Congenital cytomegalovirus (cCMV) is arguably the most common unheard of virus. How common is common? CMV will infect the majority of people at some point in their lives.
It is the most frequent infectious complication for organ transplant recipients, the leading infectious cause of birth defects, and the No. 1 non-genetic cause of hearing loss in children. However, most people have never heard of it.
Specific to maternal and neonatal health, this is a common virus 1 in 200 infants are born with. Notably, the virus will cause 1 in 5 of these infants to be born with a defect or develop a permanent disability. The virus also causes about 400 infant deaths each year in the United States.
Yet less than 9 percent of women have even heard of CMV, according to the National CMV Foundation. There is no vaccine for CMV available at this time and infants are not routinely tested for the virus.
What is cCMV?
Generally speaking, CMV is a common virus that typically causes mild to no symptoms in healthy people. CMV can, however, devastate immunocompromised people and infants who are infected before birth (cCMV).
cCMV causes approximately 4,000 infants and children to be permanently disabled in the United States each year. These disabilities range from mild to severe, and can include hearing loss, brain damage, seizures, cerebral palsy, and more. While some infants are born without symptoms, some will go on to develop sequelae in the months and years following birth.
Testing is critical and cCMV testing must be completed during the first 21 days of life. Since infant screening for cCMV is not routine, most infants born with it will unfortunately never be identified. Inconsistent screening practices may cause many infants to miss opportunities for early intervention, hearing and vision screenings, and antiviral treatments, when appropriate.
To address the cCMV screening needs, in 2015, a group of scientists and advocates convened to review the best available research and make recommendations about cCMV. In 2017, these consensus recommendations were published. The recommendations included the following:
- All pregnant women and healthcare providers should be educated about cCMV infection and preventive measures.
- Valganciclovir treatment for 6 months is recommended for cCMV-infected
- Neonates with moderate to severe symptomatic disease.
- Consideration should be given to universal neonatal cCMV screening to enable early detection, facilitating early detection, and intervention for sensorineural hearing loss and developmental delay
Reducing cCMV transmission
Since there is no vaccine currently available for cCMV, hygienic measures are recommended to reduce CMV exposure during pregnancy. According to the Centers for Disease Control and Prevention, pregnant women may be able to lessen their risk of getting the virus by avoiding contact with the urine and saliva of young children.
Moreover, you can reduce your risk by avoiding sexual contact with new partners during pregnancy. The National CMV Foundation features key risk reduction strategies for pregnant women, including:
- Not sharing food, utensils, drinks, or straws
- Not putting a pacifier in your mouth
- Avoiding contract with saliva when kissing a child
- Not sharing a toothbrush
- Washing your hands frequently, especially after changing diapers
- Avoiding sexual contact with new partners during pregnancy
The best option to eliminate cCMV will be a vaccine that can be routinely given before pregnancy and there are many efforts ongoing to develop this vaccine.
Until a vaccine is widely available, the best weapons we have against cCMV include increasing awareness in the general population and especially among women of childbearing age, following preventative measures during pregnancy, screening all newborns, treating newborns when appropriate, and early intervention for impacted infants.
We need to work together to increase cCMV awareness and screening, in order to reduce the impact and burden of cCMV infection on children and families. Together, we can spread the word, not the virus.