Table 2.

Gaps in Knowledge Related to Prevention of Maternal and Congenital Cytomegalovirus (CMV) Infection That Can Be Addressed With Well Designed Research Programs

Problem or Question	Studies Needed
1) What is the best strategy for a woman to prevent acquisition of CMV from her own child?	More rigorous testing of preventive messages in large study populations Determine the best approach to dissemination of this message
2) How can we increase the role of healthcare providers in prevention of maternal CMV infection?	Determine ways to incorporate CMV counseling and education into routine prenatal care Test the feasibility and impact of having pediatricians provide education on CMV prevention to young mothers and to youth
3) Child-to-child transmission of CMV in daycare centers	Develop and test strategies for preventing child-to-child transmission of CMV, especially in children from 1 to 4 years of age
4) High risk of CMV infection in daycare workers	Develop and test strategies for prevention of child-to-worker transmission of CMV in daycare centers Improve the performance of daycare centers in providing information on congenital CMV infection and occupational risk of infection to their workers
5) Maternal CMV infection from intimate partner	Develop and test strategies for prevention of CMV transmission from an intimate partner (discordant couple studies)
6) Can transmission of CMV to the fetus be prevented after primary CMV infection in the mother?	Determine whether passive immunization of pregnant women after primary CMV infection will prevent transmission to the fetus Determine whether antivirals can be used safely in pregnant women to prevent transmission of CMV to the fetus
7) Why do women who are immune to CMV before conception transmit CMV to the fetus, and can we determine when transmission occurs?	Develop strategies to determine the source of virus for these events Develop a test for a marker in maternal blood of fetal CMV infection
8) Can CMV vaccine be used to prevent maternal and congenital CMV infections?	Continue to address this question with phase 1, 2, and 3 studies of improved CMV vaccines