Congenital Cytomegalovirus Infection. Epidemiology, Diagnosis, Therapy

ABOUT THIS BOOK

Congenital cytomegalovirus (CMV) infection is the most common intrauterine transmitted viral infection, with a tremendous impact on fetuses and newborns. In this book the history of this disease, its pathophysiological background, epidemiology and symptoms, as well as diagnostic and therapeutic strategies, will be discussed. Since economic aspects are gaining more and more importance in health politics, one chapter is dedicated to this issue in the context of congenital CMV infection. The content is based on the latest scientific findings and written in an understandable manner, allowing persons not working in the field of congenital CMV to also profit from it. Thus, this book is of interest for medical doctors, nurses, midwives, economists, but also for men and women who want to inform themselves about this topic.

Content Level » Professional/practitioner

Related subjects » Gynecology - Internal Medicine - Medical Microbiology - Public Health

TABLE OF CONTENTS

1 Long known, long ignored – a brief history of cytomegalovirus research
1.1 Beginnings: 1881–1914
1.2 Between the wars: 1914–1930
1.3 From 1930 to 1960
1.4 From 1960 to the present
References

2 Virus-host interaction for defence and transmission
2.1 The virus
2.2 The host
2.2.1 Cell types involved in replication and distribution
2.2.2 The immune system – strengths and weakness
2.2.3 The placenta – a barrier?
2.2.4 Cytomegalovirus – placenta – fetus: a slippery slope between defence and transmission
References

3 Epidemiology – the influence of socioeconomic differences
3.1 Infant mortality as a social mirror
3.2 One effect – many causes
3.2.1 Maternal aetiology
3.2.2 Foetal aetiology
3.2.3 Placental aetiology
3.3 Epidemiology of congenital CMV infection
3.3.1 Congenital CMV and virus strains
References

4 Prospects and obstacles of diagnosis
4.1 Screening for congenital CMV infection
4.1.1 Screening of the mother
4.1.2 Screening of the newborn
4.2 Diagnosis of congenital CMV infection
4.2.1 Prenatal diagnosis
4.2.2 Neonatal diagnosis
References

5 Clinical outcome: acute symptoms and sleeping hazards
Thorsten W. Orlikowsky
5.1 Relevance of connatal CMV infection for the paediatrician and neonatologist
5.2 The tip of the iceberg
5.3 Lucky chance by neonatal immune response
5.4 Features of symptomatic CMV infection
5.5 Timing of infection
5.6 Symptoms of the central nervous system in detail
5.6.1 Microcephaly5.6.2 Ocular defects
5.6.3 Hearing loss
5.6.4 Mental and psychomotor retardation
5.6.5 Seizures
5.7 Unspecific symptoms in detail
5.7.1 Temperature instability
5.7.2 Perfusion and rash
5.7.3 Lung
5.7.4 Liver
5.7.5 Jaundice
5.7.6 Spleen
5.7.7 Platelet system
5.7.8 Anaemia
5.7.9 Gastrointestinal tract
5.8 Asymptomatic infection
5.9 Differential diagnosis
References

6 Prevention and therapy – more than trial and error
6.1 Antivirals
6.1.1 Treatment of pregnant women
6.1.2 Treatment of neonates
6.2 Passive immunisation
6.3 Active immunisation (vaccination)
References

7 How to save money: congenital CMV infection and the economy
Evelyn Walter, Christine Brennig, Vera Schollbauer
7.1 Introduction
7.2 Methodology
7.2.1 Incidence-based approach
7.2.2 Cost calculation
7.2.3 Cost of sequelae
7.3 Cost of illness in Germany
7.3.1 Total societal costs
7.3.2 Sensitivity analysis
7.3.3 Impact through prevention
7.4 Discussion
References

Index
List of contributors

AUTHORS & EDITORS

CV ao. Univ. Prof. Prim. Dr. med. Gabriele Halwachs-Baumann, MSc, MBABorn: 21. 02. 1962, Gmunden, AustriaAcademic studies:1981 – 1990 Medical study at the Karl-Franzens-University in Graz, Austria19. 12. 1990 Medical degreePostgraduate studies:2005 – 2006 University Course Health Services Management (Master of Science, MSc) at the Donau University Krems, Austria2006 – 2007 University Study Health Care Management (Master of Business Administration, MBA), at the University of Economics and Business, Vienna, AustriaAcademic career:1991 – 1996 Assistant at the Department of Internal Medicine, Division for Laboratory Medicine, University Hospital Graz1996 – 1997 Research period at the University of Tübingen, Germany, Department of Virology15.02.1998 Specialist for Laboratory Medicine27.05.1998 University lecturer for Laboratory Medicine01.10.1998 ao. University Professor for Laboratory Medicine2001 – 2006 Head of the Division for Laboratory Medicine at the University Clinics for Surgery, University Hospital Graz2006 – pres. Head of the Department (Primaria) for Laboratory Medicine at the Hospital Steyr