Annually, intrauterine infection with cytomegalovirus (CMV) causes between 1,000 and 3,000 infants to be mentally retarded and/or deaf. These effects occur following primary maternal CMV infection during the first half of pregnancy. Our studies have found that between 25% and 80% of children acquire CMV infections in day-care and shed virus for a mean of 18 months. We also found that at least half of seronegative mothers with infected children under age 2 years acquire CMV from their children within one year compared to an annual rate of < 5% among other seronegative women. Because a majority of mothers are planning additional pregnancies, finding a simple way to prevent primary maternal infection during pregnancy is important. Annual infection rates of 50% for seronegative mothers makes it feasible to evaluate behavioral intervention as a means for preventing maternal acquisition. Up to 300 families with seronegative mothers and young children shedding CMV will be randomly divided into three groups. A Control Group receives no intervention. An Education Group receives an intervention that could easily be incorporated into regular monthly prenatal obstetric visits: written instructions on how to prevent acquiring CMV from the child by use of gloves, hand washing, and contact avoidance. A third Education and Adherence Group receives the same written instructions as those provided to the Education Group but they also receive adherence interventions to enhance their activities to reduce risk of CMV transmission. Adherence strategies for Group 3 includes mastery experiences during the educational session, frequent monitoring and goal setting and corrective feedback. Each woman and her family members will be monitored every three months for one year. Efficacy of intervention will be assessed by comparing the incidence of CMV seroconversion among mothers in each of three groups and confirming the source of infection using restriction enzyme digestion of CMV DNAs.
| Adler, S P (1986) Nosocomial transmission of cytomegalovirus. Pediatr Infect Dis 5:239-46 |
| Adler, S P; Baggett, J; Wilson, M et al. (1986) Molecular epidemiology of cytomegalovirus in a nursery: lack of evidence for nosocomial transmission. J Pediatr 108:117-23 |
| Adler, S P (1985) The molecular epidemiology of cytomegalovirus transmission among children attending a day care center. J Infect Dis 152:760-8 |
