rubella is considered a mild
adolescence disease.  However a maternal infection could be
transmitted through the placenta to the fetus, causing congenital
rubella. Congenital rubella may result in chronic cardiac disease,
growth retardation, hepatosplenomegaly, malformations and other severe
anomalies. Children born asymptomatic may develop these abnormalities
later in life.   To reduce risk of such severe complications,
accurate serological methods must be performed to determine the
serologic status of childbearing aged women. The presence of rubella
specific IgG in the bloodstream attests immunity to rubella. A woman
tested to be non-immune can be educated on the availability of
vaccination. An increase in rubella IgG denotes an acute infection and
differentiates rubella from other exanthematous diseases. 
Expecting women with current rubella infection should be counseled on
the consequences 
of congenital infection. 
 
 
SUMMARY AND EXPLANATION OF THE TEST
for HSV-1 and HSV-2: 
HSV-1 is usually associated with infection in the oropharyngeal area
and eyes while HSV-2 causes mostly gennital and neonatal infections
(1,2) however, the tissue specificity is not absolute (3). HSV-2 can be
isolated occasionally from the oropharynx and 5-10% of primary genital
infections may be caused by HSV-1. Infants infected with HSV appear
normal at birth but almost invariably develop symptoms during the
newborn period(1,4,5). Neonatal HSV infection may remain localized or
become disseminated. Localized infection may in volve one or a
combination of sites. These are skin, eyes, mouth or central nervous
system. Disseminated infection is manifested by pneumonitis, hepatitis,
dissembinated intravascular coagulopathy and encephalitis. Of the
infants with neonatal HSV, about one half 
of the serviving infants will develop severe neurological or ocular
sequelae.  A number of serological procedures have been developed
to detect antibodies to HSV. 
These include complement fixation, indirect immunoflorescent antibody,
plaque neutralization, and ELISA (2,4,6). Antibody of the IgM class is
produced during the first 2-3 weeks of infection with HSV and exists
only transiently in most patients. Serologic procedures which measure
the presence of IgM antibodies help discriminate between primary and
recurrent infections since IgM antibodies is rarely found in recurrent
infections.  
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