Control and Prevention
General Guidance for Employers
To prevent or reduce workers' cytomegalovirus (CMV) infection risk, employers should develop an infection control plan that addresses sources of CMV exposure and infection prevention measures. This is recommended for childcare facilities by the American Academy of Pediatrics (AAP) and is also required by many states’ childcare licensing agencies (see Additional Resources). OSHA's Bloodborne Pathogens (BBP) standard (29 CFR 1910.1030) applies to workers who have occupational exposure to blood, saliva in dental procedures, and other potentially infectious materials. Healthcare workers, childcare workers, and others who may be routinely exposed to potentially infectious body fluids may have exposures that fall under the scope of the BBP standard.
When the BBP standard applies, employers must implement universal precautions and other infection prevention measures, such as a written exposure control plan, engineering and work practice controls, personal protective equipment (PPE), and training. These measures could also serve as a framework to control infectious diseases like CMV that are contracted through non-bloodborne exposures. A comprehensive infection control plan will include training on CMV risks. A recommended best practice is for employers to explain CMV risks to employees prior to them becoming pregnant.
Consider encouraging workers who are pregnant or planning to become pregnant, or those whose sexual partner(s) is or is planning to become pregnant, to discuss potential CMV risks with their healthcare provider. If a worker with pregnancy concerns requests reassignment, consider reassigning the worker to a job where they are not exposed to young children's body fluids or, for childcare workers, to a job where they can work with older children. Employers can also encourage workers to notify the employer if they are pregnant or planning to become pregnant. The Pregnancy Discrimination Act protects employees from adverse consequences in response to an employee notifying their employer of pregnancy plans or requesting reassignment due to pregnancy concerns.
Provide disposable gloves and encourage employees to use them for any activities that involve contact with body fluids. Latex-free gloves, such as nitrile and vinyl, are preferred to prevent allergic reactions. Require workers to discard gloves immediately after use, and to wash their hands, preferably with soap and water, rather than use an alcohol-based hand sanitizer. OSHA's Personal Protective Equipment (PPE) Safety and Health Topics page provides information on PPE selection and use.
Workplace surfaces that may be contaminated with body fluids should be cleaned regularly with disinfectant. Common problem areas include countertops, tables, cabinets, chairs, door knobs, telephones, faucet handles, and equipment. In addition to the previous items, childcare workers should consider disinfecting any toys or small objects that may have been exposed to a child’s saliva or other body fluids.
General Guidance for Childcare Workers
To minimize infection risk, childcare workers should treat all body fluids as if they are infectious, and avoid sharing food, drinks, or utensils with young children.
Childcare workers can also wear gloves for all contact with children's body fluids and wash their hands frequently and thoroughly. Washing hands with soap and water is more effective at removing germs, including CMV, than using alcohol-based hand rubs (ABHRs), especially when hands are visibly soiled. When washing hands, workers should lather for at least 15 seconds. Always wash hands after glove removal, as gloves are not a replacement for hand washing.
Childcare workers concerned about CMV exposure should talk to their healthcare provider about the virus, their infection risk, and ways to keep themselves healthy. Workers at risk of exposure can be tested before becoming pregnant, but, as discussed on the Medical Information page, there is no consensus on these tests' utility. If pregnant or planning pregnancy, workers should talk to a healthcare provider about whether to request reassignment to work with older children.
General Guidance for Healthcare Workers
Healthcare workers routinely have exposure to potentially infectious body fluids. Following the guidelines of OSHA's Bloodborne Pathogen standard and routinely following standard precautions can help protect healthcare workers from most potential sources of CMV infection. Healthcare workers should use PPE, such as gloves, whenever there is a chance they may encounter body fluids. They should also follow good hand hygiene practices, including washing hands for at least 15 seconds with soap and running water or using ABHRs that contain at least 60% alcohol when soap and running water are not available. Always wash hands after glove removal, as gloves are not a replacement for hand washing. Always wash hands that are visibly soiled. Frequently sanitizing surfaces can also help prevent exposure to CMV when those surfaces are contaminated.
Healthcare workers who are pregnant or may become pregnant, or those whose sexual partner(s) is or is planning to become pregnant, should speak with their healthcare provider about their risks of contracting CMV in the healthcare environment and how they can protect themselves. Employers should consider reassigning such workers to jobs that do not expose them to potentially infectious body fluids.
Workers Who are Pregnant or may Become Pregnant
Workers who are pregnant or may become pregnant should avoid potential CMV infection sources to prevent possibly passing the infection to their fetus. They should be especially cautious when visiting or working in childcare facilities, healthcare facilities, schools, and other places of social gathering. If workers are required to work around potentially infectious body fluids, they should utilize PPE such as disposable gloves. In addition, they should follow standard hygiene guidelines including regular and thorough handwashing and sanitizing frequently touched surfaces.
These workers should contact their healthcare provider to learn about the virus, their infection risk, and ways to keep themselves and a developing fetus healthy. Their healthcare provider may advise them to request reassignment to work with older children or to work in an environment where they are not routinely exposed to infectious body fluids. The Pregnancy Discrimination Act protects women who are pregnant or are planning to become pregnant from adverse employer actions that may result from notifying their employer of pregnancy plans or requesting reassignment due to pregnancy concerns.