Persistence of cytomegalovirus in human milk after storage

Dworsky, Meyer E.; Stagno, Sergio; Pass, Robert F.; Cassady, George; Alford, Charles A.

doi:10.1016/s0022-3476(82)80081-4

Cited by 72 publications

(48 citation statements)

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“…29 In our studies and these, frozen milk was mainly used and the transmission rates were low compared with Hamprecht et al's 11 findings. Additional studies that examined the effects of storing CMV-infected breast milk specimens at À20 1C by viral culture 30,31 found that the storage of breast milk at À20 1C for >3 days reduced the CMV titer by >99%, and storage for >7 days reduced CMV infectivity by 100%. However, no studies performed to date had evaluated the effects of frozen-thawed breast milk in a clinical context.…”

Section: Discussionmentioning

confidence: 99%

Transmission of cytomegalovirus via breast milk in extremely premature infants

et al. 2010

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Objective: We prospectively evaluated the rate of postnatal cytomegalovirus (CMV) transmission through breast milk in extremely premature infants to address the impact of CMV infection on preterm infants during lactation.Study Design: A total of 25 mothers and 27 infants (two sets of twins) with birth weights <1000 g and/or gestational ages <28 weeks were enrolled in the study. They were mostly fed frozen-thawed breast milk. Breast milk, serum and urine samples were collected every 2 weeks and screened for CMV infection using the real-time polymerase chain reaction.Result: All of the 21 CMV-seropositive mothers had detectable CMV DNA in their breast milk, with a peak at 4 to 6 weeks postpartum. CMV infection was confirmed in only one infant (4.3%) who displayed almost no clinical symptoms. Conclusion:At our institutes, we mainly use frozen-thawed breast milk. We found low CMV transmission rates even in extremely premature infants, and the CMV-positive infant did not develop serious symptoms.

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Section: Discussionmentioning

confidence: 99%

Transmission of cytomegalovirus via breast milk in extremely premature infants

et al. 2010

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“…isolation on HEL cells [12,13]. Moreover, isolation rates of infectious CMV are variable and 20±70% of mature milk samples can yield virus [15].…”

Section: Antiviral Activity Of Human Milk Factors 721mentioning

confidence: 99%

Effect of antimicrobial factors in human milk on rhinoviruses and milk-borne cytomegalovirus in vitro

Clarke

May

2000

Journal of Medical Microbiology

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Various antimicrobial factors present in human milk were tested for in-vitro antiviral activity against three rhinoviruses (two clinical isolates and rhinovirus 2) and an isolate of cytomegalovirus (CMV) from human milk. These factors included the gangliosides GM1, 2 and 3, sialyl-lactose, chondroitin sulphates A, B and C, prostaglandins E2 and F2á, monolaurin, vitamin A and the protein lactoferrin. All were tested for their ability to inhibit growth of the viruses in cell culture. Human milk was also tested for antiviral activity against these viruses. Only vitamin A, monolaurin and lactoferrin inhibited the growth of CMV, whereas both prostaglandins enhanced the growth of this virus at least four-fold. CMV infects infants from milk but, nevertheless, the milk-borne CMV isolate showed no special resistance to any of the antiviral factors tested. None of the compounds inhibited or enhanced the growth of the rhinoviruses. However, human milk decreased the growth of some of the rhinoviruses and speci®c secretory immunoglobulin A (sIgA) neutralised the virus.

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“…Recent recommendations for virus inactivation in human milk by freezing, which destroys the virus (5,6), are still based on three studies that evaluated freezing for viral decontamination of stored milk in the context of human milk banking 20 y ago (7)(8)(9). Only two studies analyzed the effect of storage at Ϫ20°C using naturally infected milk specimens (8,9).…”

mentioning

confidence: 99%

“…Only two studies analyzed the effect of storage at Ϫ20°C using naturally infected milk specimens (8,9). Storage of milk for 3 d at Ϫ20°C reduced the viral titre by more than 99% (9), and storage of naturally infected milk specimens for 7 d or longer at Ϫ20°C eliminated infectivity (8).…”

mentioning

confidence: 99%

“…On the other hand, CMV survived when the milk sample was frozen at Ϫ15°C for 10 d in the presence of low lipase levels (7). Interestingly, the persistence of viral infectivity or the enhanced CMV recovery after overnight storage at 4°C was discussed in the context of cell-free or cell-associated virus (8). Recent analysis revealed that cell-free virus is present in nearly every seropositive milk (2).…”

mentioning

confidence: 99%

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Cytomegalovirus (CMV) Inactivation in Breast Milk: Reassessment of Pasteurization and Freeze-Thawing

Hamprecht¹,

Maschmann

Müller³

et al. 2004

Pediatr Res

191

152

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Breast-feeding mothers frequently transmit cytomegalovirus (CMV) to preterm infants of very low birth weight. Current recommendations for prevention of virus transmission are based on data published 20 y ago in the context of human milk banking. Two recent clinical trials examined storage of breast milk at Ϫ20°C to reduce virus transmission. However, in both studies, CMV transmission occurred. Using sensitive tools like quantitative PCR, CMV pp67 late mRNA assay, and a high-speed, centrifugation-based microculture assay for quantification of CMV infectivity, we reassessed the virological and biochemical characteristics of freeze-storing breast milk at Ϫ20°C, compared it with traditional Holder pasteurization (30 min at 62.5°C), and a new short-term pasteurization (5 s at 72°C) based on the generation of a milk film. Both heat treatment procedures were able to destroy viral infectivity and pp67 RNA completely. Preliminary results showed short-term heat inactivation below 72°C was less harmful in reducing the activity of marker enzymes than Holder pasteurization. Freezing breast milk preserved the biochemical and immunologic quality of the milk; however, late viral RNA and viral infectivity was also preserved. Breast-feeding in premature infants is beneficial (1). However, breast-feeding of a high-risk group of preterm infants (birth weight Ͻ1000 g, gestational age at birth Ͻ30 wk) may be associated with symptomatic CMV infection (2,3). If CMV transmission from breast milk to preterm infants is clinically important, then prevention of virus transmission will be critical (4).Recent recommendations for virus inactivation in human milk by freezing, which destroys the virus (5,6), are still based on three studies that evaluated freezing for viral decontamination of stored milk in the context of human milk banking 20 y ago (7-9). Only two studies analyzed the effect of storage at Ϫ20°C using naturally infected milk specimens (8,9). Storage of milk for 3 d at Ϫ20°C reduced the viral titre by more than 99% (9), and storage of naturally infected milk specimens for 7 d or longer at Ϫ20°C eliminated infectivity (8). On the other hand, CMV survived when the milk sample was frozen at

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Persistence of cytomegalovirus in human milk after storage

Cited by 72 publications

References 9 publications

Transmission of cytomegalovirus via breast milk in extremely premature infants

Transmission of cytomegalovirus via breast milk in extremely premature infants

Effect of antimicrobial factors in human milk on rhinoviruses and milk-borne cytomegalovirus in vitro

Cytomegalovirus (CMV) Inactivation in Breast Milk: Reassessment of Pasteurization and Freeze-Thawing

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