Dr. Michael Cannon, a research epidemiologist at the CDC’s National Center on Birth Defects and Developmental Disabilities, discusses congenital cytomegalovirus. This webinar was originally presented by Dr. Cannon on behalf of the CMV Public Health & Policy Conference.
CMV infection is a major health concern for expecting mothers, with 30,000 U.S. children born with the virus each year. Congenital CMV infection (cCMV) occurs when the virus is transmitted to a baby before birth, often by a mother who is unaware of the infection. While only ten percent of infants congenitally infected with CMV display symptoms, one in six children born with CMV, or more than 5,000 children annually, go on to develop permanent complications including hearing loss, vision loss, and intellectual disabilities.
The number of children impacted by CMV is greater than the number of children affected by fetal alcohol syndrome or Down syndrome. cCMV is responsible for one in five cases of infant hearing loss, and more than $1B per year is spent on persons affected by CMV.
Spread of Infection
CMV is transmitted through direct contact with bodily fluids, most often saliva and urine. CMV seropositive children are a major source of infection due to their high viral loads and shedding. CMV is easily spread among children with infected siblings. Parents with a child who is shedding the virus have a 25 percent chance of infection. Because they work with young children, day care workers are at particularly high risk of infection.
Possible interventions to reduce the occurrence of cCMV include prenatal screening, behavioral modification (e.g., the avoidance of behaviors that could result in transmission, like sharing utensils or kissing on the lips), treatment to prevent fetal infection (with antiviral therapies), and early detection and intervention immediately after birth. Currently none of these interventions are routine in the U.S. Utah is the only U.S. state to mandate testing for cCMV in newborns who display hearing loss.
Current treatment options for newborns diagnosed with cCMV include antiviral drugs. Antivirals have been shown to have limited and perhaps temporary benefits including the reduction or elimination of CMV viral shedding.
In a 2011 survey published in the journal Pediatrics, many respondents viewed CMV screening favorably, with the majority somewhat or strongly agreeing that they would want to have their newborn tested for CMV, even when it is not performed routinely or if a small payment was required.
While there is currently no vaccine available to treat cCMV, the Institute of Medicine ranks development of a vaccine to treat CMV as a “highest priority” item. In addition, legislatures in two states, Connecticut and Illinois, have considered laws requiring screening for newborns who display signs of hearing loss.
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