Abstract
Congenital cytomegalovirus (cCMV) infections cause more children to have permanent disabilities than Down Syndrome, Fetal Alcohol Syndrome, Spina Bifida, and pediatric HIV/AIDS combined. The risk of infection during pregnancy can be significantly decreased using universal precautions, such as thorough handwashing and cleansing of surfaces and objects that have come into contact with infected body fluids. Children under 3 years of age are commonly asymptomatic excretors of CMV, with the highest viral loads present in saliva. Pediatric therapists have regular close contact with young children, and are thus likely at elevated occupational risk of acquiring CMV. Our objective was to evaluate therapist knowledge of cCMV and its transmission. We recruited American Occupational Therapy Association (AOTA) and American Physical Therapy Association (APTA) members via electronic newsletters and printed flyers from April to September 2015. Participants completed an online, anonymous 24-question survey using Survey Monkey. We compared responses between groups and previously published CMV awareness data using binomial tests of difference of proportions and multiple logistic regression. Our study identified both a low level of therapist awareness and poor demonstrated understanding of cCMV. Self-reported cCMV awareness amongst therapists was greater than awareness in the general population, and equivalent to awareness amongst health care professionals. Whereas 52% of participants self-reported awareness of cCMV, only 18% demonstrated understanding of the behavioral modes of CMV transmission. Fewer therapists reported awareness of cCMV than other, less prevalent conditions. Higher levels of health risk knowledge were associated with greater contact with children. Most participants reported learning about cCMV from the workplace. The knowledge gaps between self-reported awareness of cCMV and demonstrated understanding of modes of transmission described by our results emphasize the need for additional training of therapists. cCMV is preventable, and accurate knowledge of modes of transmission is crucial for the health of practitioners and clients.
Highlights
Cytomegalovirus (CMV) is a common virus that remains latent in multiple organs, and is periodically excreted throughout an individual’s life [1]
We targeted American Physical Therapy Association (APTA), and American Occupational Therapy Association (AOTA) members to participate in our study
The demographic distribution of respondents adequately reflects the membership profiles of practicing therapists, as reported by APTA [52] and AOTA [53], our sample is skewed towards pediatric therapists
Summary
Cytomegalovirus (CMV) is a common virus that remains latent in multiple organs, and is periodically excreted throughout an individual’s life [1]. CMV infection in healthy adults and children is usually mild or asymptomatic. Maternal transmission to her fetus or newborn can cause significant visceral damage [4]. CCMV is a leading cause of prenatal infection worldwide, and the most common congenital infection in the United States [5, 6]. In the US, approximately 40,000 newborns are diagnosed with cCMV annually, resulting in an estimated 400 deaths, and 8,000– 10,000 children with permanent disabilities, including cognitive impairments, movement disorders, and hearing and/or vision loss [4, 7]. More children have disabilities due to cCMV than other well-known infections and syndromes, including Down Syndrome, Fetal Alcohol Syndrome, Spina Bifida, and Pediatric HIV/AIDS combined [8]
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