Congenital Cytomegalovirus Infection: Management Update

Asma Khalil; Chrissie Jones; Yves Villec

Disclosures

Curr Opin Infect Dis. 2017;30(3):274-280. 

In This Article

Prevention

There is no licensed vaccine for CMV nor is one likely for some time. An alternative strategy to reduce the risk of infection is behaviour modification to minimize contact with CMV. The primary source of CMV in pregnancy is the saliva and urine of infected young children, in whom viral shedding can persist for several years. Simple hygiene-based measures such as handwashing after contact with urine or saliva, and avoiding sharing utensils, drinks or food with young children can reduce the risk of CMV acquisition.

Several studies have investigated such measures in pregnancy;[13–15,16] however, most have been underpowered or nonrandomized. In a cluster randomized trial, seronegative women with children under the age of 3 years were randomized to a day care centre that included information on hand hygiene and glove use or to one that did not. There was no difference in the seroconversion rates between the intervention and control groups. However, in the subgroup of women who had a child shedding CMV, those pregnant before enrolment had a significantly lower seroconversion rate than women attempting pregnancy (5.9 vs. 41.7%; P = 0.008).[14] This suggests that such educational interventions to reduce CMV acquisition in pregnancy are more likely to be effective during pregnancy than before, probably because pregnant women are more motivated to adhere to these recommendations. In the most recent published study, seronegative women with a child less than 36 months received preventive information from a midwife or obstetrician in oral and written forms. The seroconversion rate in these women was 1.2% compared with 7.6% in a group of pregnant women who did not receive such advice in pregnancy (P < 0.001) providing further evidence that risk reduction is possible.[16] A study assessing the feasibility of an educational intervention to reduce the risk of congenital CMV in the UK (reducing acquisition of CMV through antenatal education-FIT) has started in 2017 (http://cmvaction.org.uk/news/new-uk-research-project-will-educate-pregnant-women-about-cmv).

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