Congenital Cytomegalovirus Infection: Epidemiology and Treatment

Abstract

Cytomegalovirus (CMV) is the most common cause of congenital virus infection worldwide, occurring in approximately 1% of all live borns with a prevalence ranging from 0.2% to 2.2% (Stagno et al., 1983). Congenital infection is the consequence of transplacental transfer of virus from mother to fetus. Maternal infection can either be primary or recurrent. Maternal primary infection usually results from contact with a young child in the day care environment (Demmler, 1994). Women working at day care centers, nursery schools, or preschools have an increased risk for acquisition of CMV, if seronegative (Adler, 1989). In such circumstances, the rate of acquisition can be 8%–20% as compared to 3%–5% for the general population (Pass et al., 1986, 1990; Adler, 1989; Murph et al., 1991; Alder et al., 1996). In adolescents and young adults, persistent excretion of CMV in saliva, cervical secretions, and semen incriminates sexual transmission as a mode of infection. Demographic factors, including urban residence, ethnicity, and socioeconomic status, influence the rate of acquisition of CMV. For middle and upper socioeconomic individuals, adults have seropositivity rate of 40%–60% as compared to those of lower socioeconomic status where seropositivity varies between 80%–100%. Similarly, higher rates of CMV seropositivity exist in developing countries (Griffiths and Baboonian, 1984; Ashraf et al., 1985; Wang and Evans, 1986; Yow et al., 1988; Demmler, 1994; Troendle-Atkins et al., 1994).