Hayley Smithers-Sheedy1,2,3, Camille Raynes-Greenow1,2, Nadia Badawi1,2,3, Gulam Khandaker1,4,2,5, Robert Menzies1,5, Cheryl A Jones1,4,2,5. 1. Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia. 2. Centre for Perinatal Infection Research, Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, New South Wales, Australia. 3. Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, New South Wales, Australia. 4. Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, New South Wales, Australia. 5. National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Abstract
AIM: Cytomegalovirus (CMV) is an important cause of congenital infection, which can result in neonatal deaths or contribute to deaths in later childhood. Post-natally acquired CMV is a less common cause of disease and mortality, and only in preterm infants or immunocompromised children. Here we sought to describe CMV as a direct or secondary contributor to childhood mortality in Australia. METHOD: We searched national mortality data sets between1999 and 2011 for cases <15 years with CMV recorded as an underlying or contributing cause of death. RESULTS: Eighty-three CMV-associated deaths in children <15 years were identified (0.2 cases per 100 000 <15 years; 95% confidence interval 0.16-0.24). Childhood deaths associated with CMV were evenly distributed between males and females, and the majority (n = 57; 68%) occurred in children less than 12 months of age, with 22 cases <1 month of age. Over the 13-year study period, the mortality rate remained stable and CMV resulted in an estimated age-adjusted 5925 years of potential life lost. CONCLUSIONS: CMV makes a small but important contribution to childhood mortality in Australia. Most CMV-related deaths occurred in infants <12 months of age. These infant deaths may be an indirect marker of the burden of severe intrauterine CMV disease given the natural history of this infection.
AIM: Cytomegalovirus (CMV) is an important cause of congenital infection, which can result in neonatal deaths or contribute to deaths in later childhood. Post-natally acquired CMV is a less common cause of disease and mortality, and only in preterm infants or immunocompromised children. Here we sought to describe CMV as a direct or secondary contributor to childhood mortality in Australia. METHOD: We searched national mortality data sets between1999 and 2011 for cases <15 years with CMV recorded as an underlying or contributing cause of death. RESULTS: Eighty-three CMV-associated deaths in children <15 years were identified (0.2 cases per 100 000 <15 years; 95% confidence interval 0.16-0.24). Childhood deaths associated with CMV were evenly distributed between males and females, and the majority (n = 57; 68%) occurred in children less than 12 months of age, with 22 cases <1 month of age. Over the 13-year study period, the mortality rate remained stable and CMV resulted in an estimated age-adjusted 5925 years of potential life lost. CONCLUSIONS: CMV makes a small but important contribution to childhood mortality in Australia. Most CMV-related deaths occurred in infants <12 months of age. These infant deaths may be an indirect marker of the burden of severe intrauterine CMV disease given the natural history of this infection.