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Torch
Torch
T
O
R
C
H
oksoplasma
ther: Syphilis, Strepto Gr-B, Listeriosis
ubella
ytomegalovirus, Chlamydia
erpes, HIV, HPV, H.Parvovirus B19, HBV,
HCV
CMV (Mucosa)
HSV1 (Nerve)
HSV2 (Nerve)
EXPOSURE TO CONTACT:
Intensity and duration
CONTACT:
Inborn defenses
Immune defenses
NO INFECTION
INFECTION:
Cell mediated immunity
Humoral mediated
Latency, tolerance
NO DISEASE
DISEASE:
Early
Late
Conoid
Pole-ring
HSV1/2
Micronemen
Rhoptrien
CMV
Nucleus
Mitochondria
T. Gondii
Nucleocapsid and
ssRNA genome
Rubella
VZV
Herpesviridae
EBV
Antibody block/neutralize
Lipotheic
Fimbriae
Capsules
Lipid bilayer
Attachment
Bacterial
proliferation
Bacterial metabolic
transportand receptor
100
10
M protein
Capsule
Phagocyte
avoidance
1
0.1
Host damage
0.01
1
Toxin
Toxic
Invasive
2 hour
Inflammatory mediators
Ts
2B4
Mast cell
C3a/C5a
Hageman.F
2B
2
Th
2A2
Histamine
Tc
IgM/G
2B3
Bradikinin
Fibrinogen
Injury
IgE
2B
1
1B
1A
TRANSMITTY OF TORCH
TOXOPLASMA
(Fecal-oral)
RUBELLA
Aerosal
CMV
(In-/direct contact,
Trans-fuse/plantation)
HSV1/2
(Intimate.C)
Salad (oocyst)
Raw meat (cyst)
Droplet
Sexual intercourse
Sexual.I
Mother-baby
+, labor, lactation
+ labor
TOKSO (%)
IgG
IgM
RUBELLA
IgG IgM
CMV (%)
IgG
IgM
HSV2 (%)
IgG IgM
Jakarta
Bandung
Semarang
Yogyakarta
Surabaya
Denpasar
61,6
74,5
44,0
55,4
55,5
23,0
16,4
11,3
18,0
16,3
18,8
5,0
67,1
74,5
78,0
79,4
77,2
78,0
1,4
1,0
3,0
93,2
94,3
99,0
98,9
99,0
98,0
2,7
-
42,5
55,7
48,0
44,6
39,6
56,0
12,3
16,0
20,0
28,3
16,8
21,0
National
52,1
14,2
76,1
0,9
97,2
0,4
48,1
19,2
Kalimantan
Lampung
Sumut
Tuban
Gresik
Jakarta
Jabar
Irian
Yogya
Goat
(%)
61,0
47,5
23,5
20,6
20,0
50
Cat
(%)
9,0
3,3
72,7
-
Dog
(%)
75,6
-
Fog
(%)
51,0
50,0
40,0
National
20-61
3-73
40-50
Urine
Oral secrete
Cement
Cervical secrete
Milk
Neonatus
(%)
Child
(%)
Adult
(%)
0,5-2,5
0,5-2,5
-
10-29
10-29
-
0-2
0-2
5-10
10-28
13-27
Fetus
Toksoplasma
Rubella
Cytomegalo
Herpes
Transplacental
++
++
+
+
Newborn
During birth
++
++
TOK
RUB
CMV
HSV2
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
-
+
+
+
+
+
-
+
-
+
+
+
-
60%
45%
15%
Kardiovaskuler
(MI,Septal,Stenosis,PDA) 70%
Mata
Katarak bilateral
Retinopatia
Mikroptalmia
Opasitas kornea
Glaukoma
77%
30%
25%
10%
7%
5%
Hepatomegali
Splenomegali
Ikterik
Anemia hemolitik
65%
60%
15%
13%
Trombositopenia
50%
Tuli
50%
Retardasi
40%
Protein liquor >
5%
Mikrosefal
2%
Radioluscent femur,tibia 35%
Infected Fetus
(%)
1st Trimester
2nd Trimester
3th Trimester
25
54
65
TOKSOPLASMOSE
Severe (%)
Mild/Nonsymptom (%)
60
30
0
40
70
100
% Janin
terinfeksi
% Janin
Cacat
<11W
11-12W
13-14W
15-16W
17-18W
19-22W
23-26W
27-28W
7 Bulan
8 Bulan
9 Bulan
90
67
67
47
39
34
25
12
35
60
100
90
33
11
24
Fetal.D
and
Sequele
-
CHLIDREN/ADULT
AIDS
Eyes
Lung
GIT
Nervous system
Lymphoid system
Major organ
Diseases
Polineuromyelitis
MI
Carditis
Subclinic
Chorioretinitis
Pneumonia
Esophagocolitis
Meningoencephalis
Lpenia, limfositosis
Hepatitis
Severe, generalized
Re-/1st INFECTION
Transfusion
Contact
REACTIVATION
Old age
Hydraemia
AIDS/Transplantation
Chronic diseases
Toxo
-
Rub
+
+
+
+
+
CMV
-
HSV1/2
-
+
+
+
+
+
+
+
+
+
+
+
-
+
-
PCR1/ml
1 Particle MO
Detection
4 Antigen
Detection
Culture 104/ml
4 IgM anti MO
Detection
Microscope105/ml
IgM
IgA
IgG low avidity
IgE anti-TORCH
.0
.3
.6
.12
.24 Months
G/M
Tox
G/M
Rub
G/M
cmv
G/M
Hsv
G/M
Aca
Ket
Jan
Feb
Mar
Apr
Mei
Jun
S
Jul
Agt
S
Sep
Okt
S
Nov Des
S
Ket