by
Lisa Saunders
Former licensed daycare provider
Former licensed daycare provider
Want a healthy baby? Want your friends to have one? Then know the numbers of congenital (present at birth) Cytomegalovirus (CMV), the #1 viral cause of birth defects.
The New York Times states,"CMV is a Greater Threat to Infants Than Zika, but Far Less Often Discussed."
The New York Times states,"CMV is a Greater Threat to Infants Than Zika, but Far Less Often Discussed."
Mothers of toddlers in daycare and child care workers are at increased risk for contracting CMV.
CMV (cytomegalovirus) can cause birth defects if a woman contracts the virus when she is pregnant. Toddlers in child care are often shedding the virus, putting their caregivers at higher risk for contracting CMV. Congenital (present at birth), is the leading viral cause of birth defects, causing more disabilities than Down Syndrome, Fetal Alcohol Syndrome, Spina Bifida, and Pediatric HIV/AIDS.
The American Academy of Pediatrics states: "Spread of CMV from an asymptomatic infected child in child care to his or her mother or to child care providers is the most important consequence of child care-related CMV infection."
To protect future babies, please ask child care centers to adhere to the following guidelines set forth and co-authored by the American Academy of Pediatrics in the book, "Caring for Our Children." Excerpt:
The American Academy of Pediatrics states: "Spread of CMV from an asymptomatic infected child in child care to his or her mother or to child care providers is the most important consequence of child care-related CMV infection."
To protect future babies, please ask child care centers to adhere to the following guidelines set forth and co-authored by the American Academy of Pediatrics in the book, "Caring for Our Children." Excerpt:
Standard 7.7.1.1: Staff Education and Policies on Cytomegalovirus (CMV) states childcare workers of childbearing age should be informed about their increased probability of exposure to CMV and:
- Hygiene measures (especially handwashing and avoiding contact with urine, saliva, and nasal secretions) aimed at reducing acquisition of CMV;
- The availability of counseling and testing for serum antibody to CMV to determine the caregiver/teacher’s immune status.
The following is congenital CMV in numbers with embedded links for more information:
- 1 out of 150 babies are born with congenital CMV.
- 1 out of 5 babies born with congenital CMV will be permanently disabled according to the Centers for Disease Control and Prevention (CDC).
- 1 baby every hour is disabled by congenital CMV (cerebral palsy, mental impairment, hearing and vision loss, epilepsy).
- 8- 20% of female child care providers contract CMV infection every year.
- 44% to 100% of two-year-olds in group daycare are excreting CMV.
- #1 Birth Defects Virus--Congenital CMV causes more disabilities than Down Syndrome, Fetal Alcohol Syndrome, Spina Bifida, and Pediatric HIV/AIDS
- 91% of women surveyed in 2015-2016 have never heard of CMV.
- "$1.9 billion annually, with a average cost per child of over $300,000” was the expense in the early 1990s to the US health care system associated with congenital CMV.
What do other countries do about CMV in daycare?
In Queensland, Australia, they relocate “workers who are pregnant, or who expect to become pregnant, to care for children aged over two to reduce contact with urine and saliva.” In Germany: "Based on the German Maternity Protection Law (Mutterschutzgesetz)… to protect DCWs [day care workers] from primary infection,their CMV serostatus must be checked at the beginning of their pregnancy. When the DCW is seronegative, she is excluded from professional activities with children under the age of three years..."
Learn more:
"CMV in Child Care: Protect Your Pregnancy"
Caring for a Toddler?
Everyone agrees toddlers are cute--and they are! But if you are a daycare worker, a nursery volunteer, or have a toddler in daycare, you need to know about cytomegalovirus (CMV).
The Problem:
CMV can cause birth defects if a woman contracts the virus when she is pregnant. The Centers for Disease Control and Prevention (CDC) states, "People who care for or work closely with young children may be at greater risk of CMV infection than other people because CMV infection is common among young children," Toddlers spread infections by putting each other’s toys in their mouths, sharing cups and utensils, and needing adults to wipe their noses, feed them, and change their diapers. Between 8- 20% of female child care providers contract CMV infection every year. Mothers of children in daycare are also at increased risk for contracting CMV according to the study, "Increased Rate of Cytomegalovirus Infection among Parents of Children Attending Day-Care Centers.” (Pass, et al, 1986)
Diligence Required!
Pregnant child care givers need to be extra diligent about sanitizing surfaces used by toddlers and washing their hands after direct contact with a toddler's bodily fluids. Assume ALL toddlers are shedding CMV because between 44% to 100% of toddlers were shedding the virus in the study,“Group day care and cytomegaloviral infections of mothers and children.” Toddlers can shed CMV for many months in their saliva, urine and other bodily fluids.
What to do?
The American Academy of Pediatrics co-authored Caring for Our Children, which includes Standard 7.7.1.1: Staff Education and Policies on Cytomegalovirus (CMV), which states childcare workers of childbearing age should be informed about their increased probability of exposure to CMV and:
- Hygiene measures (especially handwashing and avoiding contact with urine, saliva, and nasal secretions) aimed at reducing acquisition of CMV;
- The availability of counseling and testing for serum antibody to CMV to determine the caregiver/teacher’s immune status...
CMV Prevention Resources
The Congenital CMV Disease Research Clinic and Registry provides resources to share with women of childbearing age. In addition, the National CMV Foundation features CMV prevention flyers for downloading. You can also print the CDC’s congenital CMV pamphlet in English or Spanish, found on the National Birth Defects Prevention Network website. Utah, the first state to pass a law requiring daycare providers are informed about CMV (2013), provides this brochure for childcare providers. Cooperative Extension has several articles on sanitizing hands and surfaces in child care centers.
Conclusion--Child Care Centers Should Provide CMV Prevention Education:
Only 18.5% of licensed “in-home” daycare providers have heard of CMV according to a 2016 study. In addition, “Providers do not know how to appropriately sanitize surfaces to reduce spread of disease.” For example, many providers use baby wipes to clean a surface. Although the surface may look clean, baby wipes do not sanitize it. "Intervening with child care providers and parents through child care facilities are key opportunities to reduce prevalence of CMV infection and other diseases."(Child Care Provider Awareness and Prevention of Cytomegalovirus and Other Infectious Diseases,”Thackeray and Magnusson, 2016).
ORGANIZATIONS THAT MAY HELP TRAIN CHILD CARE WORKERS
Agencies to Contact:
• Your state’s daycare licensing department found at: http://www.healthychildcare.org/Contacts.html
• Your local universities may have occupational medicine programs.
Fun, Free Teaching Toolkit for Students and Their Families!
"Grandma" uses Miss Cup to enforce germ prevention and uses Mr. Knife's fear that the dish will run away with the spoon to teach table-setting in the educational coloring book,"Once Upon a Placemat: A Table Setting Tale." FREE Teaching Toolkit includes:
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) plus there is space available for your organization's
Video: Short introduction of the tableware characters found in the educational coloring booklet, Once Upon a Placemat: A Table Setting Tale, co-authored by Lisa Saunders, the parent representative of the Congenital Cytomegalovirus Foundation. (Ask your library to carry a copy of Once Upon a Placemat: A Table Setting Tale, or contact LisaSaunders42@gmail.
Author's note: I am the parent representative of the Congenital Cytomegalovirus Foundation and a CMV education consultant. I was a licensed home daycare provider and church nursery volunteer who was not advised that caring for toddlers in a group setting increased my risk of contracting CMV while pregnant. Although I washed my hands after every diaper change, I should have been much more diligent about washing them after picking up toys and wiping runny noses. My daughter Elizabeth (1989-2006) was born severely disabled from congenital (present at birth) CMV. My mission is to try to prevent this from happening to other child care providers (mothers of toddlers and professional daycare providers) and their future babies. You have my permission to republish my above post, Please see below my signature for resources you may find helpful in your own quest to protect future children from suffering as my daughter did from congenital CMV.
Sincerely,
Lisa Saunders, parent representative
PO Box 389
Mystic, CT 06355
RESOURCES FOR TRAINING CHILD CARE WORKER
- Standard 7.7.1.1: Staff Education and Policies on Cytomegalovirus (CMV). American Academy of Pediatrics (AAP), American Public Health Association, National Resource Center for Health and Safety in Child Care and Early Education. Retrieved from National Health and Safety Performance Standards: Guidelines for Early Care and Education Programs: Caring for Our Children: http://cfoc.nrckids.org/StandardView/7.7.1.1
- National Health and Safety Performance Standards: Guidelines for Early Care and Education Programs. American Academy of Pediatrics, American Public Health Association, National Resource Center for Health and Safety in Child Care and Early Education. (2011). Retrieved from Caring for Our Children: http://cfoc.nrckids.org/WebFiles/CFOC3_updated_final.pdf
3. 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): http://aem.asm.org/content/80/2/455.full (Stowella, J. D. (2014, January 2014 )5. You can print the CDC’s congenital Cytomegalovirus (CMV) Pamphlet, English or Spanish, found at the National Birth Defects Prevention Network).6. A Toolkit for Early Care and Education: A Checklist for Early Care and Education. Green Cleaning, Sanitizing, and Disinfecting: Retrieved 2017, from U.S. Environmental Protection Agency: https://www.epa.gov/sites/production/files/2013-08/documents/checklist_8.1.2013.pdf- Handwashing: Green Cleaning, Sanitizing, and Disinfecting: A Toolkit for Early Care and Education: Toolkit for early child care and education discussing green cleaning, sanitizing, and disinfecting: Handwashing Fact Sheet. Retrieved from U.S. Environmental Protection Agency: https://www.epa.gov/sites/production/files/2013-08/documents/fact_sheet_hand_washing.pdf
- Henry the Hand provides infection control tool kits for schools and other groups.
- Standard 7.7.1.1: Staff Education and Policies on Cytomegalovirus (CMV). American Academy of Pediatrics (AAP), American Public Health Association, National Resource Center for Health and Safety in Child Care and Early Education. Retrieved from National Health and Safety Performance Standards: Guidelines for Early Care and Education Programs: Caring for Our Children: http://cfoc.nrckids.org/StandardView/7.7.1.1
MY PERSONAL CMV MATERIALS:
In addition to Once Upon a Placemat: A Table Setting Tale, I have authored or produced:
- CMV prevention music video about my daughter’s life: Girl with congenital cytomegalovirus (CMV)
- Memoir: Anything But a Dog! The perfect pet for a girl with congenital CMV (Unlimited Publishing, 2008, Thousand Books, Japan, 2017)
- Booklet: Surviving Loss: The Woodcutter’s Tale: Fairytale about losing a child.
- Travel memoir: Mystic Seafarer's Trail: My misadventures trying to get thin and famous like Amelia Earhart (married near my home), so people will listen to my CMV prevention message.
Note: Above image from Surviving Loss: The Woodcutter's Tale--inspired by a girl with congenital cytomegalovirus (CMV).
BIBLIOGRAPHY
Carlson, A. M., Norwitz, E. R., & Stiller, R. J. (Fall 2010). Cytomegalovirus Infection in Pregnancy: Should All Women Be Screened? Reviews in Obstetrics and Gynecology. Retrieved from National Center for Biotechnology Information: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3046747/
Centers for Disease Control and Prevention. (n.d.). Retrieved from Congenital CMV Infection Trends and Statistics: http://www.cdc.gov/cmv/trends-stats.html
Centers for Disease Control and Prevention (CDC). (n.d.). Cytomegalovirus (CMV) and Congenital CMV Infection. Retrieved from Centers for Disease Control and Prevention (CDC): http://www.cdc.gov/cmv/index.html
Centers for Disease Control and Prevention (CDC). (n.d.). Infant Health. Retrieved from Centers for Disease Control and Prevention (CDC): http://www.cdc.gov/nchs/fastats/infant-health.htm
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, MSc, Serene A, et al. (2006, Sept). Cytomegalovirus as an occupational risk in daycare educators. Retrieved from PMC: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2528629/
Harrison, Gail Demmler MD. (2016, December 2). Cytomegalovirus: The Virus All Pregnant Women Should Know About Now. Retrieved from Medscape.com: http://www.medscape.com/viewarticle/872452
Lanzieri,Tatiana M., Chung, Winnie, Flores,Marily, Blum, Peggy, Caviness, A. Chantal, Bialek, Stephanie R., Grosse,Scott D., Miller, Jerry A., Demmler-Harrison, Gail. (2017, February ). Congenital Cytomegalovirus Longitudinal Study Group. Pediatrics. Retrieved from http://pediatrics.aappublications.org/content/early/2017/02/14/peds.2016-2610
LOUIS, C. S. (2016, Oct. 24). CMV Is a Greater Threat to Infants Than Zika, but Far Less Often Discussed. The New York Times. Retrieved from http://www.nytimes.com/2016/10/25/health/cmv-cytomegalovirus-pregnancy.html?_r=0
Pass, Robert F. M.D.; Hutto, Cecelia M.D.; Ricks, Rebecca M.S.N., R.N.; and Cloud, Gretchen A. M.S. (1986, May 29). Increased Rate of Cytomegalovirus Infection among Parents of Children Attending Day-Care Centers. New England Journal of Medicine. Retrieved 2017, from New England Journal of Medicine: http://www.nejm.org/doi/full/10.1056/NEJM198605293142204
Saunders, L. (2013). Surviving Loss: The Woodcutter's Tale.CreateSpace Independent Publishing Platform. Retrieved from https://www.amazon.com/Surviving-Loss-Woodcutters-Lisa-Saunders/dp/1482315505/ref=asap_bc?ie=UTF8
Schleiss, M. R. (2008). Cytomegalovirus Vaccine Development. Retrieved Januarary 14, 2015, from US National Library of Medicine: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2831992/
WRITTEN OR PRODUCED BY LISA SAUNDERS
Saunders, L. (2006, October 18). The silent virus that
silenced Elizabeth. Times Herald Record, p. 2B. Retrieved from
https://drive.google.com/file/d/0B9Klfxar2CmjcXZqYkdNLWdub0E/view?usp=sharing
Saunders, L. (2007, September). Family Health: The
Tragic Kiss--Suffern Mom Works to Spread Word About CMV. Rockland Parent
Magazine. Retrieved from https://drive.google.com/file/d/0B9Klfxar2CmjakJDbTdsMXBWNmM/view?usp=sharing
Saunders, L. (2009). Anything But a Dog! The
perfect pet for a girl with congenital CMV (cytomegalovirus). Retrieved
from
http://www.amazon.com/Anything-But-Dog-Congenital-Cytomegalovirus/dp/1588329968/ref=sr_1_1?s=books&ie=UTF8&qid=1340644532&sr=1-1&keywords=anything+but+a+dog+lisa+saunders
Saunders, L. (2010, Fall). CMV: The Virus Nobody Talks
About. Siemens Healthcare Diagnostics magazine, p. 41. Retrieved from
https://drive.google.com/file/d/0B9Klfxar2CmjdTNiXzN5SkRTSUM5Nk4wRGRXVnJ6TzJtdGRv/view
Saunders, L. (2012). Mystic Seafarer's Trail:
Secrets behind the 7 Wonders, Titanic's Shoes, Captain Sisson's Gold, and
Amelia Earhart's Wedding . CreateSpace Independent Publishing Platform .
Retrieved from
https://www.amazon.com/Mystic-Seafarers-Trail-Titanics-Earharts/dp/1480085847/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=1484581084&sr=1-5
Saunders, L. (2013). Surviving Loss: The
Woodcutter's Tale. CreateSpace Independent Publishing Platform. Retrieved
from https://www.amazon.com/Surviving-Loss-Woodcutters-Lisa-Saunders/dp/1482315505/ref=asap_bc?ie=UTF8
Saunders, L. (2014, April ). Author Wears Many Hats.
(S. Simcox, Ed.) Inside Mystic Magazine. Retrieved from
https://drive.google.com/file/d/0B9Klfxar2CmjSTZZV0xOOTR5bVE/edit
Saunders, L. (2014, September). How a Parent Can Raise
a CMV Prevention Message. Presentation: CMV Public Health & Policy
Conference, Salt Lake City, UT . Mystic, CT. Retrieved from
https://drive.google.com/file/d/0B9Klfxar2CmjcnYwYzhrc0NfR3c/view
Saunders, L. (2015, July 13). Congenital
Cytomegalovirus (cCMV) and What Happened in Connecticut. PowerPoint
Presentation to Medical Assistance Program Oversight Council's Women’s Health
Committee. Hartford, Connecticut. Retrieved from https://www.cga.ct.gov/med/committees/med5/2015/0713/20150713ATTACH_CMV%20CT%20PowerPoint.pdf
Saunders, L. (2015, Februrary 20). Public Hearing
Testimony--Substitute for H.B. No. 5525: An Act Concerning Cytomegalovirus.
Hartford, Connecticut. Retrieved from https://www.cga.ct.gov/2015/PHdata/Tmy/2015HB-05525-R000220-Lisa%20Saunders,%20Parent%20Representative,%20Congenital%20Cytomegalovirus%20Foundation-TMY.PDF
Saunders, L. (2016). Color-Me-In Placemat with CMV
Prevention: Side One. Once Upon a Placemat: A Table Settng Tale. Mystic,
Connecticut. Retrieved from
https://drive.google.com/file/d/0B9Klfxar2CmjbWlfQlpGS3VDMlBXVklDN0JnM0lxa3lXRVpR/view?usp=sharing
Saunders, L. (2016). Color-Me-In Placemat with CMV
Prevention: Side Two. Mystic, CT. Retrieved from https://drive.google.com/file/d/0B9Klfxar2CmjcnZkNzlEOGRzX2NuTTg1T2ZZNWh3M3Zka184/view?usp=sharing
Saunders, L. (2016, Feb 26). Color-Me-In Video
Introducing Book: Once Upon a Placemat: A Table Setting Tale. Includes germ/CMV
prevention. Retrieved from Youtube: https://www.youtube.com/watch?v=_0jDOKPFg4M&feature=youtu.be
Saunders, L. (2016). Girl with congenital
cytomegalovirus (CMV) set to song, "Voice for Sam" by Debra Lynn Alt.
(L. Saunders, Producer) Retrieved from
https://www.youtube.com/watch?v=vTbvsMyCftc
Saunders, L. (2016, December). Newsletter:
Advocating for CMV awareness and policy. Mystic, Connecticut. Retrieved
from Congenital CMV Newsletter:
http://us4.campaign-archive2.com/?u=0dd2dc5fa327d215c27770e46&id=cb12b3d880&e=[UNIQID]
Saunders, L. (2017). Elizabeth and Riley the
Miracle Dog (Japanese translation of Anything But a Dog! The perfect pet for a
girl with congenital CMV). (S. Nakai, Trans.) Tokoyo: Thousands of Books
Japan. Retrieved from http://shop.thousandsofbooks.jp/items/5173204
Saunders, L. (2017). Lisa Saunders, CMV Awareness
and Policy Advocate. Retrieved from CongenitalCMV.blogspot.com: http://congenitalcmv.blogspot.com/2016/11/mother-of-congenital-cmv-girl-speaks.html
Saunders, L. (circa 1994). Elizabeth: A Christmas
Blessing. Challenge Magazine, 2(4), pp. 14, 16. Retrieved from
https://drive.google.com/file/d/0B9Klfxar2CmjN19kelJ0RGVYNEU/view?usp=sharing
Saunders, L. (Jan. 26, 2017). My Story with
Congenital CMV Plus Research. Presentation , Society of Maternal Fetal
Medicine, Las Vegas, Nevada. Retrieved from
https://drive.google.com/file/d/0B9Klfxar2CmjVnZuWW5xa0NaSmc/view?usp=sharing
Saunders, Lisa, Parent Representative, Congenital CMV
Foundation. (2014, Feb. 28). Public Hearing Testimony, Raised H.B. No. 5147.
Retrieved from Connecictut General Assembly:
http://www.cga.ct.gov/2014/PHdata/Tmy/2014HB-05147-R000228-Lisa%20Saunders,%20Parent%20Representative,%20Congenital%20CMV%20Foundation-TMY.PDF
Saunders, Lisa; Demmler-Harrison, Gail J, MD. (2016). Pregnant
Women: Most common virus you never heard of; CMV (cytomegalovirus). (L.
Saunders, Producer) Retrieved from Youtube: https://www.youtube.com/watch?v=8BEZzr0FCKQ
Saunders, Lisa; Tortora, Jackie. (2016). Once Upon
a Placemat: A Table Setting Tale. CreateSpace Independent Publishing
Platform. Retrieved from
https://www.amazon.com/gp/product/1523750790?keywords=once%20upon%20a%20placemat&qid=1454858533&ref_=sr_1_1&sr=8-1
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