CDC Warns CMV--Found in Toddler Saliva--Can Cause Birth Defects

Are you pregnant or plan to be and have a toddler in daycare (or work in child care)? If you don’t know about your increased exposure to cytomegalovirus (CMV), the leading viral cause of birth defects, you should.

I am the leader of the Child Care Providers Education Committee with the National CMV Foundation. The "inconvenient truth" about CMV is that it is often found in the child care setting. “Almost all the babies that I see who have congenital CMV, there is an older toddler at home who is in daycare,” said Dr. Jason Brophy, a pediatric infectious disease specialist, in the Ottawa Citizen (Payne, 2018).

January is National Birth Defects Prevention Month. The Centers for Disease Control and Prevention stated on Facebook (1/28/19): "Every year, babies in the United States are born with birth defects caused by cytomegalovirus (CMV). A woman infected with CMV can pass the virus to her developing baby during pregnancy. The saliva and urine of babies and young children with CMV have high amounts of the virus. Pregnant women may be able to lessen their risk of getting CMV by reducing contact with saliva and urine from babies and young children. " Find out more about congenital CMV on the CDC website.

Congenital CMV can cause hearing and vision loss, developmental delays, microcephaly and seizures. The CDC states: “About one out of every 200 infants is born with congenital cytomegalovirus (CMV) infection. However, only about one in five babies born with congenital CMV infection will have long-term health problems." Congenital CMV is estimated to disable 4,000 babies every year in the U.S. (4 million annual births/200 with 1/5 sick or long-term health problems = 4,000 disabled by congenital CMV).

I am a former in-home licensed child care provider unaware of my increased risk for CMV. My daughter Elizabeth was born with a severally damaged brain because I caught CMV when pregnant. I tried to recover from the shock when the hospital staff gave me a pamphlet stating that women who work in child care are at greater risk for CMV. Had I known this before I was pregnant with Elizabeth, I would have been extra diligent about taking prevention measures. Elizabeth died at 16 during a seizure in 2006.

Awareness has improved little since Elizabeth's birth in 1989. Recent surveys show that most women have still never heard of CMV (Doutre et al, 2016). Child care providers, too, are largely unaware of CMV, despite their occupational hazard for the virus. and many acknowledge using diaper wipes to clean (Thackeray and Magnusson, 2016). Diaper wipes do not effectively remove CMV from hands (Stowell et al., 2014).

The CDC provides a fact sheet of prevention tips: “The saliva and urine of children with CMV have high amounts of the virus. You can avoid getting a child’s saliva in your mouth by, for example, not sharing food, utensils, or cups with a child. Also, you should wash your hands after changing diapers. These cannot eliminate your risk of getting CMV, but may lessen the chances of getting it” ("Congenital CMV Facts for Pregnant Women and Parents" flyer at: cdc.gov/cmv).

Although soap and water is best, hand sanitizer will reduce levels of CMV when a sink is not readily available.

Although I was instrumental in helping Connecticut pass a CMV testing law in 2015, wrote a book about Elizabeth’s life, Anything But a Dog: the perfect pet for a girl with congenital CMV (Unlimited Publishing, 2008), and articles, "The Danger of Spreading CMV: How We Can Protect Our Children" (ChildCare Aware of America, 2017) and “Help Childcare Providers Fight CMV” (National CMV Foundation, 2018), CMV prevention steps remain little known.

RESOURCES FOR EDUCATING MOTHERS AND CHILD CARE PROVIDERS/TEACHERS ABOUT CMV

• CDC flyers: "Congenital CMV Facts for Pregnant Women and Parents" In English and En Español at: cdc.gov/cmv
• National CMV Foundation: Download wall posters.
• Staff Education and Policies on CMV (AAP et al.) can be printed by clicking "Save as PDF" at: nrckids.org/CFOC/Database/7.7.1.1