A new report authored by leading experts in pregnancy and infection is calling for urgent action to reduce the number of infections occurring in pregnancy caused by CMV - the so-called 'Stealth Virus', that is the UK's leading preventable cause of hearing loss in children.
Published by CMV Action, and launched to conclude global CMV awareness month, "We Need To Talk About CMV" explains that the risk of transmitting the virus is known to be significantly reduced by following simple hygiene practices. Around three out of every five people in the UK can expect to catch CMV at some point in their lives, yet research has shown that only around one in three adult women of child-bearing age has even heard of it.
"While CMV rarely poses problems for an otherwise healthy child or adult, the consequences of infection with this virus during pregnancy can be devastating for the unborn child. Yet there is a substantial body of evidence available that shows that we can effectively reduce the risk of transmission with really simple steps," said Professor Paul Griffiths, Professor of Virology at University College London, and contributor to the report. "The problem is that this advice is not being followed because women in the UK are not being told about it before and during their pregnancies - we have to address this as a priority."
As well as identifying the areas needed for further research, the report compares current UK practices to those of other nations in which reducing CMV infection is given far greater attention. Important differences in practice between the UK and elsewhere include:
- Prioritising finding a vaccine: In the US the Institute of Medicine has ranked development of a CMV vaccine as being of the highest priority because of the potential lives saved and disabilities prevented.
- Public education: This is widely recommended. In the US, the Centers for Disease Control and Prevention (CDC) is investing in a public education programme to facilitate this and it is included by health professional organisations in Australia and France. In some US states (Utah and Hawaii) public education is now mandatory and at least four other states are planning the same.
- Screening at birth: The US Department of Health is exploring an approach that could be used to screen all newborns in the US for CMV. In the state of Utah, CMV testing is mandatory for newborns who fail their hearing screen and other states are debating a similar approach.
To help address the findings outlined in the report, CMV Action is launching an educational programme aimed at midwives, alerting them to the latest advances in the scientific understanding of CMV and encouraging them to tell pregnant women about the virus. In addition, the organisation has produced updated information materials for use with women, providing clear advice on how to reduce the risks.
Specific actions contained in the report:
The report cites a number of measures that should be adopted, many of which require no additional resources from the NHS and can be taken up immediately. These include the immediate introduction of minimum standards of care for pregnant women such as:
- the provision of advice about reducing the risk of CMV infection, in the same way as advice is provided about taking folic acid before conception
- alerting women to the dangers from CMV in the same way as advice is given about other food and animal-borne infections, as well as ways to reduce risks
- healthcare professionals responsible for care during pregnancy (such as obstetricians, radiographers and sonographers) being alert to indicators of elevated risk, such as foetal abnormalities, so that appropriate action can be taken
The report calls for longer term changes: putting in place guidelines and pathways for testing; diagnosis and management of CMV; identifying late-onset problems; tracking longer term outcomes; and an increase into research.
Further information about CMV, including the full report, is available at: http://cmvaction.org.uk/
Response from Royal College of Paediatrics and Child Health
In response to the launch of the 'We Need to Talk about CMV' report, Professor Neena Modi, President of the Royal College of Paediatrics and Child Health, said:
"Cytomegalovirus (CMV) infection is common and while in most of us it causes no serious effects it can sometimes cause devastating problems if a woman is infected for the first time when she is pregnant. A small proportion of babies infected before they are born, amounting to around 1000 infants each year in the UK, are stillborn or develop serious problems, ranging from hearing loss, to cerebral palsy and epilepsy. Only about 14% of British women have heard about CMV infection.
"This report aims to raise awareness of CMV infection and provide women, their families, and healthcare professionals with information about simple steps to safeguard their health".