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January 1981, Vol 135, No. 1 >
Article | January 1981

Cytomegalovirus in the Perinatal Period FREE

Zehra F. K. Panjvani, MD; James B. Hanshaw, MD
[+] Author Affiliations

Reprint requests to Department of Pediatrics, University of Massachusetts Medical School, 55 Lake Ave N, Worcester, MA 01605 (Dr Hanshaw).


Am J Dis Child. 1981;135(1):56-60. doi:10.1001/archpedi.1981.02130250044014.
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References
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Cytomegalovirus (CMV) is the most frequent known cause of perinatally acquired infections. Congenital acquisition occurs in 0.5% to 2.7%1-3 and natal acquisition occurs in 4% to 10%3,4 of all deliveries. More than 90% of congenitally and natally acquired CMV infections are subclinical. Of infants infected in utero, a substantial percentage have late neurologic sequelae, such as decreased mentation and auditory impairment.2,3 Not enough studies exist to permit an accurate prediction of eventual outcome among these infants. Nevertheless, CMV is rapidly emerging as the infectious agent most frequently responsible for congenital abnormalities.

HISTORY  The first human strains of CMV were isolated in 1955 by Smith,5 from autopsy material of two infants described by Rowe et al,6 and by Weller and associates, who isolated the virus from hepatic tissue and/or urine of three living infants with cytomegalic inclusion disease (CID).7 Prior to this time, CID was

REFERENCES

1 +
Hanshaw JB:  Congenital cytomegalovirus infection: A 15 year perspective . J Infect Dis 123:555-561, 1971;.
2 +
Alford CA, Stagno S, Reynolds DW, et al:  Long-term mental and perceptual defect associated with silent intrauterine infections , in Gluck L (ed): Intrauterine Asphyxia and the Developing Fetal Brain . Chicago, Year Book Medical Publishers Inc, 1977;
3 +
Hanshaw JB, Scheiner AP, Moxley AW, et al:  School failure and deafness after 'silent' congenital cytomegalovirus infection . N Engl J Med 295:468-470, 1976;.
4 +
Reynolds DW, Stagno S, Hosty TS, et al:  Maternal cytomegalovirus excretion and perinatal infection . N Engl J Med 289:1-5, 1973;.
5 +
Smith MD:  Propagation in tissue cultures of a cytopathic virus from human salivary gland virus disease . Proc Soc Exp Biol Med 92:424-430, 1956;.
6 +
Rowe WP, Hartley JW, Waterman S, et al:  Cytopathogenic agent resembling salivary gland virus recovered from tissue cultures of human adenoids . Proc Soc Exp Biol Med 92:418-424, 1956;.
7 +
Weller TH, Macauley JC, Craig JM, et al:  Isolation of intranuclear inclusion producing agents from infants with illnesses resembling cytomegalic inclusion disease . Proc Soc Exp Biol Med 94:4-12, 1957;.
8 +
Krech U:  Complement-fixing antibodies against cytomegalovirus in different parts of the world . Bull WHO 49:103-106, 1973;.
9 +
Wentworth BB, Alexander ER:  Seroepidemiology of infections due to members of the herpesvirus group . Am J Epidemiol 94:496-507, 1971;.
10 +
Hanshaw JB, Betts RF, Simon G, et al:  Acquired cytomegalovirus infection: Association with hepatomegaly and abnormal liver function tests . N Engl J Med 272:602-609, 1965;.
11 +
Stern H, Elek SD:  The incidence of infection with cytomegalovirus in a normal population: A serologic study in greater London . J Hyg 63:79-87, 1965;.
12 +
Levinsohn EM, Foy HM, Kenny GE, et al:  Isolation of cytomegalovirus from a cohort of 100 infants throughout the first year of life . Proc Soc Exp Biol Med 132:957-962, 1969;.
13 +
Michelson-Fiske S:  Human cytomegalovirus: A review of developments between 1970 and 1976: I. Clinical developments . Biomedicine 26:16-22, 1977;.
14 +
Numazaki Y, Yano N, Morizuka T, et al:  Primary infection with human cytomegalovirus: Virus isolation from healthy infants and pregnant women . Am J Epidemiol 91:410-417, 1970;.
15 +
Hayes K, Danks DM, Gibas H:  Cytomegalovirus in human milk . N Engl J Med 287:177-178, 1972;.
16 +
Stagno S, Reynolds DW, Pass RF, et al:  Breast milk and the risk of cytomegalovirus infection . N Engl J Med 302:1073-1076, 1980;.
17 +
Lang DJ, Kummer JF:  Demonstration of cytomegalovirus in semen . N Engl J Med 287:756-758, 1972;.
18 +
Granström M, Leinikki P, Santavuori P, et al:  Perinatal cytomegalovirus infection in man . Arch Dis Child 52:354-359, 1977;.
19 +
Yeager AS:  Transfusion-acquired cytomegalovirus infection in newborn infants . Am J Dis Child 128:478-483, 1974;.
20 +
Ballard R, Prew WL, Hynagle KG, et al:  Acquired cytomegalovirus infection in preterm infants . Am J Dis Child 133:482-485, 1979;.
21 +
Michelson-Fiske S:  Human cytomegalovirus: A review of developments between 1970 and 1976: II. Experimental developments . Biomedicine 26:86-97, 1977;.
22 +
Weller TH, Hanshaw JB, Scott DE:  Serological differentiation of viruses responsible for cytomegalic inclusion disease . Virology 18:130-132, 1960;.
23 +
The TH, Klein G, Langenhuysen MMAC:  Antibody reactions to virus specific early antigens (EA) in patients with cytomegalovirus . Clin Exp Immunol 16:1-12, 1974;.
24 +
Stagno S, Reynolds D, Tsiantos A, et al:  Comparative serial virologic and serologic studies of symptomatic and subclinical congenitally and natally acquired cytomegalovirus infections . J Infect Dis 132:568-577, 1975;.
25 +
Rola-Pleszczynski M, Frenkel LD, Fuccillo DA, et al:  Specific impairment of cell-mediated immunity in mothers of infants with congenital infection due to cytomegalovirus . J Infect Dis 135:386-391, 1977;.
26 +
Gehrz RC, Marker SC, Balfour HH Jr:  Specific cell-mediated immune defect in congenital cytomegalovirus infection . Lancet 1:811-812, 1977;.
27 +
Montgomery R, Youngblood L, Medearis DN Jr:  Recovery of the cytomegalovirus from the cervix in pregnancy . Pediatrics 49:524-531, 1972;.
28 +
Dehner LP, Aslein FB:  Cytomegalovirus endometritis: Report of a case associated with spontaneous abortion . Obstet Gynecol 45:211-214, 1975;.
29 +
Berenberg W, Nankervis G:  Long-term follow-up of cytomegalic inclusion disease of infancy . Pediatrics 46:403-410, 1970;.
30 +
Stagno S, Reynolds DW, Huang ES, et al:  Congenital cytomegalovirus infection: Occurrence in an immune population . N Engl J Med 296:1254-1258, 1977;.
31 +
Monif GRG, Egan EA II, Held B, et al:  The correlation of maternal cytomegalovirus infection during varying stages in gestation with neonatal involvement . J Pediatr 80:17-20, 1972;.
32 +
Weller TH, Hanshaw JB:  Virologic and clinical observations on cytomegalic inclusion disease . N Engl J Med 266:1233-1244, 1962;.
33 +
Stern H, Elek SD, Booth JC, et al:  Microbial causes of mental retardation: The role of prenatal infections with cytomegalovirus, rubella virus and toxoplasma . Lancet 2:443-448, 1969;.
34 +
Reynolds DW, Stagno S, Stubbs KG, et al:  Congenital cytomegalovirus infection with elevated cord IgM levels-caused relationship with auditory and mental deficiency . N Engl J Med 290:291-296, 1974;.
35 +
Kumar ML, Nankervis GA, Gold E:  Inapparent congenital cytomegalovirus infection: A follow-up study . N Engl J Med 288:1370-1372, 1973;.
36 +
Whitley RJ, Brasfield D, Reynolds DW, et al:  Protracted pneumonitis in young infants associated with perinatally acquired cytomegaloviral infection . J Pediatr 89:16-22, 1976;.
37 +
Midulla M, Balducci L, Lannetti P, et al:  Infantile spasms and cytomegalovirus infection . Lancet 2:377, 1976;.
38 +
Leonidas JC, Beatty EC, Wenner HA:  Menetrier disease and cytomegalovirus infection in childhood . Am J Dis Child 126:806-808, 1973;.
39 +
Elek SD, Stern H:  Development of a vaccine against mental retardation caused by cytomegalovirus infection in utero . Lancet 1:1-5, 1974;.
40 +
Plotkin SA, Farquhar J, Hornberger E:  Clinical trials with the Towne strain of human cytomegalovirus . J Infect Dis 134:470-475, 1976;.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Hanshaw JB:  Congenital cytomegalovirus infection: A 15 year perspective . J Infect Dis 123:555-561, 1971;.
2 +
Alford CA, Stagno S, Reynolds DW, et al:  Long-term mental and perceptual defect associated with silent intrauterine infections , in Gluck L (ed): Intrauterine Asphyxia and the Developing Fetal Brain . Chicago, Year Book Medical Publishers Inc, 1977;
3 +
Hanshaw JB, Scheiner AP, Moxley AW, et al:  School failure and deafness after 'silent' congenital cytomegalovirus infection . N Engl J Med 295:468-470, 1976;.
4 +
Reynolds DW, Stagno S, Hosty TS, et al:  Maternal cytomegalovirus excretion and perinatal infection . N Engl J Med 289:1-5, 1973;.
5 +
Smith MD:  Propagation in tissue cultures of a cytopathic virus from human salivary gland virus disease . Proc Soc Exp Biol Med 92:424-430, 1956;.
6 +
Rowe WP, Hartley JW, Waterman S, et al:  Cytopathogenic agent resembling salivary gland virus recovered from tissue cultures of human adenoids . Proc Soc Exp Biol Med 92:418-424, 1956;.
7 +
Weller TH, Macauley JC, Craig JM, et al:  Isolation of intranuclear inclusion producing agents from infants with illnesses resembling cytomegalic inclusion disease . Proc Soc Exp Biol Med 94:4-12, 1957;.
8 +
Krech U:  Complement-fixing antibodies against cytomegalovirus in different parts of the world . Bull WHO 49:103-106, 1973;.
9 +
Wentworth BB, Alexander ER:  Seroepidemiology of infections due to members of the herpesvirus group . Am J Epidemiol 94:496-507, 1971;.
10 +
Hanshaw JB, Betts RF, Simon G, et al:  Acquired cytomegalovirus infection: Association with hepatomegaly and abnormal liver function tests . N Engl J Med 272:602-609, 1965;.
11 +
Stern H, Elek SD:  The incidence of infection with cytomegalovirus in a normal population: A serologic study in greater London . J Hyg 63:79-87, 1965;.
12 +
Levinsohn EM, Foy HM, Kenny GE, et al:  Isolation of cytomegalovirus from a cohort of 100 infants throughout the first year of life . Proc Soc Exp Biol Med 132:957-962, 1969;.
13 +
Michelson-Fiske S:  Human cytomegalovirus: A review of developments between 1970 and 1976: I. Clinical developments . Biomedicine 26:16-22, 1977;.
14 +
Numazaki Y, Yano N, Morizuka T, et al:  Primary infection with human cytomegalovirus: Virus isolation from healthy infants and pregnant women . Am J Epidemiol 91:410-417, 1970;.
15 +
Hayes K, Danks DM, Gibas H:  Cytomegalovirus in human milk . N Engl J Med 287:177-178, 1972;.
16 +
Stagno S, Reynolds DW, Pass RF, et al:  Breast milk and the risk of cytomegalovirus infection . N Engl J Med 302:1073-1076, 1980;.
17 +
Lang DJ, Kummer JF:  Demonstration of cytomegalovirus in semen . N Engl J Med 287:756-758, 1972;.
18 +
Granström M, Leinikki P, Santavuori P, et al:  Perinatal cytomegalovirus infection in man . Arch Dis Child 52:354-359, 1977;.
19 +
Yeager AS:  Transfusion-acquired cytomegalovirus infection in newborn infants . Am J Dis Child 128:478-483, 1974;.
20 +
Ballard R, Prew WL, Hynagle KG, et al:  Acquired cytomegalovirus infection in preterm infants . Am J Dis Child 133:482-485, 1979;.
21 +
Michelson-Fiske S:  Human cytomegalovirus: A review of developments between 1970 and 1976: II. Experimental developments . Biomedicine 26:86-97, 1977;.
22 +
Weller TH, Hanshaw JB, Scott DE:  Serological differentiation of viruses responsible for cytomegalic inclusion disease . Virology 18:130-132, 1960;.
23 +
The TH, Klein G, Langenhuysen MMAC:  Antibody reactions to virus specific early antigens (EA) in patients with cytomegalovirus . Clin Exp Immunol 16:1-12, 1974;.
24 +
Stagno S, Reynolds D, Tsiantos A, et al:  Comparative serial virologic and serologic studies of symptomatic and subclinical congenitally and natally acquired cytomegalovirus infections . J Infect Dis 132:568-577, 1975;.
25 +
Rola-Pleszczynski M, Frenkel LD, Fuccillo DA, et al:  Specific impairment of cell-mediated immunity in mothers of infants with congenital infection due to cytomegalovirus . J Infect Dis 135:386-391, 1977;.
26 +
Gehrz RC, Marker SC, Balfour HH Jr:  Specific cell-mediated immune defect in congenital cytomegalovirus infection . Lancet 1:811-812, 1977;.
27 +
Montgomery R, Youngblood L, Medearis DN Jr:  Recovery of the cytomegalovirus from the cervix in pregnancy . Pediatrics 49:524-531, 1972;.
28 +
Dehner LP, Aslein FB:  Cytomegalovirus endometritis: Report of a case associated with spontaneous abortion . Obstet Gynecol 45:211-214, 1975;.
29 +
Berenberg W, Nankervis G:  Long-term follow-up of cytomegalic inclusion disease of infancy . Pediatrics 46:403-410, 1970;.
30 +
Stagno S, Reynolds DW, Huang ES, et al:  Congenital cytomegalovirus infection: Occurrence in an immune population . N Engl J Med 296:1254-1258, 1977;.
31 +
Monif GRG, Egan EA II, Held B, et al:  The correlation of maternal cytomegalovirus infection during varying stages in gestation with neonatal involvement . J Pediatr 80:17-20, 1972;.
32 +
Weller TH, Hanshaw JB:  Virologic and clinical observations on cytomegalic inclusion disease . N Engl J Med 266:1233-1244, 1962;.
33 +
Stern H, Elek SD, Booth JC, et al:  Microbial causes of mental retardation: The role of prenatal infections with cytomegalovirus, rubella virus and toxoplasma . Lancet 2:443-448, 1969;.
34 +
Reynolds DW, Stagno S, Stubbs KG, et al:  Congenital cytomegalovirus infection with elevated cord IgM levels-caused relationship with auditory and mental deficiency . N Engl J Med 290:291-296, 1974;.
35 +
Kumar ML, Nankervis GA, Gold E:  Inapparent congenital cytomegalovirus infection: A follow-up study . N Engl J Med 288:1370-1372, 1973;.
36 +
Whitley RJ, Brasfield D, Reynolds DW, et al:  Protracted pneumonitis in young infants associated with perinatally acquired cytomegaloviral infection . J Pediatr 89:16-22, 1976;.
37 +
Midulla M, Balducci L, Lannetti P, et al:  Infantile spasms and cytomegalovirus infection . Lancet 2:377, 1976;.
38 +
Leonidas JC, Beatty EC, Wenner HA:  Menetrier disease and cytomegalovirus infection in childhood . Am J Dis Child 126:806-808, 1973;.
39 +
Elek SD, Stern H:  Development of a vaccine against mental retardation caused by cytomegalovirus infection in utero . Lancet 1:1-5, 1974;.
40 +
Plotkin SA, Farquhar J, Hornberger E:  Clinical trials with the Towne strain of human cytomegalovirus . J Infect Dis 134:470-475, 1976;.

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