Cytomegalovirus: neglected problem endangers pregnant women, children

Medscape Cytomegalovirus

Cytomegalovirus (CMV) hasn’t gotten the press accorded to Zika, yet it infects 2%-4% of pregnant women and is transmitted to the fetus. The resulting congenital infection in 40% of these cases can result in a host of serious problems that include brain maldevelopment and microcephaly. An article recently published in Medscape Family Medicine draws needed attention to his common but poorly recognized hazard.

“Congenital CMV is well recognized as a common, endemic congenital infection, infecting over 30,000 newborns each year in the United States. Although many newborns congenitally infected with CMV may have no symptoms or sequelae, up to 8000 each year will have in utero growth restriction; petechiae; liver and spleen disease; thrombocytopenia; congenital and progressive hearing loss; vision loss; brain maldevelopment syndromes; microcephaly; and permanent neurodevelopmental and motor disabilities such as cerebral palsy. In addition, fetal and neonatal death from in utero CMV occurs in approximately 400 babies each year.”

Cytomegalovirus awareness is low

Most people have heard of Zika but very few are aware of cytomegalovirus though it is a far more widespread problem.

“…despite this well-recognized and well-accepted public health impact, only 9%-15% of women of childbearing age, including those with graduate degrees and those entering medical school, have even heard of CMV.”

“CMV Knowledge Vaccine”

Just knowing that cytomegalovirus is a common infection and serious hazard in pregnancy is the start. Then there are three simple precautions based on the fact that young children commonly excrete CMV in their saliva and/or urine for a year and transmit it to their parents 45-53% of the time, often without either manifesting any symptoms. The paper cites three recommendations to reduce exposure:

  1. Not sharing food, drink, straws or eating utensils with young children;

  2. Not kissing young children on or around the mouth or lips; and

  3. Washing hands well after changing all diapers (wet with urine or dirty with stool) and wiping runny noses or mouth drool.

Unfortunately, the American College of Obstetrics and Gynecology (ACOG) has not supported active education of women about CMV risk. The author concludes:

The greatest risk reduction strategy available now to prevent CMV transmission to pregnant women is education about CMV. Patients; healthcare professionals, especially obstetricians and midwives; and public health agencies should be partners in providing women with factual information and allowing them to make informed choices regarding their pregnancy health and prevention of CMV. In other words, spread the word, not the virus.”

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