The incidence of congenital cytomegalovirus infections in The Netherlands

Abstract

Cytomegalovirus (CMV) is one of the most common causes of congenital infection without an effective treatment or an effective vaccine available to date. The emphasis has to be on preventive strategies, which rely on the epidemiological situation. The incidence of congenital CMV infections, however, is not known for The Netherlands. Therefore, a prospective virological study was carried out in a population of 7,524 pregnant women and 7,793 newborns. CMV-specific IgG antibodies were determined in cord blood by ELISA. When CMV antibodies were present, a CMV specific PCR was performed on the throat swab. A positive PCR was confirmed by urine culture. In addition, the seroepidemiology for CMV was investigated in the metropolitan region (Amsterdam and Rotterdam) which has a different ethnic composition. Congenital CMV infection was found in 7 infants (0.9 per 1,000). None had symptoms at birth or during 24 month follow-up. Carriage or CMV was 41%, with a variation between 35% and 100% depending on ethnicity. The ethnic composition in the south-eastern region was different from that in large cities, but similar to that in the rest of the country. The incidence of congenital CMV infections in The Netherlands is the lowest described to date, which does not justify special preventive policies.

Occupational risk of human Cytomegalovirus and Parvovirus B19 infection in female day care personnel in the Netherlands; a study based on seroprevalence

“…The rate of CMV IgG seropositivity found in our control group mirrors the 35% observed in an earlier Dutch study performed by Gaytant and coworkers [7]. Sixty-five percent of Dutch women of childbearing age are thus still at risk of attracting a CMV primo-infection.…”

“…In a recent Dutch study performed in the metropolitan agglomeration formed by the cities Amsterdam, Rotterdam and The Hague, CMV seropositive neonates were followed for 24 months. No significant symptoms of CMV infection were observed in these infants [7]. From studies outside the Netherlands it is known that about 7-15% of asymptomatic infants will eventually develop sensorineural hearing loss [5].…”

“…Approximately 60 and 30% of the women of childbearing age in developed western European countries, such as the Netherlands, are still susceptible to developing either a primary CMV or Parvovirus infection [7,8]. Nevertheless, there are great variations in seroprevalence according to geographical region, socioeconomic status and ethnic composition [5].…”

“…Therefore, it is important to establish local sero-epidemiology data to offer preventive strategies in a given country, as CMV and Parvovirus infections cannot yet be prevented by immunisation and therapeutic options are questionable. In the Netherlands, in a recent prospective study, an unusually low incidence of congenital CMV infection of 0.09% was reported [7]. The authors concluded that preventive measures for CMV were thus not justified, and that antenatal and perinatal counselling should be reserved for (upcoming) Parvovirus epidemics.…”

Hearing Loss and Congenital CMV Infection: A Systematic Review

“…13,14 Maternal seroprevalence depends on age, socioeconomic status, and parity. [15][16][17] But between industrialized countries there are clear differences in prevalence, probably because of race-bound predilection in addition to differences in sexual behavior, day care attendance, breastfeeding, and profession. 18,19 Spreading of CMV occurs through close contact with infected body fluids.…”