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DR. ROACH WRITES: A recent column on congenital cytomegalovirus (CMV, a herpes virus that is similar to EBV -- the virus that causes classic mononucleosis) stated that pregnant women who've had CMV are protected from further infections. But an expert on CMV -- Dr. Sallie Permar, MD, PhD -- wrote in to say that it's possible to reacquire CMV because natural immunity isn't fully protective against reinfection.
This is why it's so important for pregnant women to be careful not to get exposed (or reexposed) to CMV. Since the major route of exposure is through young children's saliva and urine, the key ways to avoid infection or reinfection during pregnancy include:
-- Handwashing or the use of gloves when being exposed to body fluids like saliva or urine. (With small children, this includes a lot of items, including diapers and toys.)
-- Avoiding kissing on the lips and sharing utensils or food with small children.
Having been a parent, I know how tough these recommendations could be. But hygiene instructions in one study did result in an almost 90% relative reduction in the acquisition of CMV, which can be very dangerous to the developing baby.
DEAR DR. ROACH: I read that a new flu vaccine based on mRNA technology will become available this year for people between 50-64 years old. I will turn 50 in October. Do you think I should wait to get this new vaccine?
-- S.G.
ANSWER: The United States Food and Drug Administration approved the Moderna mRNA flu vaccine (mFLUSIVA) in August, and it's expected to be available for the current flu season.
The new vaccine was found to be somewhat superior to the standard flu vaccines for the more-dangerous influenza A strains in two trials. However, there are a few more side effects with the mRNA vaccines. The side effects (a sore arm, fever, fatigue, and muscle aches) were mild to moderate in nearly all cases without an increase in serious adverse events. The current approval is for ages between 50-64, with expedited approval pending for ages 65 and older as I write this column.
Personally, I've never had any systemic symptoms from a flu vaccine in the 40 consecutive years that I've had them (since medical school), so I plan to get the more-effective mRNA vaccine this year if it's available. People who've had unpleasant side effects from flu shots in the past could stick with the standard vaccine. I recommend my patients to get the vaccine anytime from late October to late November.