infected body fluids, including urine and saliva, child care providers (meaning day care workers, special education teachers, as well as mothers) should be educated about the risks of CMV infection and the precautions they can take. Day care workers appear to be at a greater risk than hospital and other health care providers, and this may be due in part to the increased emphasis on personal hygiene in the health care setting. Recommendations for individuals providing care for infants and children: Employees should be educated concerning CMV, its transmission, and hygienic practices, such as handwashing, which minimize the risk of infection. Susceptible nonpregnant women working with infants and children should not routinely be transferred to other work situations. Pregnant women working with infants and children should be informed of the risk of acquiring CMV infection and the possible effects on the unborn child. Routine laboratory testing for CMV antibody in female workers is not specifically recommended due to its high occurrence, but can be performed to determine their immune status. Epidemiology Worldwide, approximately 1 in 100 to 500 babies are born with congenital CMV. Approximately 1 in 3000 will show symptoms and 1 in 7000 will die. Congenital HCMV infection occurs when the mother has a primary infection (or reactivation) during pregnancy. Due to the lower seroprevalence of HCMV in industrialized countries and higher socioeconomic groups, congenital infections are actually less common in poorer communities, where more women of child-bearing age are already seropositive. In industrialized countries up to 8% of HCMV seronegative mothers contract primary HCMV infection during pregnancy, of which roughly 50% will transmit to the fetus. Between 10 and 15% of infected fetuses are then born with symptoms, which may include pneumonia, gastrointestinal, retinal and neurological disease. 10-15% of asymptomatic babies will develop long term neurological effects. SNHL is found in 35% of children with CMV, cognitive deficits have been found in 66% of children with CMV, and death occurs in 4% of children. HCMV infection occurs in roughly 1% of all neonates with those who are not congenitally infected contracting the infection possibly through breast milk. Other sources of neonatal infection are bodily fluids which are known to contain high titres in shedding individuals: saliva (<107copies/ml) and urine (<105copies/ml ) seem common routes of transmission. The incidence of primary CMV infection in pregnant women in the United States varies from 1% to 3%. Healthy pregnant women