美国国家公共电台 NPR For Gideon, Infection With a Common Virus Caused Rare Birth Defects

 

RACHEL MARTIN, HOST:

Today in Your Health, we're going to take a look at a virus that can cause severe birth defects. Yes, as if Zika weren't scary enough, right? But this is something else. It's a virus called CMV, which causes disability for as many as 8,000 newborns in this country every year. NPR's Patti Neighmond reports.

PATTI NEIGHMOND, BYLINE¹: It was the best birthday ever. November 12, 2013 - 11/12/13. And Kathleen Muldoon's delivery of her second child went smoothly².

KATHLEEN MULDOON: When he was born, everyone said he was amazing. He had great APGAR scores. His weight was perfect.

NEIGHMOND: But as the family was leaving the hospital, a doctor noticed newborn Gideon looked a bit jaundiced. Nurses put him under a fluorescent³ light to treat the problem. It didn't work.

MULDOON: While he was under the lights, he presented pretty quickly with a red, blueberry muffin-type rash all over his body.

NEIGHMOND: Bloodwork was quickly done. And soon after, the pediatrician came to talk with Muldoon and her husband Seth.

MULDOON: And I remember him walking into the room. He wouldn't even make eye contact with Seth and I at first. He just washed his hands. And he wasn't looking directly at us when he said, I don't know what to tell you guys, but I think it's CMV.

NEIGHMOND: CMV, cytomegalovirus - like cold and flu viruses, it's transmitted directly from person to person. It travels in bodily fluids like blood, urine and saliva⁴. Dr. Joseph Bocchini, a pediatric infectious disease specialist, says CMV is extremely common.

JOSEPH BOCCHINI: Cytomegalovirus is everywhere.

NEIGHMOND: By middle age, more than half of all adults are infected. By age 5, nearly 1 in 3 children have it. They pick it up from kissing or touching⁵ someone or something, like a door handle or a toy, that's been contaminated. And once you get the virus, it stays with you for life. For most people, CMV is not a problem. Obstetrician Brenna Hughes says it rarely causes symptoms. And if it does, they're pretty mild.

BRENNA HUGHES: Most of the time, people think they just had the common cold, some sniffles. Occasionally we'll see people have a low-grade fever.

NEIGHMOND: But CMV can be a big problem if you're pregnant, especially if you get infected for the first time in the first trimester, when organs like the brain are developing. In that case, the consequences can be devastating⁶, as they were for Gideon.

MULDOON: He's been diagnosed with spastic quadriplegic cerebral⁷ palsy. He also has visual impairment because of damage to the vision centers of his brain. He has epilepsy.

NEIGHMOND: And microcephaly, the neurological condition also caused by Zika where an infant's head and brain are abnormally small. Today, Gideon's 3. He's in a wheelchair. He doesn't see well, and he can't speak.

COMPUTERIZED VOICE: I all done.

NEIGHMOND: This is a fancy new device everyone is thrilled with.

COMPUTERIZED VOICE: Sit.

NEIGHMOND: Gideon fixes his gaze on a computer screen and chooses a symbol he wants to communicate, like a picture of a cup or some juice.

COMPUTERIZED VOICE: I like juice.

MULDOON: He just chose that sentence.

NEIGHMOND: The computer then gives it a voice.

COMPUTERIZED VOICE: Juice.

NEIGHMOND: Muldoon calls it Gideon's talker.

MULDOON: Gidi (ph), do you like juice? Do you like juice, Gideon?

NEIGHMOND: Now, not every child who's infected with CMV has disabilities as severe as Gideon. The majority of babies born with the virus don't have any symptoms. For those who do, the most common problems are hearing loss and developmental delay. The difference has a lot to do with timing⁸. If a woman is already infected with CMV before getting pregnant, there's only a very small chance her baby will have any problems. But it's a whole different story if she gets infected for the first time when she is pregnant. In that case, about 10 percent of babies will be born with CMV-related problems. Pediatrician Joseph Bocchini.

BOCCHINI: Probably because there's more virus and less of an immune response already present when the infection occurs. That may lead to more infections of the fetus⁹.

NEIGHMOND: And doctors told Muldoon she was likely infected at the worst time, during her first trimester.

MULDOON: (Singing) The wheels on the bus go round and round, round and round...

NEIGHMOND: Music is precious for Gideon. His hearing is mostly intact, and he loves listening to his mom sing.

MULDOON: (Singing) ...All day long.

GIDEON: (Laughter).

NEIGHMOND: But Muldoon's worried. CMV can cause hearing loss three to five years after the initial infection, and Gideon's starting to show some hearing loss in his left ear. Muldoon says she can't believe she never heard of CMV, especially since she teaches anatomy¹⁰ to medical students.

MULDOON: Even before Gideon was born, for close to a decade, I had been teaching about embryology and all the different factors that can go into creating a congenital birth defect. And yet, I'd never heard of this virus.

NEIGHMOND: She's not alone. Dr. Brenna Hughes, who's also a spokesperson for ACOG, the American College of Obstetricians and Gynecologists (ph), says fewer than half of OBs discuss CMV with their patients.

HUGHES: What we generally tell pregnant women is the best way to avoid CMV infection, like any infection when you're pregnant, is careful hand-washing and then just common sense to avoid things that could make you sick like interacting with people who are sick.

NEIGHMOND: Until 2015, ACOG recommended more aggressive efforts, especially for women who were around toddlers, who can be hot zones for viral transmission with all their dribbling¹¹ and drooling. They suggested pregnant women wash their hands every single time they handle a child's toy or laundry and stop kissing a child on the face where contaminated saliva might be present. Those suggestions were scrapped¹² when they found no conclusive¹³ evidence they actually prevent infection. But when Kathleen Muldoon got pregnant again, she eagerly embraced aggressive precaution. She didn't want to get infected by another strain of CMV.

MULDOON: It wasn't that hard to do that for nine months, you know. I explained to my daughter that we didn't kiss on the face while Mommy had a baby growing inside her, and it was no big deal.

NEIGHMOND: Her third child, Cormac, was born healthy. There's currently a debate in the medical community about whether to screen all newborns for CMV. But many doctors don't want to do that until there's proven treatment. The big push now is to develop a vaccine¹⁴ and get more funding for research.

Patti Neighmond, NPR News.

(SOUNDBITE OF RAS G SONG, "JUJU")

1 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

2 smoothly   

adv.平滑地，顺利地，流利地，流畅地

参考例句：

• The workmen are very cooperative,so the work goes on smoothly.工人们十分合作，所以工作进展顺利。
• Just change one or two words and the sentence will read smoothly.这句话只要动一两个字就顺了。

3 fluorescent   

adj.荧光的，发出荧光的

参考例句：

• They observed the deflections of the particles by allowing them to fall on a fluorescent screen.他们让粒子落在荧光屏上以观察他们的偏移。
• This fluorescent lighting certainly gives the food a peculiar color.这萤光灯当然增添了食物特别的色彩。

4 saliva   

n.唾液，口水

参考例句：

• He wiped a dribble of saliva from his chin.他擦掉了下巴上的几滴口水。
• Saliva dribbled from the baby's mouth.唾液从婴儿的嘴里流了出来。

5 touching   

adj.动人的，使人感伤的

参考例句：

• It was a touching sight.这是一幅动人的景象。
• His letter was touching.他的信很感人。

6 devastating   

adj.毁灭性的，令人震惊的，强有力的

参考例句：

• It is the most devastating storm in 20 years.这是20年来破坏性最大的风暴。
• Affairs do have a devastating effect on marriages.婚外情确实会对婚姻造成毁灭性的影响。

7 cerebral   

adj.脑的，大脑的；有智力的，理智型的

参考例句：

• Your left cerebral hemisphere controls the right-hand side of your body.你的左半脑控制身体的右半身。
• He is a precise,methodical,cerebral man who carefully chooses his words.他是一个一丝不苟、有条理和理智的人，措辞谨慎。

8 timing   

n.时间安排，时间选择

参考例句：

• The timing of the meeting is not convenient.会议的时间安排不合适。
• The timing of our statement is very opportune.我们发表声明选择的时机很恰当。

9 fetus   

n.胎，胎儿

参考例句：

• In the fetus,blood cells are formed in different sites at different ages.胎儿的血细胞在不同时期生成在不同的部位。
• No one knows why a fetus is not automatically rejected by the mother's immune system. 没有人知道为什么母亲的免疫系统不会自动排斥胎儿。

10 anatomy   

n.解剖学，解剖；功能，结构，组织

参考例句：

• He found out a great deal about the anatomy of animals.在动物解剖学方面，他有过许多发现。
• The hurricane's anatomy was powerful and complex.对飓风的剖析是一项庞大而复杂的工作。

11 dribbling   

n.（燃料或油从系统内）漏泄v.流口水( dribble的现在分词 )；（使液体）滴下或作细流；运球，带球

参考例句：

• Basic skills include swimming, dribbling, passing, marking, tackling, throwing, catching and shooting. 个人基本技术包括游泳、带球、传球、盯人、抢截、抛球、接球和射门。 来自互联网
• Carol: [Laurie starts dribbling again] Now do that for ten minutes. 卡罗：（萝莉开始再度运球）现在那样做十分钟。 来自互联网

12 scrapped   

废弃(scrap的过去式与过去分词)； 打架

参考例句：

• This machine is so old that it will soon have to be scrapped. 这架机器太旧，快报废了。
• It had been thought that passport controls would be scrapped. 人们曾认为会放开护照管制。

13 conclusive   

adj.最后的，结论的；确凿的，消除怀疑的

参考例句：

• They produced some fairly conclusive evidence.他们提供了一些相当确凿的证据。
• Franklin did not believe that the French tests were conclusive.富兰克林不相信这个法国人的实验是结论性的。

14 vaccine   

n.牛痘苗，疫苗；adj.牛痘的，疫苗的

参考例句：

• The polio vaccine has saved millions of lives.脊髓灰质炎疫苗挽救了数以百万计的生命。
• She takes a vaccine against influenza every fall.她每年秋季接种流感疫苗。