Table 3.

Areas for further research, study, and policy development

Epidemiological studies Develop standardized case definition of cCMV disease Determine rates of CMV-associated fetal loss Better define age-specific incidence and transmission rates Better define burden and costs of sequelae of cCMV disease and infection Further define predictors of outcome in cCMV

Virological/Immunological studies Further study the role of maternal reactivation vs re-infection in CMV-seropositive individuals and resulting burden of cCMV disease Develop improved serological assays to differentiate between re-infection and reactivation in CMV-seropositive individuals Identify and develop a mechanistic correlate of protection that could predict vaccine effect, which would have value in studies of vaccine immunogenicity and duration of protection. The correlate may differ between protection of seronegative women and seropositive women. Develop improved assays to assess CMV antibody neutralization, avidity, and functionality

Policy Resolve potential liability issues associated with inadvertent immunization of pregnant women Reduce uncertainties regarding potential recommendations for use of a CMV vaccine Increase public awareness of CMV infection and disease