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Preventing Birth Defects Caused By Congenital Infection Development of International Collaboration in Infectious Disease Research State Research Center of Virology and Biotechnology VECTOR 8-10 September 2004 The Global Toll of Birth Defects • Each year, an estimated 7.7 million children worldwide are born with serious genetic birth defects that cause death or lifelong disability for the individual and hardship for entire families • Approximately 3.7 million of these infants (>48%) will die before the age of five years • The majority of the rest will suffer life-long disability Birth Defects Risk Factors Congenital Infections Rubella (Congenital rubella syndrome) 110,000 cases worldwide Cytomegalovirus (CMV) 1/100 live births Varicella-Zoster Virus (VZV) 1/62,500 live births Herpes Simplex Virus (HSV) 1/435 live births Human Parvovirus (HPV) B19 1/3333 live births Congenital Rubella Syndrome Complications: Eye defects, hearing loss, heart defects, mental retardation and movement disorders Prevalence: 110,000 births per year Prevention: Immunization, with the goal of rubella immunity at least 28 days before conception Cytomegalovirus Complications: Neurological, growth and developmental problems; sight and hearing problems; and dental abnormalities Incidence of Infection in Newborns: 1/100 live births Prevention: Hand washing, good hygiene. Avoidance of exposure to CMV+ toddlers. Immunization? Varicella-Zoster Virus Complications: Congenital varicella syndrome, leading to defects of muscle and bone, malformed and paralyzed limbs, a smaller-than-normal head, blindness, seizures and mental retardation Incidence of Infection in Newborns: 1/62,500 live births Prevention: Immunization Herpes Simplex Virus Complications: Isolated CNS disease; disseminated disease with CNS involvement; or isolated skin, eye, or mouth infection Incidence of Infection in Newborns: 1/435 live births Prevention: Safe sexual practices to avoid exposure to herpes simplex virus. Immunization? Human Parvovirus B19 Complications: Hemolytic anemia, heart failure and fetal death; suspected but not proven association with birth defects Incidence of Infection in Newborns: 1/3333 live births Prevention: Avoid exposure to children with fifth disease (must be before appearance of disease or at least rash). Immunization?