Thursday, September 13, 2018

Ask your Local Access TV station to Air Interview with CMV Doctor, Mom, and Singer/Songwriter!

Debra Lynn Alt, Lisa Saunders and Dr. Gail Demmler-Harrison discuss preventing congenital cytomegalovirus (CMV), the leading viral cause of birth defects, on SEC-TV  on September 5, 2018.  Photograph by Neil Harrison. 


Want your community to watch a TV interview about congenital cytomegalovirus (CMV) found at: https://www.youtube.com/watch?v=oJRTYQbEj7c&t=318s?

Everyone in the U.S. has a Local Access TV station. Their purpose is to air shows that serve the community. Find the local access station for your town/state by googling it or click on this link because it may be found on this list:

Contact your station by calling them first so they can tell you what they need (like proof you live in their viewing area). They may be able to get all the information they need through an email that goes something like the following:

Dear Local Access Station:

I live and/or work in the region serviced by your community access TV station and would like you to air a 30-minute talk show about congenital cytomegalovirus (CMV), the leading viral cause of birth defects. It can be prevented if women are educated about CMV. You can learn more about congenital CMV at the Centers for Disease Control Prevention at: https://www.cdc.gov/cmv/overview.html


The talk show guests include: 


  1. Gail Demmler-Harrison, MD, Director of Congenital CMV Disease Research, Clinic and Registry; Professor, Pediatrics, Section Infectious Diseases, Baylor College of Medicine; Attending Physician, Infectious Diseases Service, Texas Children's Hospital, (832) 824-4387, Email: cmv@bcm.edu. Visit: https://www.bcm.edu/departments/pediatrics/sections-divisions-centers/cmvregistry
  2. Lisa Saunders, host of the show and mother of a child born disabled by congenial CMV: Email: LisaSaunders42@gmail.com, Visit: www.authorLisaSaunders.com
  3. Debra Lynn Alt, singer/songwriter, performs her song about CMV, "Had I Known (about CMV)"; debrasong@gmail.com;  www.debrasong.com

To retrieve the 30-minute TV interview about CMV, please click into this Dropbox link

There, you will find three files.
  1. The one with "YouTube" can be uploaded to any web site that takes videos, YouTube, FB, etc.
  2. The one with "MPEG2 LF" can be played "as is" by many Community Access TV stations.
  3. The one with "ProRes LF" is the very large data original file and can be converted to any other playback type.

My address (or work address) is: (your address)

The show was filmed at Southeastern Connecticut Television (SEC-TV) Studios.
SEC-TV: Community Television for Groton, Ledyard, Mystic, Stonington, North Stonington, and Voluntown, Connecticut. Address: SEC-TV, 80 Plaza Court, Groton, CT 06340
Studio Phone: 860-449-1477Email: info@sec-tv.org, Visit: http://www.sec-tv.org/


Sincerely,
[your name and contact information]



Friday, August 24, 2018

Poster: "Increasing Child Care Provider Awareness of Congenital Cytomegalovirus", "What you can do to help" and References

"Increasing Child Care Provider Awareness of Congenital Cytomegalovirus (cCMV)" 

by

Lisa Saunders, Leader of Childcare Providers Education & Outreach, National CMV Foundation; Brenda Balch, MD, American Academy of Pediatrics (AAP) Early Hearing Detection and Intervention Connecticut Chapter Champion

To be presented at the 
CMV Public Health and Policy Conference
September 23-25, 2018 (poster session: Mon., Sept 24, 2018)
DoubleTree Hotel
Burlington, Vermont: https://cmv.usu.edu/schedule.cfm

Click for poster as a PDF document or PowerPoint slide.


WHAT YOU CAN DO TO HELP

        Contact your state’s Departments of Health, Labor, OSHA, and Child Care Licensing (found at: childcareaware.org/providers), and ask for CMV education to be featured on their websites. Ask that CMV education be included in the training child care providers receive on infectious diseases.
        CMV flyer links are available at the CDC, National CMV Foundation, some state websites, and CongenitalCMV.blogspot.com. The “Staff Education and Policies on Cytomegalovirus” in Caring for Our Children can be found at: nrckids.org/CFOC/Database/7.7.1.1
        Child care directors may worry about frightening their workers. Remind them they probably already have proper sanitizing procedures in place through compliance with protocols set forth by the National Association for the Education of Young Children (NAEYC), which states, “Procedures are in place that address steps to reduce occupational hazards such as infectious diseases (e.g., exposure of pregnant staff to CMV…)" (NAEYC, 2014, p.90).
        Contact state chapters of organizations that promote the health of their members such as child care and teacher unions, NAEYC, Early Head Start programs, and child care centers. Offer CMV flyers or links to them.
        In 2015, Connecticut passed a law requiring CMV testing when an infant fails the hearing screen. Prevention education did not pass, but the Connecticut Office of Early Childhood’s Division of Licensing for Child Care Providers/Operators now includes “Congenital Cytomegalovirus” under “Disease and Prevention” on its website. We are still working on making CMV training mandatory for child care providers.

REFERENCES
Adler, S. P. (2015, September). Prevention of Maternal–Fetal Transmission of Cytomegalovirus. Volume 2, Issue 9, Pages 1027–1028. BioMedicine. Retrieved November 9, 2016, from http://www.ebiomedicine.com/article/S2352-3964(15)30098-0/fulltext
American Academy of Pediatrics, American Public Health Association, National Resource Center for Health and Safety in Child Care and Early Education. (Revised 2017). National Health and Safety Performance Standards: Guidelines for Early Care and Education Programs. Retrieved from Caring for Our Children: http://nrckids.org/CFOC/Database/7.7.1.1
American Academy of Pediatrics. "CHILDREN IN OUT-OF-HOME CHILD CARE". Pickering LK, Baker CJ,Kimberlin DW, Long SS, eds. (2012). Red Book: Report of the Committee on Infectious Diseases (29th ed.). Elk Grove Village, IL: American Academy of Pediatrics. Retrieved from https://redbook.solutions.aap.org/DocumentLibrary/RB12_interior.pdf
Billette de Villemeur; Agathe; Gratacap-Cavallier, Bénédicte; Caseya, Romain; Baccard-Longère, Monique; Goirand, Laurence; Seigneurin, Jean-Marie; Morand, Patrice. (2011). Occupational risk for cytomegalovirus, but not for parvovirus B19 in child-care personnel in France. ScienceDirect, 457-467. Retrieved from https://www.sciencedirect.com/science/article/pii/S0163445311004592
Centers for Disease Control and Prevention (CDC). (Page last reviewed: June 6, 2018). Cytomegalovirus (CMV) and Congenital CMV Infection. Retrieved from Centers for Disease Control and Prevention (CDC): https://www.cdc.gov/cmv/clinical/features.html
Department of Labor, Occupational Employment Statistics: Childcare Workers. (2017, May). Retrieved from Bureau of Labor Statistics: https://www.bls.gov/oes/current/oes399011.htm
Department of Labor, Occupational Outlook Handbook, Childcare Workers,. (2018 , June 11). Retrieved from Bureau of Labor Statistics, U.S.: https://www.bls.gov/ooh/personal-care-and-service/childcare-workers.htm
DeWald, Olivia; Turovac, Casey; Balch, Brenda; Cienkowski, Kathleen. (2018). National Child Care Provider's Awareness of Congenital Cytomegalovirus. Poster session presented at Early Hearing Detection and Intervention (EHDI) Conference in Denver, CO.
Doutre, S. M. Barrett, T. S. Greenlee, J. & White, K. R. . (2016). Losing Ground: Awareness of Congenital Cytomegalovirus in the United States. Journal of Early Hearing Detection and Intervention, 1(2), 9-48. Retrieved from http://digitalcommons.usu.edu/cgi/viewcontent.cgi?article=1035&context=jehdi
Joseph, Serene A; Béliveau, Claire; Muecke,Cristin J; Rahme, Elham; Soto,Julio C; Flowerdew, Gordon; Johnston, Lynn; Langille, Donald; Gyorkos, Theresa W. (2006, Sept). Cytomegalovirus as an occupational risk in daycare educators. Retrieved from PMC: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2528629/
March of Dimes. (Last reviewed: Nov. 2013). Cytomegalovirus and Pregnancy. Retrieved from March of Dimes: https://www.marchofdimes.org/complications/cytomegalovirus-and-pregnancy.aspx
Modlin, John F; Arvin, Ann; Fast, Patricia; Myers, Martin; Plotkin, Stanley; Rabinovich, Regina . (2004, July 15 ). Vaccine Development to Prevent Cytomegalovirus Disease: Report from the National Vaccine Advisory Committee. Oxford Academic. Retrieved from https://academic.oup.com/cid/article-lookup/doi/10.1086/421999
NAEYC. (2014, April 1). National Association for the Education of Young Children: Early Childhood Program Standards and Accreditation Criteria & Guidance for Assessment. Retrieved from National Association for the Education of Young Children: https://s3.amazonaws.com/fwk-interactives/0Early+Childhood+Studies/Assessments+/EP004/CECS+EP004_Assessment_Criteria+and+Standards.pdf
Nesti,Maria M. M. and Goldbaum, Moisés . (2007, July/Aug). Infectious diseases and daycare and preschool education. Jornal de Pediatria, 83(40). Retrieved from http://www.scielo.br/pdf/jped/v83n4/en_v83n4a04.pdf
Occupational Safety and Health Administration. (Revised 2016). Workers' Rights Booklet. Retrieved from Department of Labor: Occupational Safety and Health Administration: https://www.osha.gov/Publications/osha3021.pdf
Pass RF, Hutto C. (1986, Jul-Aug 8). Group day care and cytomegaloviral infections of mothers and children. Retrieved from National Center for Biotechnology Information: http://www.ncbi.nlm.nih.gov/pubmed/3018892
Queensland Government (Australia). (Last Updated 04 April 2017). Cytomegalovirus (CMV) in early childhood education and care services. Retrieved January 1, 2017, from Workplace Health and Safety: https://www.worksafe.qld.gov.au/injury-prevention-safety/workplace-hazards/hazardous-exposures/biological-hazards/cytomegalovirus-cmv-in-early-childhood-education-and-care-services
Saint Louis, Catherine . (2016, Oct. 24). CMV Is a Greater Threat to Infants Than Zika, but Far Less Often Discussed. New York Times. Retrieved from https://www.nytimes.com/2016/10/25/health/cmv-cytomegalovirus-pregnancy.html
Stowella, Jennifer D; Forlin-Passoni, Daniela; Radford, Kay; Bate, Sheri L; Dollard, Sheila C; Bialek, Stephanie R.; Cannon, Michael J; Schmid, D. Scott . (2014, January). Cytomegalovirus Survival and Transferability and the Effectiveness of Common Hand-Washing Agents against Cytomegalovirus on Live Human Hands. American Society for Microbiology, 80(2 455-461). Retrieved from http://aem.asm.org/content/80/2/455.full
Stranzinger J, Kozak A, Schilgen B, et al. (2016). Are female daycare workers at greater risk of cytomegalovirus infection? A secondary data analysis of CMV seroprevalence between 2010 and 2013 in Hamburg, Germany. Retrieved from GMS Hygiene and Infection Control: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4844919/
Thackeray, Rosemary; Magnusson, Brianna M. (2016, April). Child Care Provider Awareness and Prevention of Cytomegalovirus and Other Infectious Diseases. Child & Youth Care Forum, 45(2), 301–314. Retrieved from http://link.springer.com/article/10.1007%2Fs10566-015-9325-y
Adler refers to five prevention education studies in his article, “Prevention of Maternal–Fetal Transmission of Cytomegalovirus” (2015). They are:
  1. Adler, S.P., Finney, J.W., Manganello, A.M., and Best, A.M. Best prevention of child-to-mother transmission of cytomegalovirus by changing behaviors: a randomized controlled trial. Pediatr. Infect. Dis. J. 1996; 15: 240–246
  2. Adler, S.P., Finney, J.W., Manganello, A.M., and Best, A.M. Prevention of child-to-mother transmission of cytomegalovirus among pregnant women. J. Pediatr. 2004; 145: 485–491
  3. Finney, J.W., Miller, K., and Adler, S.P. Changing protective and risky behaviors to prevent child-to-parent transmission of cytomegalovirus. J. Appl. Behav. Anal. 1993; 26: 471–472 
  4. Revello, M.G., Tibaldi, C., Masuelli, G., Frisina, V., Sacchi, A., Furione, M., Arossa, A., Spinillo, A., Klersy, K., Ceccarelli, M., Gerna, G., Todros, T., and the CCPE Study Group. Prevention of primary cytomegalovirus infection in pregnancy.EBioMedicine. 2015; 2: 1205–1210 
  5. Vauloup-Fellous, C., Picone, O., Cordier, A.G. et al. Does hygiene counseling have an impact on the rate of CMV primary infection during pregnancy? Results of a 3-year prospective study in a French hospital. J. Clin. Virol. 2009;46: S49–S53 

Links to read the PREVENTION STUDIES listed in Adler's 2015 summary paper, 

"Prevention of Maternal–Fetal Transmission of Cytomegalovirus"
  1. Adler, S.P., Finney, J.W., Manganello, A.M., and Best, A.M. Best prevention of child-to-mother transmission of cytomegalovirus by changing behaviors: a randomized controlled trial. Pediatr. Infect. Dis. J. 199615240–246
  2. Adler, S.P., Finney, J.W., Manganello, A.M., and Best, A.M. Prevention of child-to-mother transmission of cytomegalovirus among pregnant women. J. Pediatr. 2004145485–491
  3. Finney, J.W., Miller, K., and Adler, S.P. Changing protective and risky behaviors to prevent child-to-parent transmission of cytomegalovirus. J. Appl. Behav. Anal. 199326471–472 
  4. View in Article 
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  12. Revello, M.G., Tibaldi, C., Masuelli, G., Frisina, V., Sacchi, A., Furione, M., Arossa, A., Spinillo, A., Klersy, K., Ceccarelli, M., Gerna, G., Todros, T., and the CCPE Study Group. Prevention of primary cytomegalovirus infection in pregnancy.EBioMedicine201521205–1210 
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  23. Vauloup-Fellous, C., Picone, O., Cordier, A.G. et al. Does hygiene counseling have an impact on the rate of CMV primary infection during pregnancy? Results of a 3-year prospective study in a French hospital. J. Clin. Virol. 2009;46S49–S53 
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For more information, contact: 

Lisa Saunders, PO Box 389, Mystic, CT 06355, LisaSaunders42@gmail.com, CongenitalCMV.blogspot.com

Wednesday, June 20, 2018

Ways to Share CMV Prevention Tips to End #1 Birth Defects Virus--have any ideas?


Can you think of ways to share CMV (cytomegalovirus) prevention tips in honor of June as National Cytomegalovirus Month? 

Some of you have been posting one CMV fact a day on your Facebook pages--good idea! At the bottom of this post, I include links to flyers from the CDC, etc., that you may wish to send out. 


I got the idea to create the above CMV prevention goody bags for the children at Riverfront Children's Center in Groton, Connecticut, from Jessica Rachels of the Idaho CMV Advocacy Project who donated goody bags to her local head start programs. In my bags, which the curriculum director said might be something the staff could work into their STEAM (Science, Technology, Engineering, Art and Math) theme*, I followed my motto, "Share a Meal, Not the Germs!" My goal is to teach children, their families, and child care staff the importance washing hands before setting the table and eating, and to never share cups, etc, through my "color-me-in" fairytale, Once Upon a Placemat: A table Setting Tale. In addition to what the children got in their bags (coloring book, crayons, plastic tableware, bathroom sink sign and Placemat with tableware characters), I gave the staff a different bathroom sink sign to remind them that diaper wipes do not kill CMV! (See: https://drive.google.com/file/d/1wcGpHOfu3lLKl9vYR_KhI5LIqI_h1tvC/view)


You can write an article about CMV and ask your local media to publish it. Mine, "June: National Cytomegalovirus Month: Had I Known (about CMV)," was published in the magazine, Groton-Mystic Neighbors (June 2018). This coverage resulted in an invitation to speak at the local chapter of the teacher's sorority, ADK.

When I contacted Connecticut's News 8 about June and CMV, a reporter and cameraman came to my home to discuss it with Dr. Brenda Balch and the singer/songwriter, Debra Lynn Alt. The News 8 reporter, Sarah Cody, created a short video to promote her upcoming CMV coverage: https://www.facebook.com/sarah.cody.10/videos/1421707187974926/  Here is the full interview with Debra's CMV song played throughout: http://www.wtnh.com/on-air/connecticut-families/mystic-mother-raises-awareness-of-cmv-a-risk-for-pregnant-women-and-their-babies/1235975184

Another way to raise awareness is through music. My friend, singer/songwriter Debra Lynn Alt, was shocked to learn there are so many mothers of children born disabled by CMV who never heard of CMV when pregnant--never been given the chance to protect their unborn babies. She felt inspired to write and release the song, "Had I Known (about CMV) in June, which was featured on CT's News 8The studio recording of the CMV song, with Debra Lynn Alt as lead vocalist, includes keyboard and harmony vocals by another friend, Connie Howard, mandolin and guitar (Jim Carpenter), violin (Stacy Phillips), cello (Ann West), and bass (Jeff Fuller). It can be heard at this link: https://drive.google.com/file/d/0B9Klfxar2CmjRGN0cnBNQXRDdExMQWJOVHVZRGR1aWFJX0lJ/view?usp=sharing (recorded at Loco Dare Productions, Niantic, Connecticut).   

Another way to show the media how important their coverage of CMV is, is to write a letter to the editor to keep the topic "hot." The following one of mine was accepted for publication when I commented on the article, "Drs. Effie Siomos and Ken Ostermann: Learn about and take precautions to prevent CMV" (June 16, 2018): 



Dear Editor: 
Thank you for sharing the "inconvenient truth" about CMV (cytomegalovirus), the leading viral cause of birth defects, which causes more disabilities than Zika and fetal alcohol syndrome. It's an inconvenient truth because women who care for young children are at highest risk. Not only are mothers of toddlers unaware they should never kiss their toddlers around the mouth or share food, cups and utensils with them, but very few states tell their child care workers they have an occupational risk for CMV. I'm a former Maryland licensed child care provider who never heard of CMV until after my daughter Elizabeth was born severely disabled by congenital CMV in 1989.
The March of Dimes states: “As many as 7 in 10 children (70 percent) between 1 and 3 years of age who go to day care may have CMV. They can pass it on to their families, caretakers and other children.”
Many women who care for young children use diaper wipes to save time when cleaning up bodily fluids such as saliva and urine. Diaper wipes do not kill CMV! Wash hands with soap and water, and if that's not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol.
Who will tell child care providers the truth about CMV in toddlers? Who will tell mothers of toddlers in group care that they, too, are at increased risk for CMV?
Lisa Saunders
Mystic, Connecticut
LisaSaunders42@gmail.com

I provided the editor of the above publication the following sources for my above comments:

REFERENCES FOR THE STATEMENTS I MADE ABOVE:

  • Caregivers of young children are at increased risk for CMV, the leading birth defects virus that disables 4,000 babies each year in the U.S. (Centers      for Disease Control and Prevention)
  • 44 - 100% of two-year-olds in group daycare are excreting CMV (Pass et al., 1986).
  • Diaper wipes do not kill CMV (Stowella et al., 2014 ).
  • 8 - 20% of child care providers contract CMV infection every year (AAP et al., 2011) VERSUS 1-4% in general population (CDC).   
  • Mothers of children in group care are also at increased risk for CMV (Pass et al., 1986).
  • Only 18.5% of licensed “in-home” daycare providers surveyed have heard of CMV and “Providers do not know how to appropriately sanitize surfaces to reduce spread of disease.” Many use diaper wipes to clean surfaces, which do not sanitize (Thackeray et al., 2016).
  • “Women may be able to lessen their risk of getting CMV by reducing contact with saliva and urine from babies and young children. Some ways to do this are: kissing children on the cheek or head rather than the lips, and washing hands after changing diapers. These cannot eliminate your risk of getting     CMV, but may lessen your chances of getting it” states the CDC. Download this flyer from the CDC: https://www.cdc.gov/cmv/downloads/pregnant-patients-cmv.pdf

GENERAL LIST of CMV Prevention 


1. "Staff Education and Policies on Cytomegalovirus (CMV)," American Academy of Pediatrics (AAP) et al., Caring for Our Children: http://cfoc.nrckids.org/CFOC/Database/7.7.1.1 Available as a pdf: file:///C:/Users/Lisa/Downloads/CFOC_3rd_7_7_1_1.pdf


3. National CMV Foundation features several types of CMV flyers for downloading and hanging on your wall such as: https://www.nationalcmv.org/NCMVF/media/ncmvf/download-content/CMV_Awareness-Flyer_11x17.pdf?ext=.pdf

4. CDC’s CMV info available in English and Spanish:
Español: Acerca del citomegalovirus: https://www.cdc.gov/cmv/overview-sp.html

5. Check your state’s childcare care licensing department, department of health, department of labor, and local universities with occupational medicine and public health programs. CMV is a bloodborne Pathogen. See Occupational Safety and Health Administration (OSHA) for bloodborne pathogens: https://www.osha.gov/OshDoc/data_BloodborneFacts/bbfact01.pdf

6. Handwashing: Centers for Disease Control and Prevention (CDC) has a video and posters on handwashing procedures and what to do if soap and water are not available: https://www.cdc.gov/handwashing/index.html

7. MotherToBaby.org provides factsheet on CMV and mentions childcare workers: https://mothertobaby.org/fact-sheets/cytomegalovirus-cmv-pregnancy/pdf/


9. "The Danger of Spreading CMV: How We Can Protect Our Children" by Lisa Saunders published by ChildCare Aware of America (June 2017).

10. Utah created English/Spanish brochures specifically for childcare providers:

11. Connecticut Department of Public Health (CT DPH) website has flyers and information: http://portal.ct.gov/DPH/Family-Health/EHDI/CMV. The National CMV Foundation allowed the CT DPH to embed their logo in their “Are You Pregnant” National CMV Awareness Flyer.

For social media, a photo of the flyer will be easier to share. Find the jpeg of “Are You Pregnant” by the National CMV Foundation at:
https://drive.google.com/file/d/1AVG9RXGVsbBTwOImOb18NWDdG3rHbHbm/view?usp=sharing

If you need a pdf of the above flyer with information relevant for childcare providers from CT DPH, then: https://drive.google.com/file/d/0B9Klfxar2CmjemlkcElQQkZfQWs/view)

12. Article, “Help Childcare Providers Fight CMV” by Lisa Saunders published by National CMV Foundation (March 5, 2018)

13. NAEYC: National Association for the Education of Young Children and its "Early Childhood Program Standards and Accreditation Criteria and Guidance for Assessment (10.D.01, p.91)" includes: "a. steps to reduce occupational hazards such as infectious diseases (e.g., exposure of pregnant staff to CMV [cytomegalovirus], chicken pox)..." Find their accredited childcare centers/preschools

14. Need CMV articles? See my Bibliography at: http://congenitalcmv.blogspot.com/2017/05/cmv-bibliography-with-source-links.html

15. Song for mothers who learned too late about protecting their unborn child from congenital CMV--"Had I Known (about CMV): by Debra Lynn Althttps://drive.google.com/file/d/0B9Klfxar2CmjRGN0cnBNQXRDdExMQWJOVHVZRGR1aWFJX0lJ/view



        Materials produced by the "ChildCare Providers Fighting CMV" project

        1) Above-sink wall flyer on hand-washing, "Share a Meal Not the Germs" 
        Colored in version of wall sign, "Share a Meal Not the Germs" :

        Above-sink wall flyer for hand-washing, "Diaper Wipes Don't Kill CMV"
        https://drive.google.com/file/d/1wcGpHOfu3lLKl9vYR_KhI5LIqI_h1tvC/view?usp=sharing

        For children to color in version: "Share a Meal Not the Germs":


        2) Wall Flyer For Women Who Care for Toddlers: 

        3) Fun Teaching Tool Kit for Students and Families: Fairytale tells how to “Share a Meal, Not the Germs.” 
        a. An educational “coloring book, Once Upon a Placemat: A Table Setting Tale by Lisa Saunders and Jackie Tortora. Free pdf version of Once Upon a Placemat: A Table Setting Tale (or the educational fairy tale can be purchased as a bound coloring book, visit Amazon for $5.38).
        b. Placemats: Side one: Placemat with tableware characters with space for your coloring artist's name (perfect for laminating and using as a table-setting reminder): https://drive.google.com/file/d/0B9Klfxar2Cmjd21OTjB6SjNfYVU/view
        c. Side two: Germ prevention tips and hand-washing instructions.

        5) Book, Help Childcare Providers Fight CMV: People can click here for the free 133-page pdf manuscript or at:

        6) PowerPoint Presentation:" Help Childcare Providers Fight CMV": Available as:

        c. YouTube Presentation by Lisa Saunders: https://youtu.be/dDkICFULA7M

        7) Warning Photograph for Wall/Sharing on Social Media:

        Suggested lesson plan for children: Read aloud the fairytale, "Once Upon a Placemat: A Table Setting Tale," available as a free pdf by clicking here, then share a meal together (you can watch the author introduce the book and read an excerpt by clicking here). Help the children wash their hands and set their place setting by referring to the characters in Once Upon a Placemat. You can say things like, "Remember, Mr. Knife is afraid the dish will run away with the spoon, so put his teeth toward Mr. Plate" and "Miss Cup hates it when people share her without giving her a bath first because of those naughty germs." If possible, give each child a "Share a Meal, Not the Germs" picnic kit with these suggested items:  
        • Bag (paper or reusable insulated bag).
        • Plate, cup, napkin, fork, spoon, knife.
        • Crayons or washable markers.
        • Placemat with tableware characters (free pdf for coloring and possible laminating).
        • Picnic food (homemade or prepackaged that would use all utensils, such as peanut butter, crackers, applesauce and cake).
        • Hand sanitizer or sanitizing wipes. 
        • Sink hand-washing sign and tri-fold flyer on CMV prevention to take home.
        • If funds are available, give a child their own bound copy of Once Upon a Placemat: A Table Setting Tale to color and share with their families so their parents can reinforce the table-setting lesson and learn how to prevent CMV, the #1 birth defects virus, as well as other diseases (book available on Amazon for $5.38).
        *STEAM:
        I asked the curriculum director what she meant by STEAM. She told me STEAM is a popular way to better package and present the interconnectedness of  Science, Technology, Engineering, Art and Math in the regular curriculum. She said, "Too many times people treat these topics as mutually exclusive, when they all work to support the learner and their personal method of learning.  I was thinking that when you talk about germs, your book (Art and Literacy), which appeals to the children that have strengths in those areas, and introduces germs (science, biology) in a format that integrates the arts.  Drawing and writing activities can be planned to further integrate those domains.  Teachers can further bring in Technology and engineering by designing activities that help the children to "invent" equipment or machines to help better wash hands, keep food fresh and germ free, etc.  Math can enter into the plan by graphing how long children wash there hands, how often they wash their hands, keep track how many uses the classrooms get out of a single pump bottle of hand soap, etc...That's just a quick example of how your topic can be enhanced by identifying the STEAM components in the concept of germs and health.  With a little more thought (and a few trips to Pinterest!) lots of germ based activities can be created and integrated."