School Failure and Deafness after “Silent” Congenital Cytomegalovirus Infection

Hanshaw, James B.; Scheiner, Albert P.; Moxley, Ann W.; Gaev, Lilly; Abel, Vaudeen; Scheiner, Barbara

doi:10.1056/nejm197608262950902

Cited by 267 publications

(66 citation statements)

References 5 publications

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“…As expected (19), this virus was not lethal for suckling mice and replicated poorly in the reticuloendothelial system 3 11/12 (92) 6.0 x 106 7.4 x 104 4 13/14 (93) of weanling mice. In addition, a relatively large challenge dose (105 PFU) of the vaccine virus failed to kill weanling animals immunosuppressed with ALS.…”

Section: Discussionsupporting

confidence: 83%

Adverse Effects of Cytomegalovirus Vaccination in Mice

Jordan¹

1980

J. Clin. Invest.

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Section: Discussionsupporting

confidence: 83%

Adverse Effects of Cytomegalovirus Vaccination in Mice

Jordan¹

1980

J. Clin. Invest.

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“…In our prospective study of lead and cognitive development, children with high umbilical cord blood lead levels (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) Ag/dL) achieved significantly lower Mental Development Index scores through 2 years of age than did infants whose cord blood lead levels were low (< 3 ,g/dL) or medium (6-7 jig/dL) (1). In contrast to the results of the infant assessments, cord blood lead level was not significantly related to children's performance on the McCarthy Scales of Children's Abilities at age 57 months (2).…”

Section: Introductionmentioning

confidence: 99%

Antecedents and Correlates of Improved Cognitive Performance in Children Exposed in Utero to Low Levels of Lead

Bellinger¹,

Leviton²,

Sloman³

1990

Environmental Health Perspectives

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Up to 2 years of age, children with umbilical cord blood lead levels of 10 to 25 4g/dL achieve significantly lower scores on tests of cognitive development than do children with lower prenatal exposures. By age 5 years, however, they appear to have recovered from, or at least compensated for, this early insult. Change in performance between 24 and 57 months of age was examined in relation to level of postnatal lead exposure and various sociodemographic factors Among children with high prenatal lead exposure, greater recovery of function was associated with lower blood level at 57 months, higher socioeconomic status, higher Home Observation for Measurement of the Environment scores, higher maternal IQ, and female gender. The difference between the scores at 57 months of children with optimal and less optimal values on these variables generally exceed % standard deviation. Higher prenatal lead exposum is associated with an increased risk of early cognitive deficit. Furthermore, the risk that a deficit will persist through the preschool years is increased among children with high prenatal exposure and either high postnatal exposure or less optimal sociodemogaphic characteristics.

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“…As many as 2.5% of all newborns have been estimated to be congenitally infected with CMV (10,11,13,25,26). About 5% of congenitally infected infants develop symptomatic congenital CMV syndrome.…”

mentioning

confidence: 99%

Ganciclovir prophylaxis for cochlear pathophysiology during experimental guinea pig cytomegalovirus labyrinthitis

Woolf

Ochi

Silva

et al. 1988

Antimicrob Agents Chemother

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The effectiveness of the antiviral agent ganciclovir (9-[1,3-dihydroxy-2-propoxymethyl]guanine) against guinea pig cytomegalovirus was tested in vitro in guinea pig embryonic fibroblasts and in vivo in an experimental guinea pig cytomegalovirus labyrinthitis model. In vitro, ganciclovir completely prevented guinea pig cytomegalovirus infection of guinea pig embryonic fibroblasts at concentrations above 32.6 ,ug/ml. In vivo, antibody-negative animals had an average 17-dB elevation in their auditory nerve compound action potential thresholds (P < 0.01, t test) and showed signs bilaterally of guinea pig cytomegalovirus labyrinthitis 8 days after intrathecal inoculation of virus. Ganciclovir administration starting 1 day before inoculation prevented the development of both cochlear histopathologic change and hearing loss. Guinea pig cytomegalovirus meningitis was observed in both the drug-treated and untreated groups. High-pressure liquid chromatography confirmed the presence of ganciclovir in the serum, perilymph, and cerebrospinal fluid of the drug recipients. Prophylactic ganciclovir thus can protect the cochlea from the histopathologic changes and hearing loss normally associated with experimental guinea pig cytomegalovirus labyrinthitis.Cytomegalovirus (CMV) is the leading infectious cause of congenital sensorineural hearing loss in humans. As many as 2.5% of all newborns have been estimated to be congenitally infected with CMV (10,11,13,25,26). About 5% of congenitally infected infants develop symptomatic congenital CMV syndrome. One half of these infants die, and the survivors typically exhibit significant and permanent intellectual, auditory, visual, or neurologic sequellae of their infection (26). Ninety-five percent of infants congenitally infected with CMV are asymptomatic at birth. However, as many as 20% of infants who appear normal at birth are later found to have sensorineural deafness, neurologic abnormalities, or mental retardation (11,18). Recent epidemiological studies have concluded that in the United States alone both congenital CMV infections and primary CMV infections later in life may account for as many as 40,000 new cases of sensorineural hearing loss per year (6). CMV may also be a significant factor in the sensorineural hearing loss and central auditory dysfunction found in up to 68% of patients with acquired immunodeficiency syndrome (J. Gardi, C. D. Sooy, D. Morledge, P. Chambers, R. Gorter, and I. Medina, Assoc. Res. Otolaryngol. 10:93, 1987), over 90% of whom are infected with CMV (20). The pathogenesis of CMVinduced sensorineural hearing loss is poorly understood, and there is no known effective treatment.The species specificity of CMV has prevented the development of animal models using human CMV. However, it was recently demonstrated that the virology and histopathology of guinea pig CMV (GPCMV) closely resemble those of human CMV disease (2, 27). Using GPCMV, we established a model of virus labyrinthitis in guinea pigs after inoculation of seronegative animals with GPCMV via intra...

show abstract

School Failure and Deafness after “Silent” Congenital Cytomegalovirus Infection

Cited by 267 publications

References 5 publications

Adverse Effects of Cytomegalovirus Vaccination in Mice

Adverse Effects of Cytomegalovirus Vaccination in Mice

Antecedents and Correlates of Improved Cognitive Performance in Children Exposed in Utero to Low Levels of Lead

Ganciclovir prophylaxis for cochlear pathophysiology during experimental guinea pig cytomegalovirus labyrinthitis

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