Congenital cytomegalovirus disease in the Louisville area: a significant public health problem.

Using a passive surveillance system, 15 cases of symptomatic congenital cytomegalovirus (CMV) infection were identified in the Louisville area over approximately 3 years. When compared to mothers delivering healthy infants in Jefferson County, mothers of infants with congenital CMV were younger, more often nonwhite, and from lower socioeconomic status. Affected infants had a lower mean gestational age and birth weight, and most demonstrated classic features of congenital CMV infection such as jaundice, petechiae, hepatosplenomegaly, intrauterine growth retardation, and microcephaly. The overall infant mortality rate was 33%. Maternal and infant characteristics were similar to those of 167 cases in a national database and 106 cases reported from Birmingham, Alabama. The estimated minimal incidence of symptomatic congenital CMV disease in this area was 1.16/10,000 live births for white and 6.06/10,000 for nonwhites, establishing this as a significant public health problem in this part of Kentucky.