Our sign-off, “wash your hands, ya filthy animals”, has never been more appropriate than with this episode on puerperal or childbed fever, now known as maternal peripartum infections. It took us over seventy episodes to get here, but today we finally tell the tragic story of Ignác Semmelweis, the “father of hand hygiene” and “savior of mothers”, whose keen observations and devotion to his patients earned him ridicule in his time and respect in ours. But the tragedy of this episode’s topic doesn’t reside solely in the past. Today maternal peripartum infections are still a major contributor to maternal morbidity and mortality worldwide, and, surprise surprise, the impact is not equally felt across racial, ethnic, and socioeconomic groups. Join us as we dive into this historically rich, medically complicated, and still appallingly prevalent group of infections.
| History | Biology |
| Nuland, Sherwin B. The doctors’ plague: germs, childbed fever, and the strange story of Ignac Semmelweis (great discoveries). WW Norton & Company, 2004. | Ferretti JJ, Stevens DL, Fischetti VA, editors. Streptococcus pyogenes : Basic Biology to Clinical Manifestations [Internet]. Oklahoma City (OK): University of Oklahoma Health Sciences Center; 2016-. Available from: https://www.ncbi.nlm.nih.gov/sites/books/NBK333424/ |
| Thompson, Morton. The Cry and the Covenant. United States, Doubleday, 1949. | NEWTON, ER, PRIHODA, TJ, GIBBS, RS. 1990. A Clinical and Microbiologic Analysis of Risk Factors for Puerperal Endometritis. Obstetrics & Gynecology 75:3; 402-406. |
| Colebrook, Leonard. “The story of Puerperal fever—1800 to 1950.” British medical journal 1.4961 (1956): 247. | Anderson, BL. 2014. Puerperal group A streptococcal infection: beyond Semmelweis. Obstetrics & Gynecology. 123:4; 874-882 |
| De Costa, Caroline M. ““The contagiousness of childbed fever”: a short history of puerperal sepsis and its treatment.” Medical Journal of Australia 177.11 (2002): 668-671. | Shinar, S. , Fouks, Y. , Amit, S. , Pauzner, D. , Tarabeia, J. , Schechner, V. & Many, A. (2016). Clinical Characteristics of and Preventative Strategies for Peripartum Group A Streptococcal Infections. Obstetrics & Gynecology, 127(2), 227–232. doi: 10.1097/AOG.0000000000001238. |
| DeLacy, Margaret. “Puerperal fever in eighteenth-century Britain.” Bulletin of the History of Medicine 63.4 (1989): 521-556. | Deutscher, M., Lewis, M., Zell, E. R., Taylor, T. H., Jr, Van Beneden, C., Schrag, S., & Active Bacterial Core Surveillance Team. 2011. Incidence and severity of invasive Streptococcus pneumoniae, group A Streptococcus, and group B Streptococcus infections among pregnant and postpartum women. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 53(2), 114–123. https://doi.org/10.1093/cid/cir325 |
| Gould, Ian M. “Alexander Gordon, puerperal sepsis, and modern theories of infection control—Semmelweis in perspective.” The Lancet infectious diseases 10.4 (2010): 275-278. | Hamilton, S. M., Stevens, D. L., & Bryant, A. E. (2013). Pregnancy-related group a streptococcal infections: temporal relationships between bacterial acquisition, infection onset, clinical findings, and outcome. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 57(6), 870–876. https://doi.org/10.1093/cid/cit282 |
| Hallett, Christine. “The attempt to understand puerperal fever in the eighteenth and early nineteenth centuries: the influence of inflammation theory.” Medical history 49.1 (2005): 1-28. | O’Brien, K.L., Beall, B., Barrett, N.L., Cieslak, P.R., Reingold, A., Farley, M.M., Danila, R., Zell, E.R., Facklam, R., Schwartz, B. and Schuchat, A., 2002. Epidemiology of invasive group A streptococcus disease in the United States, 1995–1999. Clinical Infectious Diseases, 35(3), pp.268-276. |
| Loudon, Irvine. “Puerperal fever, the streptococcus, and the sulphonamides, 1911-1945.” British medical journal (Clinical research ed.) 295.6596 (1987): 485. | World Health Organization, 2016. WHO recommendations for prevention and treatment of maternal peripartum infections. World Health Organization. |
| Lowis, George W. “Epidemiology of puerperal fever: the contributions of Alexander Gordon.” Medical history 37.4 (1993): 399-410. | Howell E. A. (2018). Reducing Disparities in Severe Maternal Morbidity and Mortality. Clinical obstetrics and gynecology, 61(2), 387–399. https://doi.org/10.1097/GRF.0000000000000349 |
| Parsons, Gail Pat. “The British medical profession and contagion theory: puerperal fever as a case study, 1830–1860.” Medical history 22.2 (1978): 138-150. | Acosta, C. D., Kurinczuk, J. J., Lucas, D. N., Tuffnell, D. J., Sellers, S., Knight, M., & United Kingdom Obstetric Surveillance System (2014). Severe maternal sepsis in the UK, 2011-2012: a national case-control study. PLoS medicine, 11(7), e1001672. https://doi.org/10.1371/journal.pmed.1001672 |
| Phillips, Miles H. “History of the prevention of puerperal fever.” British medical journal 1.4017 (1938): 1. | Say, L., Chou, D., Gemmill, A., Tunçalp, Ö., Moller, A.B., Daniels, J., Gülmezoglu, A.M., Temmerman, M. and Alkema, L., 2014. Global causes of maternal death: a WHO systematic analysis. The Lancet global health, 2(6), pp.e323-e333. |
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