MRC Centre of Epidemiology for Child Health

Congenital cytomegalovirus

A mother who has a new or reactivated cytomegalovirus infection in pregnancy may infect her fetus or newborn child. Although this often causes no problem for the baby, in 10 to 20% of infected children it can result in hearing loss and other long-term disability (for example, cerebral palsy, developmental delay) and may result in severe disease or even neonatal death.

We have investigated such infections in the UK, and are currently combining British and Swedish data to investigate the relationship between asymptomatic congenital cytomegalovirus infection and hearing loss.

Principal investigators: Pat Tookey,  Claire Townsend

Group B streptococcus

Approximately 25% of women carry group B streptococcus bacteria, with no ill effect to themselves. However the bacteria can be passed from the mother to their newborn baby and cause serious consequences, particularly in premature babies.  

This Health Technology Assessment aimed to establish the cost-effectiveness of prenatal strategies for reducing the risk of infection, to identify research that was needed to make evidence-based decisions on this issue, and to help design these future studies.

Principal investigator: Ruth Gilbert

More information: HTA website

Hepatitis C

This study will make use of anonymised newborn blood spots with the aim of establishing the prevalence of hepatitis C among women giving birth in North Thames (inner and outer North London, Essex, Hertfordshire and Bedfordshire). Results from this project will inform public health policies on screening for the hepatitis C virus (HCV).

Principal investigators: Mario Cortina Borja, Claire Thorne

HIV

We have an extensive programme of research on HIV in children and pregnant women, and work in close collaboration with a number of HIV research collaborations in Europe.

Dr Pat Tookey co-ordinates the National Study of HIV in Pregnancy and Childhood, which has been collecting data on HIV-positive pregnant women and children since 1986. Dr Claire Thorne leads the European Collaborative Study on HIV-infected pregnant women and their children and a programme of research in Ukraine.

More information: HIV research

Immunisation

Immunisation is proven to be the most effective medical and, after clean water, the most effective public health intervention to protect against potentially serious diseases. Information for parents combined with well-organised and accessible services are key to giving all children the opportunity to have the protection vaccines can provide.

Our research has investigated factors that determine whether a child is completely or partially immunised according to recommended schedules in both population and hospital settings. Our findings have been used to improve services, increase immunisation rates and help health professionals understand and respond to parental questions and concerns.

More information: Immunisation

Neonatal herpes

Neonatal herpes simplex virus (HSV) infection is a rare but potentially devastating condition. Early diagnosis is vital as antiviral therapy can significantly improve outcome.

Active surveillance of neonatal HSV was carried out for three years (2004-2006) through the BPSU. The aim of the study was to estimate the prevalence of neonatal HSV in the UK, to distinguish the proportion caused by different strains of HSV, and explore the presentation and management of diagnosed cases.

This information has been used to assess whether a national screening programme should be introduced.

Principal investigator: Pat Tookey

More information: BPSU website

Rubella

If a woman acquires rubella during early pregnancy she can pass the infection on to her fetus. A baby born with congenital rubella may have many associated problems, including deafness and damage to the eye and heart.  Congenital rubella is now extremely rare in the UK because of a highly effective immunisation programme.

Through the National Congenital Rubella Surveillance Programme we collect information about any new cases of congenital rubella in order to help to monitor the effectiveness of the rubella immunisation programme.

Principal investigator: Pat Tookey

More information: BPSU website

Syphilis

Between 2000 and 2007, there was a six-fold increase in reported cases of infectious syphilis in pregnant women. The aim of the Surveillance of Antenatal Syphilis Screening (SASS) study, funded by the National Screening Committee, is to provide evidence to improve current antenatal screening practice. We are trying to establish what proportion of women identified at antenatal screening need treatment to reduce the risk of transmitting syphilis to their babies, how they are managed, and what happens to their babies.

We are collaborating with the Health Protection Agency and BPSU on a parallel surveillance study of congenital syphilis.

Principal investigator: Pat Tookey, Claire Townsend

Toxoplasmosis

Toxoplasmosis is caused by a parasite. If a woman contracts toxoplasmosis during pregnancy, the infection may be passed to the fetus. Although this may not affect the child, it can sometimes result in deafness, blindness or cerebral palsy. The European Multicentre Study on Congenital Toxoplasmosis (EMSCOT), funded by the European Commission, was a cohort study based on over 1200 toxoplasma-infected pregnant women. The study involved 15 centres in 7 countries, in Europe and Brazil. 

The study addressed questions about the risks of transmission and signs of damage in the child and how these risks are modified by prenatal treatment.

Principal investigator: Ruth Gilbert

More information: EMSCOT website

CATheter infections in CHildren (CATCH)

Most children who are admitted to children’s intensive care units need to have medicines given to them through their veins using a narrow tube called a central venous catheter or central line.

Very occasionally these catheters can cause infections in the blood and sometimes the catheter can get blocked by small blood clots. Some hospitals use catheters coated with antibiotics, which might prevent infections by killing bacteria, whilst some use catheters coated with heparin – an anti-clotting medicine – and some use standard catheters.

The CATCH multi-centre trial is funded by the NIHR Health Technology Assessment Programme. CATCH involves 11 paediatric intensive care units in the UK and is coordinated by the MCRN Clinical Trials Unit in Liverpool.

The trial will evaluate which type of catheter is most effective in preventing blood infections. The results from this trial will be used to inform infection control policies in paediatric intensive care unit.

Principal investigator: Ruth Gilbert

More information: CATCH website

The role of early life infection and the later development of asthma and allergies

It has been suggested that infections in early life may alter immune development and the subsequent risk of asthma and allergies.

We are studying this in the Millennium Cohort Study by looking at certain infections in three-year-olds and relating them to later onset of asthma and allergies.

Principal investigator: Carol Dezateux