European Centre for Disease Prevention and Control

Surveillance for hepatitis B virus infection in pregnant women in Greece shows high rates of chronic infection among immigrants 5 and low vaccination-induced protection rates: preliminary results of a single center study Factors affecting the adherence to an antenatal screening programme: an experience with toxoplasmosis screening in France 21 Perinatal and congenital infections cause morbidity and mortality throughout the world. While there are a large number of pathogens that can occasionally be harmful for the unborn child, some are of considerable public health impact, for example rubella, varicella, syphilis, hepatitis B, toxoplasmosis, or infections with cytomegalovirus (CMV) or human immunodeficiency virus (HIV). The advances in the field of clinical microbiology have increased our options in terms of preventive strategies, early diagnosis, clinical interventions and therapeutic alternatives to combat these infections. When a considerable public health impact of a given infection is evident, preventive measures can be discussed in relation to the epidemiology, the available resources and the acceptance in the population. Information on hygienic measures and other means to avoid infection is another cornerstone in the preventive work. Immunisation before pregnancy is an option for rubella, hepatitis B and varicella. In cases where intervention to prevent damage to the unborn child is possible, large screening programmes can be organised in order to identify maternal infections that may otherwise not be recognised due to uncharacteristic or subclinical symptoms. Congenital syphilis can be prevented by antibiotic treatment in early pregnancy, transmission of HIV by antiviral treatment of mother and newborn, and transmission of hepatitis B by vaccination and immunoglobulin treatment of the newborn. Identification of a neonate with congenital CMV infection or toxoplasmosis allows treatment to reduce harm. Lack of resources and appropriate maternal care stand in the way of efficient programmes, but there is also a need of increased knowledge. Many of these interventions could be improved not only by a better understanding of the epidemiology and the impact of the diseases as well as further research into improved diagnostics and treatments and development of vaccines, but also by distribution of information to pregnant women and health care professionals. This issue of Eurosurveillance is dedicated to infectious diseases and pregnancy and contains a number of articles highlighting different aspects of the epidemiology and control and prevention efforts for diseases such as toxoplasmosis, rubella, varicella, sexually transmitted diseases e.g. HIV and hepatitis B, and cytomegalovirus infections. Safe vaccines against, for example, rubella, …