Cytomegalovirus Survival on Common Environmental Surfaces: Opportunities for Viral Transmission

Congenital cytomegalovirus (CMV) infection, which occurs as a result of infection during pregnancy, affects ∼1 of 150 live births and is a leading cause of hearing loss and intellectual disability in the United States [1–3]. In a typical cohort of 4 million live births, this translates to ∼30 000 babies born with a congenital CMV infection [1]. Of those born with CMV, ∼6000 (20%) will suffer permanent sequelae (eg, sensorineural hearing loss and intellectual disability), and ∼150 (0.5%) will die of complications of the infection. CMV is an enveloped virus that establishes lifelong latency following primary infection and periodically reactivates, usually without symptoms. Reinfection with additional strains is known to occur [4]. Transmission occurs via direct contact with bodily fluids of an infected individual. In adults, asymptomatic shedding of virus in saliva and urine may persist for weeks to months after initial infection. Children, especially those congenitally infected or <3 years old, may actively shed CMV in saliva and urine for months to years [5–8]. Exposure to bodily fluids from young children poses substantial risk for CMV exposure among women of reproductive age. Consequently, recommendations set forth by various experts for reducing CMV exposure have centered on behavioral precautions, such as routinely washing hands after exposure to bodily fluids, refraining from sharing food or drink with young children, and avoiding contact with saliva when kissing young children [2, 9–12]. However, little is known about the duration of CMV viability on environmental surfaces and the extent to which bodily fluids deposited on surfaces may be sources of exposure.