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

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

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 fluorescent 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 saliva. 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 touching 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 devastating, as they were for Gideon.

MULDOON: He's been diagnosed with spastic quadriplegic cerebral 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 timing. 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 fetus.

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 anatomy 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 dribbling 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 scrapped when they found no conclusive 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 vaccine and get more funding for research.

Patti Neighmond, NPR News.

(SOUNDBITE OF RAS G SONG, "JUJU")