Free, downloadable educational resources are available for child care workers and women of childbearing age to prevent congenital (meaning present at birth) cytomegalovirus (CMV), which according to the
Centers for Disease Control and Prevention (CDC), disables a child every hour in the U.S. Many women of childbearing age have heard of the Zika virus spread by mosquitoes, yet only 7% of men and 13% of women surveyed had heard of congenital CMV or how to stop it from attacking their unborn by taking precautionary measures such as refraining from kissing their toddlers around the mouth or sharing cups and utensils with them.
Congenital CMV it is the most common cause of nonhereditary sensorineural hearing loss in childhood. In addition to deafness, Congenital Cytomegalovirus (cCMV) causes mental retardation, liver disease, and cerebral palsy as a result of infection in pregnant women.
- About 1 in 150 children is born with congenital CMV infection, and about 20% percent of those are permanently disabled by it. In other words, about 1 in 750 children is born with or develops permanent problems due to congenital CMV infection.
- More than 5,000 children each year suffer permanent problems caused by congenital CMV.
- Every hour, congenital CMV causes one child to become disabled.
I am the mother partly responsible for the 2015 passing of a new law in Connecticut to combat congenital CMV (click here to see my photograph with Governor Malloy at the ceremonial bill signing holding a photograph of my daughter, Elizabeth Saunders, born with microcephaly--a small head/damaged brain--in 1989 from congenital CMV).
None of my OB/GYNs had warned me about CMV or how to prevent it in pregnancy. I was at high risk because I not only had a toddler of my own, but I ran a licensed daycare center and nowhere in the literature was CMV information and how to prevent it. I am not alone. "75% of women with a primary infection during pregnancy acquire CMV from their own child under two years of age,” said Stuart Adler, M.D.
When educating daycare providers, it would be helpful if there was a flyer posted on the child care center to remind their clients of the precautions to take with their own toddlers.
In 2015, I,
along with Dr. Brenda Balch, Connecticut's American Academy of Pediatrics Early Hearing
Detection and Intervention Chapter Champion, were instrumental in helping
Connecticut pass a law requiring testing for congenital CMV for
infants who fail their required hearing screen. If a baby tests positive for
congenital CMV, doctors can offer the antiviral that has shown to improve
outcomes (brain size, hearing, etc.). Upon the Connecticut bill passing, I
presented to Connecticut's Medical Assistance Program Oversight Council's Women’s Health Committee to explain congenital CMV and the required testing. Here is
my PowerPoint uploaded to Google drive. “We must
commit to educating the public about cytomegalovirus so that we can potentially
prevent the devastating consequences of this disease on our children,"
said Brenda K. Balch, MD. The Connecticut Public Health Department now provides
congenital CMV information on its website at:
http://www.ct.gov/dph/cwp/view.asp?a=3138&q=527824
The prevention education part of the Connecticut bill did not pass because it would cost the state $40,000 a year to educate the public about the disease. Perhaps you can help spread CMV prevention awareness by posting tips on your website, conducting webinars, and providing pediatrician and OB/GYN offices with CMV prevention brochures? To learn how to stop the spread of CMV, see the CDC's website at: http://www.cdc.gov/cmv/index.html, or print this CDC flyer: CDC: CMV Prevention Flyer, www.congenitalcmv.org/CDCbrochure.pdf
The annual medical cost of caring for children born physically and mental disabled by congenital CMV is very high: “In the early 1990s, the expense to the US health care system associated with congenital H[human]CMV infection was estimated at approximately $1.9 billion annually, with an average cost per child of over $300,000” (Arvin et al. 2004).
“This figure is almost certainly an underestimate, especially now with enhanced mobility aids, surgical interventions, cochlear implants, antiviral therapies, occupational and physical therapies, etc., which were not likely included in the older cost estimates,” says Dr. Demmler-Harrison, Director, Congenital CMV Disease Registry and Research Program. For example, one of her patients born in 2001 needed a hemispherectomy (half of her brain removed) to control intractable seizures from polymicrgyria cortical malformation of one side of her brain caused by congenital CMV.
The little girl’s mother, Sandra Salerno of Texas, who resigned from her position as a financial analyst to be the primary caretaker of her daughter, Lillian, featured in Fox News, said of her daughter’s medical costs, “I have tried to sum up her medical costs for the first three years of life and they exceed $1.4 million. The surgery and five-week subsequent hospital stay was probably half of the total costs. She attends ten weekly therapies that last an hour each. At one point, she was taking seven medications. I believe she's been sedated 20 times in her life. Multiple MRI's, heart echos, PET scan, brain surgery, ear tube placement and several Auditory Brainstem Response studies.”
Although the annual cost to care for a child disabled by congenital CMV of $300,000 per child annually is an old cost figure, Connecticut’s annual cost of caring for children disabled by congenital CMV can be estimated by using the following 2014 CDC figures of: 36,285 births in Connecticut X .0013 (1/750) disabled by congenital CMV= 47 babies born disabled by congenital CMV in Connecticut annually X $300,000/year = $14,100,000, or, over $14 million annually to care for children born disabled by congenital CMV in Connecticut.
Will it make a
difference if women are educated on CMV prevention?
Yes,
according to studies in the U.S. and France. Dr. Demmler-Harrison, Director, Congenital CMV Disease Research,
Clinic & Registry, states: “Studies have shown that women who know they are
CMV seronegative, know they are pregnant, and know about their toddler's CMV
shedding are the most likely to prevent CMV transmission and reduce their risk
from over 50 percent during pregnancy to a risk of less than 5 percent during
pregnancy. It is not likely that isolated instances of exposure to saliva
or drool will result in transmission. Most studies suggest prolonged repeated
exposures over time are important for CMV transmission.”
There is no
vaccine yet to prevent congenital cytomegalovirus (cCMV), which
causes more disabilities (hearing loss, cerebral palsy, learning disabilities)
than Down syndrome or toxoplasmosis (the kitty litter disease). If
more people knew about human cytomegalovirus (HCMV) not only
would children be spared the suffering my daughter endured for 16
years until her death during a seizure, but one reason for the delay
in successful development of a vaccine is “there has been
insufficient education about the problem of HCMV infection…” Pharmaceutical companies need to know that a vaccine will be used
because people know about the disease.
Why don’t doctors
warn women of childbearing age about congenital CMV?
Doctors
don’t realize how prevalent it is. Fewer than half (44%) of OB/GYNs surveyed
reported counseling their patients about preventing CMV infection. “The virtual
absence of a prevention message has been due, in part, to the low profile of
congenital CMV. Infection is usually asymptomatic in both mother and infant,
and when symptoms do occur, they are non-specific, so most CMV infections go
undiagnosed,” according to “Washing
our hands of the congenital cytomegalovirus disease epidemic.”
How many know about
congenital CMV?
My OB/GYNs
didn’t tell me how to prevent congenital CMV until after Elizabeth was born
profoundly mentally and physically disabled by the disease. It was then that I
received literature stating women who work in daycare, or have a young child in
daycare, are at a higher risk for catching it as toddlers are the majority of carriers.
While I was pregnant with Elizabeth, I not only had a toddler if my own, I was
also running a licensed daycare center in my home. Nowhere in the licensing
literature was there a CMV prevention message. In milder cases, children
may lose hearing or struggle with learning, but Elizabeth's case was not a
mild one.
If you can
think of ways we can collaborate to prevent the suffering my daughter Elizabeth
endured, please contact me. Below my signature is a talk I can provide to your members, contact information for
medical professionals, and an excerpt of a press release I wrote when Connecticut passed the
congenital cytomegalovirus bill. I have also included some of the media
coverage of my work.
Perhaps you
would like to send a representative to be interviewed on my TV show if a studio taping of this topic would be helpful for your website?
Sincerely,
Lisa
Saunders
PO Box 389,
Mystic, CT 06355
Lisasaunders42@gmail.com
Congenital
CMV blog: http://congenitalcmv.blogspot.com
Personal
website: www.AuthorLisaSaunders.com
Lisa Saunders can present to your group:
Stop #1 Birth Defects Virus, Congenital Cytomegalovirus (CMV).
Abstract: In 2015, Lisa Saunders of Mystic was instrumental in helping Connecticut to become the second state in the U.S. to pass a law aimed at combatting the leading viral cause of birth defects, congenital cytomegalovirus (CMV). According to the Centers for Disease Control and Prevention (CDC), every hour a child is born disabled by congenital CMV, yet the vast majority of women of childbearing age have never heard of congenital CMV or how to prevent it. Lisa will share how the disease is spread, who is most susceptible and steps to prevent CMV. She will discuss how she gained the attention of Connecticut media and legislators to enlist their help in educating the public and the successes achieved through writing about congenital CMV in letters to the editor, blogs, books, and press releases, and making presentations to organizations. “By joining forces with others, you can move mountains!”
About Lisa Saunders: Lisa Saunders is an award-winning writer, speaker and TV host living in Mystic, Connecticut, with her husband and hound. A graduate of Cornell University, she is the author of several books and an instructor at New London Adult & Continuing Education. Lisa is a part-time historical interpreter at Mystic Seaport and the parent representative of the Congenital Cytomegalovirus (CMV) Foundation. Lisa’s work
on the Connecticut bill was featured in Cornell’s Alumni Magazine (Sept/Oct 2015) and was widely covered in the media (click to see News 8 at CT Capitol RE: CMV.) A Letter from Cornell University President, David Skorton, MD, includes appreciation for her work with Congenital CMV. See Certificate for Promoting Awareness of Congenital
Cytomegalovirus from the Infection Control
Nurses of Connecticut.
FOR
IMMEDIATE RELEASE
DATE: June
4, 2015
House Bill 5525 - An Act
Concerning Cytomegalovirus: "A screening test for cytomegalovirus for
newborns who fail a newborn hearing screening."
Mystic,
Conn.— Ever since Lisa Saunders, the parent representative of the Congenital Cytomegalovirus (CMV) Foundation, learned Utah became the first state to pass a bill on the leading viral cause of birth defects in 2013, she has been asking Connecticut to become the second. A CMV bill was passed by the House in 2014,
but the Senate failed to vote on it before the end of the legislative session.
Then it happened--in the 2015 legislative session, Governor Malloy
signed House Bill 5525: "An Act Concerning
Cytomegalovirus" on May 26, 2015.
From a press release issued June 4, 2015, by the State Senate Democrats of
the Connecticut General Assembly: "With bipartisan support, the legislature approved and the
governor signed a bill that will help mitigate the devastating impact that this
disease has on families. The bill requires that hospitals and other health care
institutions test newborn infants for CMV if they fail a newborn hearing test.
This will help parents intervene early and get their newborn child the help it
needs."
"This is a game-changing step forward in our ability to determine CMV causality
and give parents a viable option for early treatment," said Scott R.
Schoem, MD, FAAP, Director of Otolaryngology, Connecticut Children’s Medical
Center.
Stephanie
Browning McVicar, Au.D., CCC-A, Utah Department of Health, Director, Early
Hearing Detection and Intervention / Cytomegalovirus Public Health Initiative,
said, "I am so excited that another state is bringing attention to
congenital cytomegalovirus. Utah is looking forward to partnering with
Connecticut in their upcoming endeavors." In addition to testing
newborns for CMV if they fail their hearing screen, Utah’s H.B 81 requires CMV prevention brochures for doctors, parents,
and daycare providers.
For a
detailed presentation on the disease and testing for it, print the
presentation, "Congenital CMV 101: From Prevention to Treatment," by
Dr. Michael Cannon of the Centers for Disease Control and Prevention (CDC), by
clicking on: cCMV 101 Webinar Slides [PDF]. You
can hear watch/hear his presentation with the slides at: cCMV 101 Webinar Recording.
###
Additional Notes:
Q. What are
the costs of screening for congenital CMV as a result of this new law?
A. “The
cytomegalovirus test costs approximately $150.00. As only a few infants
annually fail the newborn hearing screening at UCHC [University of Connecticut
Health Center], any cost incurred at UCHC is expected to be minimal,” states
the House Bill 5525 webpage.
“Usually, if
the CMV test is positive, no further testing, such genetic testing (which can
cost thousands of dollars and may require pre-approvals), is done, unless there
are unusual circumstances. Certainly, on rare occasion, a poor baby can be born
with two conditions, but that is not at all common. Therefore, early diagnosis
of a clear condition with a clear diagnostic test saves the doctor and the
family a costly and heart breaking/stressful diagnostic odyssey,” states Dr.
Demmler-Harrison, Director, Congenital
CMV Disease Registry and Research Program. Fox News reported on the terrible consequences of a delayed cCMV diagnosis for the child Lillian Salerno mentioned above.
LISA’S
PRESENTATIONS AND MEDIA COVERAGE:
Presentations
and references include:
Congenital Cytomegalovirus Conferences
(CDC, Atlanta, GA, 2008; San Francisco, CA, 2012; Salt Lake City, UT,
2014). References
for all three conferences include:
Lenore
Pereira, Ph.D., Founder of Congenital Cytomegalovirus Foundation, and
Professor, Cell and Tissue Biology Department, University of California San
Francisco. lenore.pereira@ucsf.edu, or visit www.congenitalcmv.org.
The Congenital CMV Foundation raises awareness about maternal testing for first
infection during pregnancy, newborn testing and the need to develop a vaccine.
Gail
J Demmler-Harrison, MD, Professor, Pediatrics, Section Infectious Diseases,
Baylor College of Medicine, Attending Physician, Infectious Diseases Service,
Texas Children's Hospital, CMV Registry, CMV Research and CMV Clinic. Contact: 832-824-4330,gjdemmle@texaschildrens.org. The CMV
Registry supports CMV research, disseminates information and provides parent
support.
Michael
Cannon, Ph.D. mrc7@cdc.gov, a research epidemiologist at
the Centers for Disease Control and Prevention. Dr. Cannon is particularly
interested in developing strategies to prevent congenital CMV infection through
public awareness and education.
The Woman’s City Club of Norwich (2015): How a Mother Raised Awareness of #1
Viral Cause of Birth Defects and Got Connecticut to Pass a Bill to Combat It.
Reference:
The Westerly Registered Nurse’s
Club(April 22, 2014).
Siemens Healthcare Diagnostics (Fall 2010 webinar and my story
published in their magazine).
References:
Theresa
Spence, M.B.A., Senior Marketing Manager, Disease State Marketing, Siemens
Healthcare Diagnostics, Inc., theresa.m.spence@siemens.com
MEDIA
COVERAGE ON LISA’S WORK AGAINST CONGENITAL CMV
2015:
- CT Magazine June 2015 (One Mystic Mother is Trying to Raise
Awareness of a Common Virus That Can Have Devastating Consequences for
Pregnant Women)
2014
2013
2009
###
Regarding Zika and CMV:
Zika raises profile of more common birth-defect virus: Cytomegalovirus is a much greater global problem than Zika. http://www.nature.com/news/zika-raises-profile-of-more-common-birth-defect-virus-1.20199
The Zika-like virus no one talks about