Document Detail


Surveillance of congenital cytomegalovirus in the UK and Ireland.
MedLine Citation:
PMID:  21289013     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To explore the presentation and management of congenital cytomegalovirus (CMV) identified through routine clinical investigations, and ascertain outcome in early childhood.
DESIGN: Active population-based surveillance.
SETTING: UK and Ireland.
METHODS: Infants born in 2001-2002 with confirmed or suspected congenital CMV infection were reported through the British Paediatric Surveillance Unit, and clinicians completed questionnaires on presentation, diagnosis, management and subsequent outcome.
RESULTS: 86 confirmed and 70 possible cases of congenital CMV infection were reported. Over a third (27/72) of singleton infants with confirmed and 44% (27/61) with possible congenital infection were preterm (<37 weeks gestation). Among confirmed cases, 75% (64/85) presented with neonatal manifestations compatible with congenital CMV, over half (34/64) of whom had neurological signs; 17 infants were treated with gancyclovir. Among confirmed cases with information on outcome, 31% (24/78) were developing normally, 18% (14/78) had mild, 24% (19/78) moderate and 14% (11/78) severe sequelae, and 13% (10/78) had died. Median age at follow-up among survivors was 18 months (IQR 15-22 months). Children with neonatal CMV manifestations were significantly more likely than those without to have moderate or severe outcomes (including death) (60%, 36/60, vs 22%, 4/18, p=0.001). 27% of survivors (17/63) had bilateral hearing loss.
CONCLUSIONS: The number of confirmed cases of diagnosed congenital CMV reported in this study was lower than expected, highlighting the need for early and appropriate investigations when congenital infection is suspected. Due to the unexpectedly high proportion of preterm infants, resulting from differential case ascertainment, it was difficult to distinguish prematurity and CMV-related symptoms.
Authors:
Claire L Townsend; Catherine S Peckham; Pat A Tookey
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-02-02
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  96     ISSN:  1468-2052     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-14     Completed Date:  2011-12-07     Revised Date:  2012-10-24    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F398-403     Citation Subset:  AIM; IM    
Affiliation:
MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK. c.townsend@ich.ucl.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Antiviral Agents / therapeutic use
Cytomegalovirus Infections / complications,  congenital*,  diagnosis,  drug therapy,  epidemiology*
Developmental Disabilities / virology
Female
Ganciclovir / therapeutic use
Gestational Age
Great Britain / epidemiology
Hearing Loss, Bilateral / virology
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / diagnosis,  drug therapy,  epidemiology
Ireland / epidemiology
Male
Population Surveillance / methods
Prognosis
Treatment Outcome
Grant Support
ID/Acronym/Agency:
//Department of Health; //Medical Research Council
Chemical
Reg. No./Substance:
0/Antiviral Agents; 82410-32-0/Ganciclovir
Comments/Corrections
Comment In:
Arch Dis Child Fetal Neonatal Ed. 2012 Sep;97(5):F390   [PMID:  22556203 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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