Friday, March 10, 2023

Free Ways to Educate Pregnant Women About Preventing #1 Birth Defects Virus, CMV


Cost of NOT preventing congenital CMV: "at least 3000 [newborns] are estimated to develop permanent neurologic disabilities each year due to cCMV infection...With an estimated annual cost of up to $4 billion in the United States, cCMV infection is an enormous public health concern..." ("Cost-effectiveness of Universal and Targeted Newborn Screening for Congenital Cytomegalovirus Infection" (Gantt, S, 2016). 


1)  Ask the Commissioner of  Health to upload the free CMV educational materials to the Department of Health Website. The CDC, AAP and Medscape have great materials.  If materials are from the CDC, they don't seem to have to go through an approval process. 

Medscape, which offers free professional online education and CME (Continuing Medical Education) to physicians and healthcare professionals, now works to advance awareness of congenital CMV. Gail J. Demmler-Harrison, MD can be seen introducing its new CMV program: “As chair of the steering committee, I’d like to welcome you to Clinical Advances in Cytomegalovirus or CMV, a comprehensive learning center for clinicians who treat patients with CMV or who treat patients who are at risk for CMV…” (medscape.org/sites/advances/cmv). Dr. Demmler-Harrison told Saunders, “This is just the first of many CME educational programs Medscape has planned. Check back often for new programs!" 

2) Ask legislators to ask doctors who provide prenatal care to distribute information about CMV prevention (CT DPH website has letter: About CMV For Obstetric Health Care Providers”. It needs to be written in statute, similar to Iowa law, “An attending health care provider shall provide to a pregnant woman during the first trimester of the pregnancy the informational materials published under this subsection. The center for congenital and inherited disorders shall make the informational materials available to attending health care providers upon request.

3) Distribute links to fliers to doctors and child care providers through association newsletters.  


4) Ask student interns to create materials especially for child care providers. Although the CT DPH has info for child care providers (see: https://portal.ct.gov/DPH/Family-Health/EHDI/CMV), it doesn't have a flyer specifically for child care providers. 


I asked CT DPH: 

As you may be aware, the  Cytomegalovirus education  bill is now Raised H.B. No. 6821: AN ACT 

CONCERNING EDUCATION REGARDING CYTOMEGALOVIRUS, which only requires CMV info on the DPH website. Commissioner of Health, Manisha Juthani, MD, stated in her letter of testimony: "DPH currently maintains a website, portal.ct.gov/DPH/Family-Health/EHDI/CMV, that provides information on symptoms, diagnosis, and treatment of cytomegalovirus. We are happy to work with practitioners and community providers if they would like additional information on cytomegalovirus to be added to the website..."
  • 3/06/2023 Juthani, Manisha, Commissioner-Department of Public Health-
 
Commissioner of Health, Manisha Juthani, MD, dph.commissioner@ct.gov

ADD:

UCONN students created a CMV training video for child care providers. 
  • CMV Training Module for child care providers (University of Connecticut):https://youtu.be/k9MFAEYVuLs
  • CDC flyers in English and Spanish:https://www.cdc.gov/cmv/resources/pregnant-women-parents.html
  • Recommendations from the AAP for caregivers/teachers at:http://nrckids.org/CFOC/Database/7.7.1.1"Staff Education and Policies on Cytomegalovirus (CMV)," 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

CT DPH currently have this for child care providers: 
For Childcare Providers and Pediatrics Professionals:

 

Due to frequent contact with young children, childcare providers and other pediatric professionals, may be at greater risk for CMV.  According to the National CMV Foundation,  “Contact with infected bodily fluids, including saliva or urine of young children, is a major cause of CMV infection among pregnant women –  especially mothers, daycare workers, preschool teachers, therapists, and nurses. Studies in childcare settings suggest that as many as 75% of toddler-aged children have CMV in their urine or saliva, and viable CMV can persist on hands for at least 15 minutes.” Following standard hygiene practices mentioned above may help prevent the spread of CMV.


*)Ask CDC to include child care workers on its list of occupations affected by bloodborne pathogens since they bandage up cuts/scrapes: https://www.cdc.gov/niosh/topics/bbp/occupations.html

 "Under OSHA's bloodborne pathogens standard, employers having employees with exposure to blood or other potentially infectious materials (OPIM) must train employees annually regardless of the employees' prior training or education" (Standard Interpretations, 2007). I, and others, have contacted OSHA, asking them to put CMV on their official bloodborne pathogen list, because then it means that child care providers across the country will receive training in CMV.

CMV info should be a part of bloodborne pathogens/universal precautions training for child care providers since they must bandage cuts and handle blood. Their CMV Hazard Recognition page indicates rationale for why it could be included, yet it is not a requirement: https://www.osha.gov/cytomegalovirus/hazards 

Cytomegalovirus - Standards | Occupational Safety and Health Administration (osha.gov)

  • OSHA's Personal Protective Equipment (PPE) standards (29 CFR 1910 Subpart I), which include requirements for when employees must use gloves and eye and face protection, may apply to protecting workers from CMV.
  • OSHA's Bloodborne Pathogens (BBP) standard (29 CFR 1910.1030) applies to occupational exposure to human blood and other potentially infectious materials. The BBP standard applies to occupational exposure to some human body fluids, including blood and saliva in dental procedures, which can transmit CMV. The BBP standard also describes measures could serve as a framework to control non-bloodborne exposures, including to body fluids such as urine, feces, and saliva (except in dental procedures) to which the standard does not apply.

*) I just asked the Red Cross the following: Thank you for your information on cytomegalovirus

I understand that blood-collecting folks tell donors WHY they are happy if a donor is CMV-negative. Is there any way you can help provide more information, like handing out a flier  to everyone about CMV, not to just those who are negative?

Women of childbearing age are not told about CMV, the leading viral cause of birth defects. As you may be aware, 1 in 200 babies is born with congenital CMV (my daughter was one of them and lived for 16 years with a severely damaged brain).

Here is an excerpt from a recent article that illustrates what I'm talking about: "One afternoon, a technician looked at my blood-donor card and pointed out the three letters with a minus sign typed on the bottom right. "How wonderful!" he said. "Your blood can be donated to preemies!" It meant I'd never contracted CMV...I was proud that my blood could help newborns — but looking back, I wish I'd understood that it also meant I should try to avoid CMV if I ever became pregnant. Eventually, my son was on the receiving end of those blood donations because of challenges that had been preventable."
 "My son was born sick from a virus he caught in utero. He's now 10 and has several disabilities" JACLYN GREENBERG,
 March 7, 2023: https://africa.businessinsider.com/health/my-son-was-born-sick-from-a-virus-he-caught-in-utero-hes-now-10-and-has-several/5bfd2v3

 *) Find one catchy phrase to get out on social media, such as "don't share you pacifier", etc., to get it as known as the kitty litter virus (even though toxoplasmosis is contracted other ways, the kitty litter thing at least gets one thinking about it).  Examples: #ReduceYourRisk, Save pregnancy from CMV, etc



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