Washing our hands of the congenital cytomegalovirus disease epidemic.
Washing our hands of the congenital cytomegalovirus disease epidemic.
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DOI：
10.1186/1471-2458-5-70
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发表时间：
2005-06-20
影响因子：
4.5
通讯作者：
Davis KF
中科院分区：
文献类型：
--
作者：
Cannon MJ;Davis KF
在美国，每年估计有40，000名儿童出生时患有先天性巨细胞病毒（CMV）感染，估计造成400人死亡，并使大约8000名儿童患有永久性残疾，如听力或视力丧失或智力迟钝。更多的儿童受到严重的CMV相关残疾的影响，而不是一些更好的儿童疾病，包括唐氏综合症，胎儿酒精综合症和脊柱裂。先天性CMV是预防的主要目标，不仅因为其巨大的疾病负担，而且因为CMV的生物学和流行病学表明有减少病毒传播的方法。由于接触幼儿的唾液或尿液是孕妇感染CMV的主要原因，因此良好的个人卫生，特别是洗手，可以降低CMV感染的风险。专家们一致认为，这些措施可能是有效的（即，如果坚持遵循，它们将起作用），美国妇产科医师学会建议医生建议孕妇通过注意卫生来预防CMV感染。然而，由于对有效性的关注（即，妇女是否会因干预措施而始终遵守卫生习惯？），医疗和公共卫生界似乎不愿意通过改善卫生习惯来进行CMV的初级预防，而且教育干预也很少。目前有关此类措施预防巨细胞病毒感染有效性的数据很有希望，但有限。然而，有强有力的证据表明，教育干预可以预防具有类似传播模式的其他传染病，这表明也可以为CMV找到有效的干预措施。在CMV疫苗可用之前，需要有效的教育干预措施，以告知妇女先天性CMV预防。也许在美国，目前没有任何一种出生缺陷和发育障碍的原因能比先天性CMV更有机会改善更多儿童的结局。鉴于目前的知识状况，妇女应该被告知如何降低怀孕期间感染CMV的风险，并需要进行试验以确定有效的教育干预措施。
Each year in the United States, an estimated 40,000 children are born with congenital cytomegalovirus (CMV) infection, causing an estimated 400 deaths and leaving approximately 8000 children with permanent disabilities such as hearing or vision loss, or mental retardation. More children are affected by serious CMV-related disabilities than by several better-known childhood maladies, including Down syndrome, fetal alcohol syndrome, and spina bifida. Congenital CMV is a prime target for prevention not only because of its substantial disease burden but also because the biology and epidemiology of CMV suggest that there are ways to reduce viral transmission. Because exposure to the saliva or urine of young children is a major cause of CMV infection among pregnant women, it is likely that good personal hygiene, especially hand-washing, can reduce the risk of CMV acquisition. Experts agree that such measures are likely to be efficacious (i.e., they will work if consistently followed) and the American College of Obstetricians and Gynecologists recommends that physicians counsel pregnant women about preventing CMV acquisition through careful attention to hygiene. However, because of concerns about effectiveness (i.e., Will women consistently follow hygienic practices as the result of interventions?), the medical and public health communities appear reluctant to embrace primary CMV prevention via improved hygienic practices, and educational interventions are rare. Current data on the effectiveness of such measures in preventing CMV infection are promising, but limited. There is strong evidence, however, that educational interventions can prevent other infectious diseases with similar transmission modes, suggesting that effective interventions can also be found for CMV. Until a CMV vaccine becomes available, effective educational interventions are needed to inform women about congenital CMV prevention. Perhaps no single cause of birth defects and developmental disabilities in the United States currently provides greater opportunity for improved outcomes in more children than congenital CMV. Given the present state of knowledge, women deserve to be informed about how they can reduce their risk of CMV infection during pregnancy, and trials are needed to identify effective educational interventions.
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