1. #1 Birth Defects Virus by Lisa Saunders www.authorlisasaunders.com Stop CMV

2. My CMV Story Miscarriage on Christmas Eve of 1988—was offered no blood test to help determine cause. Pregnant three months later Elizabeth arrived on Dec. 18, 1989 Her head was small, misshapen. She had difficulty breathing Purple skin splotches on cheeks Diagnosed with congenital CMV

3. What is CMV? CMV, or cytomegalovirus (sī-to-MEG-a-lo-vī-rus), is a common virus. Most infections with CMV are “silent,” meaning most people who are infected with CMV have no signs or symptoms. Between 50% and 80% of adults in the U.S. are infected with CMV by 40 years of age CMV can cause disease in unborn babies and in people with a weakened immune system.

4. Symptoms of Congenital CMV Temporary Symptoms Liver problems Spleen problems Jaundice (yellow skin and eyes) Purple skin splotches Lung problems Small size at birth Seizures Permanent Symptoms or Disabilities Hearing loss Vision loss Mental disability Small head Lack of coordination Seizures Death

5. CDC Compares Causes of Birth Defects

6. As Elizabeth Grew Profoundly mentally impaired Severe Cerebral Palsy Progressive hearing loss Cortically Blind Non-verbal Central and structural apnea Developed epilepsy Stayed as a three-month-old Could only eat pureed food and wore diapers Surgeries: spinal fusion, hip reconstruction, hamstring lengthening Despite all this, she was extremely happy and adorable--to us anyway!

8. Jackie was proud of her little sister (my father-in-law made Elizabeth this walker)

9. Daddy’s little girl

10. Elizabeth at age four

11. Elizabeth working hard at school and enjoying a stroller trip

12. Big, formerly homeless dog keeps Elizabeth company

13. Sisters giggle at private slumber party

14. Elizabeth (at 15) and Jackie on the boardwalk at night

15. Elizabeth died during a seizure at 16

17. CMV Awareness Among Women After Elizabeth died in 2006, I began researching CMV awareness among women. Only 22% have heard of it (A 2006 survey published in the article, "Knowledge and Awareness of Congenital Cytomegalovirus Among Women," concluded that of the 643 women surveyed about their CMV awareness, only 22% had heard of it and most of those could not correctly identify modes of CMV transmission or prevention.) I had a tormenting dream about parents wondering why I didn’t do more to warn about CMV

18. CDC Charts CMV Awareness

19. Why don’t OB/GYNs warn about CMV? Less than half (44%) of OB/GYNs warn patients about CMV (surveyed by the American College of Obstetricians and Gynecologists in 2007) Don’t want to frighten their patients (An OB/GYN quoted in FitPregnancy magazine (June/July '08) said, "The list of things we're supposed to talk about during women's first visit could easily take two hours and scare them to death.” ) Don’t realize the prevalence of congenital CMV. In the article, “Washing our hands of the congenital cytomegalovirus disease epidemic,” Drs. Cannon and Davis state: “The virtual absence of a prevention message has been due, in part, to the low profile of congenital CMV. Infection is usually asymptomatic in both mother and infant, and when symptoms do occur, they are non-specific, so most CMV infections go undiagnosed.”

20. CDC Stats: www.cdc.gov/cmvwww.cdc.gov/cmv Every hour, congenital CMV causes one child to become disabled Each year, about 30,000 children are born with congenital CMV infection About 8,000 children each year suffer permanent disabilities caused by CMV About 1 in 150 children is born with congenital CMV infection About 1 in 750 children is born with or develops permanent disabilities due to CMV

21. How is CMV Spread? Person to person contact (kissing, sexual contact, getting saliva or urine on hands and then touching eyes, or the inside of nose or mouth) Through the breast milk of an infected woman Infected pregnant women can pass the virus to their unborn babies Blood transfusions and organ transplantations

22. Pregnant Women and CMV Contact with the saliva or urine of young children is a major cause of CMV infection among pregnant women. Risk of CMV infection is likely to be reduced by careful attention to good personal hygiene, such as hand washing.

23. Reduce Chances of Contracting CMV Wash hands often with soap and water for 15-20 seconds, especially after wiping runny noses, changing diapers, picking up toys, etc. If soap and water are not available, use alcohol-based hand gel. Use soap and water or a disinfectant to clean hard surfaces that have been contaminated by secretions Don’t share food, drinks, or eating utensils with young children Don’t kiss young children on the lips—give them a big hug and a kiss on top of the head. If you work in a day care center, limit close contact with children younger than 2½ years of age, especially if you've never been infected with CMV or don't know if you've been infected.

24. Considering getting pregnant? Check your CMV status. Your doctor can perform a simple blood test. If you are currently infected for the first time, consider avoiding pregnancy until your primary CMV infection has resolved. Ask your doctor when it is safe to become pregnant. Daycare workers: The CDC website states: "Adults who have not had CMV and who work with children in day care, especially children 1 to 2 ½ years of age, are at high risk for CMV infection."

25. What I do to Stop CMV Write a congenital CMV blog at: http://congenitalcmv.blogspot.com/http://congenitalcmv.blogspot.com/ Write to magazine/newspaper editors asking if they’d like to feature CMVmagazine/newspaper editors Write to producers about my/others willingness to speak on T.V. about CMVT.V. about CMV Write letters to elected officials asking for a CMV education campaignelected officials Use Youtube. Twitter, Facebook, and LinkedIn to raise awareness.YoutubeTwitterFacebookLinkedIn Submit articles about CMV to newspapers/online publicationsnewspapers/online publications Post CMV info on social networking sites like momslikeme.commomslikeme.com Offer myself and others as public speakers on CMVpublic speakers My memoir, Anything But a Dog! The perfect pet for a girl with congenital CMV includes interviews with CMV experts and raises funds for the National Congenital CMV Disease Registry if purchased through their site.Anything But a Dog! The perfect pet for a girl with congenital CMVNational Congenital CMV Disease Registry Published a free e-book, How to Get Published, to make available an excerpt of Anything But a Dog! The perfect pet for a girl with congenital CMVHow to Get Published Anything But a Dog! The perfect pet for a girl with congenital CMV Organize “Open Mike Nights” to read aloud my CMV prevention articlesprevention articles Add my voice to CMV parents and the general public at: www.stopcmv.orgwww.stopcmv.org Elizabeth’s big sister, Jackie Saunders, summarized my work to Stop CMV on my congenital CMV blog: http://congenitalcmv.blogspot.com/my work to Stop CMV http://congenitalcmv.blogspot.com/

26. My memoir about Elizabeth and her dog raises CMV awareness

27. Why raise CMV awareness?

28. How you can Stop CMV Learn CMV facts: http://www.cdc.gov/cmv/http://www.cdc.gov/cmv/ Tell your family and friends about CMV. They can listen to short CDC podcastCDC podcast Expand public awareness through Facebook, etc. Visit www.stopcmv.org for public awareness campaigns you can joinwww.stopcmv.org Post Congenital CMV flyer in public placesCongenital CMV flyer

29. Post this flyer from StopCMV.org

30. Join Forces With Others National Congenital CMV Disease Registry: Contact Gail J Demmler-Harrison MD, Professor of Pediatrics, Director of the Congenital CMV Disease Registry and Research Program, Baylor College of Medicine, Houston, Texas, at cmv@bcm.edu or visit: www.bcm.edu/pedi/infect/cmv The Registry supports CMV research, a parent support group and disseminates information. Call:(832) 824-4387.cmv@bcm.eduwww.bcm.edu/pedi/infect/cmv Congenital CMV Foundation: Contact Lenore Pereira, Ph.D. Founder, Congenital CMV Foundation, at lenore.pereira@ucsf.edu or visit www.congenitalcmv.org/ Site includes members of the Scientific Advisory Committee with their contact information. Foundation educates the public about CMV.lenore.pereira@ucsf.edu www.congenitalcmv.org/ Stop CMV and The CMV Action Network: Contact Janelle Greenlee, President and Founder at janelle@stopcmv.org or visit: www.stopcmv.org Non-profit parent-driven group raises CMV awareness. Print and post Stop CMV awareness flyers in public meeting places. Join and help recruit today! www.causes.org/stopcmvjanelle@stopcmv.org www.stopcmv.orgwww.causes.org/stopcmv

31. Pregnant with active CMV infection? Contact the National Congenital CMV Disease Registry at cmv@bcm.edu or visit: http:// www.bcm.edu/pedi/infect/cmvcmv@bcm.eduhttp:// www.bcm.edu/pedi/infect/cmv Contact an expert at the Texas Children’s Hospital Fetal Center for advice. Visit: http://www.texaschildrens.org/CareCenters/fetalsurger y/default.aspx http://www.texaschildrens.org/CareCenters/fetalsurger y/default.aspx

32. Treatment Pregnant Women: CMV hyperimmune globulin is showing promising results. Babies: “Ganciclovir, an antiviral drug, may prevent hearing loss in infants born with congenital CMV. However, this drug has serious side effects and was only tested in children with severe congenital CMV symptoms.” --CDC Scientific papers on CMV stats and emerging treatments: http://www.congenitalcmv.org/research.htm http://www.congenitalcmv.org/research.htm

33. Annual Number of Children with Long-term Disabilities “Perhaps no single cause of birth defects and developmental disabilities in the United States currently provides greater opportunity for improved outcomes in more children than congenital CMV.” --BMC Public Health 2005, 5:70