I have
chosen that article because as far as I am concerned, non-sexual modes of
transmission of human papilloma virus is a topic quite unknown. We all believe
that the only way of being infected is by sexual via, even though it is not the
only way. For this reason I would like to make emphasis in this current issue.
About
that easy I am going to make awareness in different points.
Could it be
possible to reduce vertical transmission of HPV by detecting infected pregnant
women earlier in the pregnancy process?
And would it change the prevalence of
infected infants if it’s delivered a caesarean birth instead of a natural one?
Will it increase or decrease the number of infected newborns?
Which more
prevention measures could be taken to reduce the number of infected children?
Do you
think it could be interesting to vaccinate of HPV the newborns if they are
infected or even if they aren’t infected?
Are the
infected children (girls and boys) going to develop a cervix cancer or a penis cancer
respectively?
What do
you think about avoiding breast milk nutrition if the maternal progenitor is
infected? Could it have any side effects, the fact of not breast-feed, making
children more immunosuppressed and more susceptible of developing cancer?
Here
there is the link where you can check some information about the article:
https://www.ncbi.nlm.nih.gov/pubmed/28165175
Full text: http://onlinelibrary.wiley.com/doi/10.1111/jog.13248/full
Noemí
Hi everyone!
ResponderEliminarEvidently, the risk of vertical transmission can be reduced by controlling infected women. Moreover, all these cases should be controlled and be under treatment. If a controlled infection, with adequate C4 levels, could be maintained in mothers, the risk of transmission to the fetus would be minimal. The method of delivery of choice should be natural birth, because it has less ruptures of membranes, except in case of infected maternal genital tract, where a caesarean should be chosen. With these two measures, we could significantly reduce the prevalence of infected newborns.
However, being infected is not the same as getting cervical or penis cancer, depending on the sex. If the infection is well controlled, the disease does not have to develop and these patients are more likely to die from complications associated with the infection than from the development of the cancer.
Children should be vaccinated without a doubt. Children´s health should prevail in the minds of parents over cultural issues and social stigmas. Perhaps more should be done in these cultures to report the health risks of contracting the virus and make clear the benefits of being vaccinated.
The risk of contagion through breast milk hasn´t been demonstrated. In my opinion, breastfeeding would not be an absolute contraindication for infected mothers, I´d let them to make their choice.
Raquel.
Hello everyone!
ResponderEliminarThank you Noemi for bringing this up as this is a topic of utmost importance!
Unbeknownst to many of us, there are non-sexual ways of transmitting the human papilloma virus, such as vertical transmission in women of childbearing age (mother to newborn; infected birth canal) or more rarely via fomites/ clothing (underwear, equipment). Despite the fact that the infection via fomites is rather hypothesized, in this article it is said that in some cases HPV-DNA can be found in transvaginal ultrasound probes and colposcopes even after being disinfected, which may be cause for alarm.
We know that HPV is one of the most common sexual transmitted diseases and that some types of HPV can cause cervical cancer. Therefore, preventing HPV infections and its spread is crucial in order to prevent the vertical transmission of this rather aggressive virus. We need to raise awareness to the fact that women need to visit their gynecologists every year in order to get checked for several diseases and ergo reduce the transmission of HPV.
The best course of action would be to try and diagnose these patients earlier and to reduce the possibility of transmitting this virus to the unborn child. If not, we should try to detect infected pregnant women in the early stages of pregnancy, so that we can prevent the perinatal transmission (when going through the birth canal), bearing in mind that cesarean section is not recommended if the pregnant woman is infected.
It is also said that the persistence of infection acquired during birth is rare and that by 6 months of age it should have eventually cleared out. However, as there are other modes of transmission, perhaps an early vaccination could prevent children from getting an infection via fomites, for instance, and develop the infection later on in life. Being infected doesn’t necessarily mean that you are going to develop cancer, so not all children with HPV are going to develop cervical or penis cancer.
When it comes to breastfeeding, it shouldn’t be avoided as HPV can’t be transmitted through breast milk. Breastfeeding is very important as it creates a strong bond between mother and newborn and as it provides some immunoglobulins that the child won’t be able to produce or receive otherwise.
Marta
Hi again
ResponderEliminarTruly I think that it is a very important topic: firstly, in class we have focused more in the repercussions of the infection than in the mechanisms of transmission, and in second place, it is an emerging theme.
As my workmates have said, breast milk really constitutes a fundamental source which strengthens the inmunity of the newborn, so it is a very good thing that the restriction of breast-feeding is not advised if the mother is found to be infected with HPV.
In caesarean section point, even though the mother had a genital HPV infection, is not recommended because the risk of infection is very low, so I think that this point would not be in a future protocol for prevent more vertical transmission.
Given the lack of awareness in this issue, I think that we need more studys and more research for be able to do a good prevention and make a more serious and protocolized measurements.
Carlos
Good morning everyone!
ResponderEliminarThis is an important topic to tak about, as many people is not aware of the other possible transmisions of the HPV apart from the sexual one.
I think if we detect infeted women (before or during the early pregnancy) for sure we are going to make a change by reducing the number of infected children. I don't think that to establish caesarean in every single birth should solve the problem. Because as Raquel said before, it depends on the case to chose one or another. The caesarean should be the chosen method if the genital tract is infected, but not in every single birth.
In my opinion it is important to vaccine people to prevent HPV infeccion when they are teenagers, but I am not sure if it will make a difference in the newborns, whether they are infected or not.
It may be a pretty agressive decision to stop breast-feeding the newborns because it is a very importat part in the correct development of the inmune system. But as Carlos said, I think that we need more studies in order to make better an more efficient measurements.
Hi everyone!
ResponderEliminarSuch an interesting information and topic! As this article expressed, it´s important to let people know about other modes of HPV transmission, aside from the sexual route, but it would be necessary to undertake long-term prospective studies to understand these alternate modes.
Obviously, an early detection of infected pregnant women would be decisive to avoid children HPV infection. It would be useful using tests to detect infected women in those who want to have babies. On the other hand, as Raquel said, depending on this results, the best option –a natural birth or a caesarian- so that the risk of newborns infection would be minimal. If we consider all these points, the number of infected newborns should decrease.
Tests before, during and after pregnancy would be crucial for detecting and reducing the possible infection in unborn and newborn. I think that to vaccinate should be the last option and that it must be chosen just in specific cases, because the vaccine is showing now side effects and I believe that we should avoid it as far as possible.
Fortunately, not every infected children will develop cervix or penis cancer, although they will probably be liable to it. That´s the reason why prevention is so important.
About avoiding breast milk nutrition, it´s a very difficult choice, because if we choose it, the newborn will be probably inmunosupressed, not only to fight HPV, but also to fight many other pathogens. So this decision could have many serious consequences. It may be an option to feed the newborn with milk from milk banks, but it´s something that must be considered.
Hello!
ResponderEliminarWhen comparing breastfeeding and formula feeding, there are substancially different health outcomes not only for the baby, but also for the mother. For infants, not being breastfed means increased risk of developing infectious diseases, obesity, diabetes, leukemia and sudden infant death syndrome. For the mother, it implies an increased risk of ovarian and breast cancer, metabolic syndrome and diabetes. In this regard, experts recommend exclusive breastfeeding for the first six months of life, and as long as desired thereafter.
Taking all this into consideration, there must be proof that contraindicates breastfeeding in mothers infected with HPV. Studies show that the colostrum and milk of infected mothers is free of viruses, so restriction of breastfeeding isn't advised.
As future doctors, we must learn this concept, to then educate future mothers about the health impact of breastfeeding. We shouldn't underestimate the importance of this topic, and should always promote this practice.
Hello everyone!
ResponderEliminarMy opinion about this topic is very similar to my classmates ones.
HPV detection in pregnant women should be established as a prevention measure of HPV vertical transmission; at least, in countries with a high prevalence of infection or at-risk populations. This measure would help us to detect HPV infection at an early stage of the pregnancy and take action to avoid the foetus infection.
Nevertheless, in my view, the best way to prevent HPV transmission is primary vaccination in infants. Vaccination would reduce the prevalence of infection resulting in a lower exposure of the general population.This measure (only effective in high-prevalence of infection countries) has already demonstrated its effectiveness in some South American countries that have reduced its rate of infections thanks to general vaccination of children of both genders.
Due to vaccination wouldn't be very effective in countries with a low prevalence of infection (and, therefore, low risk of infection) like Spain or Portugal; I guess that the best approach could be the screening of at-risk pregnant women.
As my partners have already highlighted, being infected doesn’t imply necessarily cervix or penis cancer development. Developing cancer depends on other factors too; for example: patient’s immunitary system, degree of exposure or viral strain penetrance. However, we shouldn’t forget that HPV infection is an important risk factor that promotes cervix and penis cancer. For this reason, reducing the infection rate would result in a decrease of these cancers rates.
Lastly, regarding the avoidance of breast milk nutrition, I believe that we are very fortunate that HPV transmission through breast milk is a rare event. We all know the benefits of this type of nutrition: protection against infections and diseases, stronger bond between the mother and the baby, etc. Consequently, it is strongly recommended in these newborns not only because of the aforementioned benefits, but also because they are immunosuppressed and they need the protection that breast milk gives them in order to control HPV (and other possible pathogens), in case they would have got it.
Cheers!