Handbook of Clinical Neurology, Vol. 123 (3rd series) Neurovirology A.C. Tselis and J. Booss, Editors © 2014 Elsevier B.V. All rights reserved
Chapter 15
Congenital cytomegalovirus infection JAMES F. BALE, JR* Departments of Pediatrics and Neurology, The University of Utah School of Medicine, Salt Lake City, UT, USA
EPIDEMIOLOGY The prevalence of congenital cytomegalovirus (CMV) infection among live-born infants, as measured by detection of virus or CMV DNA in urine, saliva, or newborn blood spots, ranges from approximately 0.3% to 2.4% in the United States and other developed countries (Stagno et al., 1977; Istas et al., 1995; Murph et al., 1998; Kenneson and Cannon, 2007; Ludwig and Hengel, 2009). Occasional studies from other areas, such as certain regions of Africa and Latin America, have identified rates as high as 5–6% (Table 15.1). Data from the University of Alabama, Birmingham, United States, the site of several landmark studies regarding CMV infection and its consequences, indicate that congenital infections reflect both primary and recurrent maternal infections (Stagno et al., 1982b). Congenital infection rates tend to be higher in regions with high maternal seropositivity, and many of these infections are the result of recurrent maternal CMV infections. In general, primary maternal infections, as discussed further below, have more serious implications for the developing fetus. Several sociodemographic factors influence the rates of maternal CMV infection and the risk of congenital infection in a mother’s offspring (Hyde et al., 2010). These include socioeconomic status, maternal age, marital status, education level, number of sexual partners, exposure to young children, and occupation. In the Birmingham, Alabama, data, the infants of lower-class women, as measured by income, had higher rates of congenital CMV infection (1.9%) than did the infants of middle- or upper-class women (0.6%) (Stagno et al., 1982b). Subsequent Alabama studies indicated that young maternal age (
Chapter 15
Congenital cytomegalovirus infection JAMES F. BALE, JR* Departments of Pediatrics and Neurology, The University of Utah School of Medicine, Salt Lake City, UT, USA
EPIDEMIOLOGY The prevalence of congenital cytomegalovirus (CMV) infection among live-born infants, as measured by detection of virus or CMV DNA in urine, saliva, or newborn blood spots, ranges from approximately 0.3% to 2.4% in the United States and other developed countries (Stagno et al., 1977; Istas et al., 1995; Murph et al., 1998; Kenneson and Cannon, 2007; Ludwig and Hengel, 2009). Occasional studies from other areas, such as certain regions of Africa and Latin America, have identified rates as high as 5–6% (Table 15.1). Data from the University of Alabama, Birmingham, United States, the site of several landmark studies regarding CMV infection and its consequences, indicate that congenital infections reflect both primary and recurrent maternal infections (Stagno et al., 1982b). Congenital infection rates tend to be higher in regions with high maternal seropositivity, and many of these infections are the result of recurrent maternal CMV infections. In general, primary maternal infections, as discussed further below, have more serious implications for the developing fetus. Several sociodemographic factors influence the rates of maternal CMV infection and the risk of congenital infection in a mother’s offspring (Hyde et al., 2010). These include socioeconomic status, maternal age, marital status, education level, number of sexual partners, exposure to young children, and occupation. In the Birmingham, Alabama, data, the infants of lower-class women, as measured by income, had higher rates of congenital CMV infection (1.9%) than did the infants of middle- or upper-class women (0.6%) (Stagno et al., 1982b). Subsequent Alabama studies indicated that young maternal age (
