Doctors urged to combat birth-defect virus

Published Jan 28, 2008

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By Will Dunham

The US Centres for Disease Control and Prevention urged more obstetricians and gynaecologists to counsel women who are pregnant or may become pregnant to take hygiene steps to guard against becoming infected with cytomegalovirus, or CV.

Contact with the saliva or urine of preschool-age children is a leading cause of this viral infection among pregnant women, according to the CDC. Congenital cytomegalovirus infection is caused when an infected mother passes the virus to her foetus through the placenta.

The CDC said such infection occurs in about one in 150 babies born in the United States, some of whom develop hearing or vision loss, mental disability or other problems. It is the leading infectious cause of birth defects and developmental disabilities in the United States, according to the CDC.

The CDC said a nationwide survey of 305 obstetricians and gynaecologists showed only 44 percent counselled patients about how to avoid CV infection. CDC experts said this may even over-estimate how commonly doctors are addressing the issue.

The CDC recommends that pregnant women wash hands often with soap and water, especially after contact with saliva or diapers from young children, to not kiss children under age six on the mouth or cheek to avoid saliva, and to not share food, drinks or utensils with young children.

"A lot of people are really shocked when they hear that there are as many disabled kids from congenital CV as there are kids with foetal alcohol syndrome or Down syndrome or spina bifida - and people haven't heard of it," CDC epidemiologist Michael Cannon said in a telephone interview.

The CDC said 5 000 to 8 000 babies are born annually in the United States with disabilities associated with CMV infection. There is no vaccine for it, the CDC noted.

"Although some obstetricians and gynaecologists talk to their patients - pregnant women - about congenital CMV, many of them don't. So it's really a missed opportunity," Cannon said. "The doctors could play a larger role. Clearly there's room for improvement."

Many children become infected with CMV - a member of the herpes virus family - in early childhood, particularly those in child-care and preschool settings. The virus then can be passed to others, including pregnant women, who come into contact with the infected child's saliva or urine.

Most healthy children and adults infected with CMV have no symptoms and may not even know that they have been infected. Others may develop a mild illness with fever, sore throat, fatigue, and swollen glands.

The virus can be transmitted through sexual contact.

People with weakened immune systems are particularly vulnerable to ill effects from the virus. The CDC said there is no treatment for pregnant women whose foetus might be infected with CMV. Existing drugs that are effective against it have serious side effects and are not approved for use in pregnant women, the CDC said.

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