New Vaccine Could Prevent the #1 Infectious Cause of Birth Defects

Megan H. Pesch was blindsided when her third child, baby Odessa, completely lost her hearing at 2½ months due to an infection.

Pesch, a developmental and behavioral pediatrician at the University of Michigan at Ann Arbor, was in a better position than most to understand the precautions she needed to take during pregnancy and beyond. She was aware of congenital cytomegalovirus, an infection also known as congenital CMV, but had not received guidance or detailed information on it as a medical professional or an expectant mother.

“Even throughout my medical training, I never learned about what to do to protect myself or reduce my risk,” Pesch told The 19th News. “I went back to my notes from my medical residency’s board review. There were two slides on congenital CMV and they mentioned nothing about prevention.”

Pesch has since focused her research on CMV and is on the board of the National CMV Foundation.

One of the Most Common Causes of Birth Defects

According to the Centers for Disease Control and Prevention, CMV is one of the most common causes of birth defects and the top non-genetic cause of hearing loss and neurodevelopmental disabilities in babies and children. About 1 of every 200 babies is born with a congenital CMV infection and about 1 in 5 will have long-term health problems from it. Less than a quarter of women have heard of it. 

But there soon may be hope for prevention. Moderna is currently evaluating an investigational vaccine to understand if it can help the immune system guard against CMV, protecting women before they become pregnant. Moderna is studying the vaccine in women between ages 16-40 and also evaluating its safety in women who test positive to prior exposure to CMV.

“The problem is, if a woman becomes infected with CMV while she is pregnant, she can pass the infection to her unborn baby,” Dr. Lori Panther said. “This can cause her child to suffer long-term disability due to birth defects, including hearing loss, or even death in very severe cases.”

CMV is commonly spread through close contact with an infected person and can be transferred in the bodily fluids, such as saliva, breast milk, or urine, of an infected person. The risk can be lessened by parents washing their hands and not sharing food with older children.

More than half of adults have been infected by age 40. Once someone has the virus, it remains in their system forever and can go dormant for stretches of time. Most people who contract the virus will not experience any negative health effects and most won’t realize they have it.

According to the CDC, some babies with congenital CMV infection have signs at birth, such as:

  • Rash
  • Jaundice (yellowing of the skin or whites of the eyes)
  • Microcephaly (small head)
  • Low birth weight
  • Hepatosplenomegaly (enlarged liver and spleen)
  • Seizures
  • Retinitis (damaged eye retina)

The CDC also said that nearly 1 in 3 children in the U.S. are infected with CMV by age 5. Some babies with signs of congenital CMV infection at birth can have long-term health problems, such as:

  • Hearing loss
  • Developmental and motor delay
  • Vision loss
  • Microcephaly (small head)
  • Seizures
  • Hearing loss at birth or developing it later, even including babies who passed the newborn hearing test or didn’t have any other signs at birth.

Pregnant mothers and their developing fetuses are the primary concern about CMV.

“When the CMV is passed through the placenta, it can invade the growing fetal brain cells. We don’t see that in CMV in any other situation,” Pesch said. She added that in utero, the virus can also cause inflammation to the placenta, which can obstruct the blood flow and nutrients fetuses receive.

CMV detection is not part of routine newborn health screenings, though babies can have their urine, blood or saliva tested in the first two or three weeks after birth.

Pesch said that routine CMV screenings should be incorporated into infant care, even for babies who do not show symptoms right away. An early diagnosis can give a family time to provide their child with antiviral medication that may help mitigate any potential effects of the virus, she said.

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