Zika grabs headlines but herpes-related CMV harms more babies

Cytomegalovirus_01Although awareness has grown about viruses  like Zika that can devastate the unborn, cytomegalovirus (CMV), a much more common and equally harmful prenatal viral  infection, doesn’t get discussed with pregnant moms as much as it should. Medical counseling, testing, and administration of anti-viral medications could save more babies and their families from a lifetime of CMV woes.

More than half of adults older than 40 and one in three children by the age of 5 have been infected with CMV, a common virus in the herpes family. An estimated 1 in 150 babies gets infected at birth with CMV, with 1 in 5 of these infants sickened or harmed, including with hearing loss, microcephaly (a deformity so they have tiny heads), intellectual deficits or impaired vision.  This means CMV seriously harms as many as 8,000 youngsters annually across the United States, and it is fatal for about 400 infants.

Affected families and medical experts have told the New York Times that more needs to be done to increase CMV awareness, testing, and prevention, especially in comparison to the public health attention that has been paid to Zika and the damage it may inflict on the unborn.

The federal Centers for Disease Control and Prevention put up a blog post in September, indicating that 1,595 women in this country have confirmed Zika infections and 17 babies have been born with defects related to it. After long delays and extensive partisan wrangling, Congress in September approved President Obama’s request for more than $1 billion to battle Zika and for other public health measures.

In contrast, the medical community continues to debate the cost and value of increased CMV testing. With an estimated cost of between $10 and $50 per test, heightened screening, whether on a mass or targeted basis, could save the nation money or be revenue neutral, researchers reported earlier this year. Gail Demmler-Harrison, a Baylor University pediatric infectious disease expert, has written an editorial in the peer-reviewed JAMA Pediatrics journal that physicians must stop ignoring CMV, which she termed “the elephant in the room,” and help expectant moms better understand, be tested, and deal with the virus’s harms.

Anti-viral treatments, administered before birth and afterward, may help prevent defects and debilitations associated with CMV.

So, too, would more candor by physicians—only half of whom discuss this common illness with expectant moms, research shows.

The disease can be prevented with hygiene, especially frequent hand washing. Expectant moms, if they haven’t already been infected, are especially susceptible to CMV transmission from their older children, particularly if the kids are in day care. The virus spreads in human saliva and urine, so moms may be exposed by dealing with dirty diapers or handling toys, clothing, and other objects that youngsters have put in their mouths or otherwise slobbered on.

Because our firm has represented many families in medical malpractice cases involving injured babies, and we have worked on cases involving poorly treated infections in infants, it bothers me that physicians are failing to help moms and tots with CMV, and especially its preventable harms. A half dozen states have stepped forward with laws requiring testing for the virus, and this is an issue that deserves fair consideration. Doctors who fail to routinely counsel moms about conditions like CMV  should know that their conduct might create legal liability, and affected parents might well seek justice and the financial support they need through malpractice lawsuits. But wouldn’t an ounce of prevention here be so much better than a pound of cure?

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