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A photo of Mark Schleiss.

Pediatric infectious disease expert Mark Schleiss wants to establish a screening program for newborns with cytomegalovirus--a major cause of deafness and mental retardation in infants.

Silent plight

By Mary Hoff

From eNews, May 5, 2005

I've probably had it. And so, probably, have you. For most of us, cytomegalovirus (CMV) infection is no big deal, as far as symptoms go--in fact, some people who have it don't even notice they're sick.

But CMV is a big deal--a very big deal--for women who become infected for the first time when they're pregnant. Like a vandal in the night, the virus can slip silently across the placenta and wreak havoc with a fetus's developing nervous system, causing hearing loss, vision loss, and mental retardation.

CMV is, after Down syndrome, the second-most commonly identified cause of retardation in newborns and a leading cause of deafness in children. And it's alarmingly ubiquitous: transmitted through body fluids, it's common among children in group settings such as day care. A kiss or a dirty tissue is all it takes to transmit it to an unsuspecting, pregnant mother. Yet few women of childbearing age are even aware of the threat. According to the National Center for Infectious Diseases, CVM is the most frequently transmitted virus to a developing child before birth.

"Cytomegalovirus is a huge problem that nobody knows anything about," says Mark Schleiss, director of the Division of Pediatric Infectious Diseases in the Department of Pediatrics. "It's estimated that 1 percent of babies are born with cytomegalovirus. In the big picture, that's a lot of babies."

Schleiss is working to reduce the toll of CMV on two main fronts: first, by working to better understand the basic biology of the virus, and second, by encouraging the establishment of screening programs for newborns.

A kiss or a dirty tissue is all it takes to transmit the cytomegalovirus to an unsuspecting, pregnant mother.

"The basic research side of it really centers around hypotheses about the damage caused by the virus as well as ways to prevent that," Schleiss says. By studying the genes and proteins that make up CMV, he hopes to learn more about how it moves from mother to fetus and how it attacks the nervous system--important steps in strategizing ways to prevent such harm directly as well as to developing a vaccine against CMV.

Schleiss has already discovered a gene that holds promise for vaccine development and has created a genetically engineered vaccine that prevents CMV from crossing from mother to fetus in guinea pigs. He's just beginning a study exploring whether vaccination might reduce the threat of the virus, which can be deadly to immune-compromised people and to persons preparing to undergo bone marrow or stem cell transplant.

In the clinical arena, Schleiss is working to promote development of a screening program for babies at birth. A simple blood test that shows whether a newborn is infected with CMV, he says, would be valuable for alerting parents and physicians to infants who might have special needs. And it might help reduce long-term damage, too. Recent research suggests that treating CMV-infected newborns with antiviral drugs can reduce hearing loss. "We can make the case that identification of infants by screening would provide a link not only to diagnostic and support services but also would provide at least for some of these infants an opportunity for treatment that might be beneficial," he says.

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