| Contaminant |
Number of Infections |
| Viruses # |
| B-type (retrovirus-like particles) |
Nil |
| Coxsackievirus B3 |
|
| Cytomegalovirus (or virus DNA) |
About two thirds of infants consuming cytomegalovirus containing milk
excrete virus after 3 weeks. Up to a half of CMV positive mothers have
varying levels of infectious virus in their milk for up to 3 months.
Present in preterm and mature milk, but low in colostrum. One death in an
infant with an immunodeficiency syndrome. About 40% of preterm infants can
be infected from non-frozen CMV-containing milk. Symptoms may be seen in
a quarter to a half of these infected preterm infants. |
| Ebola virus |
|
| Echovirus 18 |
|
| Epstein-Barr virus DNA (glandular fever) |
No increased seroconversion (infection) in breast fed infants. |
Hepatitis B surface antigen
(or virus DNA) |
No increased seroconversion (infection) in breast fed infants. |
| Hepatitis C RNA |
Three infants had symptoms after breastfeeding for 3 months, from
symptomatic mothers with high levels of virus. Others have found no
infection from chronic infected mothers. Infants with hepC RNA may
spontaneously clear the virus and not seroconvert. Present in nil to 20% of
infected mothers' milk* |
| Hepatitis E (or RNA) |
Milk is not a major source, transmitted during pregnancy. |
| Herpes simplex virus type 1 (or DNA) [cold sores] |
One infected by 6 days. Infects also from nipple lesions, but infants
may also infect mothers. HSV-1 and HSV-2 DNA has been detected in milk
cells. |
| Human herpesvirus 6 DNA*
(febrile illness) |
Transmitted prior to breast feeding in HIV-infected infants. Present in
the milk cells of HIV-infected mothers. Cell-free virus was rare. |
| Human herpesvirus 7 DNA (febrile illness) |
No increased seroconversion (infection) in breast fed infants. |
Human immunodeficiency virus type 1 (and 2)
(or provirus
DNA or virus RNA; p24 antigen) | At least one third of transmissions
to breast-fed infants is through milk. Most occur by 5-6 months of breast
feeding. HIV RNA can be present in half of infected mothers' milk. The HIV
variant (RNA) free in milk can be different to the proviral (DNA) in milk
cells in some mothers. |
| Human T-lymphotropic virus type 1 (or provirus DNA; p24
antigen) [causes adult T-cell leukaemia] |
Transmitted to a quarter of infants almost exclusively through milk
(cells) after 6 months of breast-feeding, in restricted geographical areas;
seroconversion of infants occurs after 12-24 months |
| Human T-lymphotropic virus type II provirus DNA |
Transmission occurs through milk |
| Human papillomavirus 16 DNA |
|
| Rubella virus |
A quarter of infants seroconvert 4 weeks after consuming rubella
(normal or vaccine strains) containing milk. Two thirds of vaccinated
mothers can excrete virus in milk for up to 3 weeks. |
| Sin nombre (no name) hantavirus RNA [pulmonary syndrome] |
Nil |
| Transfusion-transmission virus (TTV) DNA [no associated
disease] |
Can be present in the milk of half to three quarters of women who have
TTV DNA in their serum (40% of women) and possibly transmitted to infants
before breastfeeding begins, or most probably (after 6 weeks) by later
contacts, as strains can vary from the mother's strain. * |
| Varicella-zoster virus DNA (chicken pox) |
One? Not found in recently vaccinated mothers' milk. |
| West Nile virus RNA ## |
One without symptoms. WNV infection of mother was probably during
postpartum transfusion. |
| Bacteria |
| Borrelia burgdorferi DNA (Lyme disease) |
? |
| Brucella melitensis |
Rare |
| Burkholderia pseudomallei (Melioidosis) |
Two? |
| Candida albicans *** |
? |
| Citrobacter freundii |
?; detected during infection in neonatal unit. |
| Coxiella burnetti (Q fever) |
? |
| Enterbacter aerogenes |
?; detected during infection in neonatal unit |
| Klebsiella pneumoniae |
?; detected during infection in neonatal unit. |
| Lactobacillus gasseri / Enterococcus faecium
(avirulent) |
None? Present in the areola and colonise the infant gut as lactic acid bacteria. |
| Leptospira australis |
Rare |
| Listeria monocytogenes |
One? |
| Mycobacterium paratuberculosis |
? |
| Mycobacterium tuberculosis (TB) |
Nil? |
| Salmonella kottbus |
One; may grow in milk ducts. |
| Salmonella panama |
One |
| Salmonella senftenberg |
One death; rare growth in milk ducts |
| Salmonella typhimurium |
Rare |
| Serratia marcescens |
?; detected during infection in neonatal unit. |
| Staphylococci |
Rare. S. aureus or skin bacteria can be found in milk of mothers
with mastitis. |
| Staphylococcus aureus (Panton-valentine leukocidin
producer; associated with chronic boils) |
One (pleuropneumonia) |
| Staphylococcus aureus enterotoxin F |
- ; mother had toxic shock syndrome |
| Streptococcus agalactiae (Group B streptococci) |
Rare, one death; grows in milk ducts. |
| Parasites |
| Necator americanus (new world hookworm) |
? |
| Onchocerca volvulus antigens (skin worm) |
Immune suppression |
| Schistosoma mansoni antigens (blood fluke) |
Hypersensitive allergy |
| Strongyloides fulleborni (threadworm) |
? |
| Toxoplasma gondii |
One? |
| Trichinella spiralis (tissue worm) |
? |
| Trypanosoma cruzi * (Changas' disease) |
? |
| Other |
| Creutzfeld-Jacob transmissible agent ** |
- |
| Mycotoxins (aflatoxins, ochratoxin) |
?; fungal toxins from food mother has eaten |
