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EMAK · Century Club Joined: 26 Nov 2006 Posts: 570

neonatal infection include:
--petechiae.....T , I think it cause TCP=petichea
--cataracts......T

Nick Raine-Fenning · Posted: Tue Nov 28, 2006 5:30 pm Post subject:

Both are true - it does pretty much everything but it is most famous for causing Calcification, Cataracts, Congenital deafness, and microCephaly - all the C's!
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jilly · Joined: 16 Jan 2008 Posts: 15

Does anyone have some good figures for CMV transmission rates and neonatal infection?

In a woman with primary CMV infection in pregnancy
a) there is a less than 5% chance of her delivering a baby with CMV-related damage
b) there is a 1% chance of the baby having serious long term sequelae

I think T, F?

SallyC · Joined: 12 Jul 2007 Posts: 50 Location: Oxford

I have spent ages looking for these figure too, the best I can come up with are;

It is one of the commonest congenital infections, about 1% of all babies are born with congenital CMV (I've found figures ranging between 0.2% and 3% but most settle on 'about 1%')

With a primary maternal infection 40% of fetuses will be infected, irrespective of gestation.
Of these infected fetuses:
- 90% are asymptomatic at birth (but up to 20% of these will develop late, usually minor sequelae, which may include unilateral or bilateral sensory-neural deafness)
- 10% are symptomatic at birth (up to one third of these will die and the rest are likely to have serious long term problems - NB Congenital CMV is estimated to account for up to 10% of mental retardation in the under 6's, second only to Down syndrome)

So in terms of couselling the mother with a proven primary infection:

If you don't know whether the baby is infected or not, there is an 89% chance it will not suffer any problems, a 7% risk of minor late problems (such as deafness) and a 4% risk of neonatal death (1.3%) or serious long term problems (2.7%).

If she has already had an amniocentesis and PCR has confirmed fetal infection, the chance of no problems drops to 72%, 18% will have minor late sequelae (including deafness) and risk of death or serious disability increases to about 10% (3% death and 6-7% serious damage).

As the majority of fetuses will be unaffected, counselling regarding invasive testing and management (including TOP) is very difficult, even in the face of confirmed fetal infection. However, close monitoring of fetal growth and well-being is clearly indicated with appropriate paediatric follow-up.

So my answers would have to be -
a) False
(as it said "CMV related damage" without quantifiying the degree, you would have to add the 4% risk of major sequelae to the 7% risk of minor sequelae giving a total of 11% damaged babies)
b) False (4%, I'd include death as a serious long term sequelae!)

I am rubbish at numbers so hate this type of question and judging by the vast number of different quotes out there in the literature this one is definitely in the realm of "lies, damned lies and statistics"! Anyone else got any ideas on the subject? and please point out if you think my numbers or reasoning are wrong!

jilly · Joined: 16 Jan 2008 Posts: 15

Thanks for that - I had found similar figures - 40% infected and 90% of those asymptomatic at birth. Luesley and Baker states 5% symptomatic at birth, with 30% of those dying and 90% of survivors having neurodevelopmental delay and 60% hearing loss.

So if my maths is correct 5% of 40% transmission rate is 2% of babies of infected mothers would die or have serious morbidity ie b)F.

shama · Joined: 17 May 2007 Posts: 32 Location: Malaysia

CMV causing cataract- any reference? Chorioretinitis is ok, but lens affected?

Nick Raine-Fenning · Posted: Thu May 15, 2008 6:58 pm Post subject:

CMV definitely causes cataracts. No ref to hand but this is definitely true.

rpwalavalkar · Teale Fenning Administrator Joined: 20 Jul 2006 Posts: 918

True--

CMV is a cause for congenital Cataract.

ref --

Pediatric Ophthalmology and Strabismus. Kenneth W. Wright, Peter H. Spiegel. Springer 2003. ISBN:0387954783
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