Pediatr Res. 2004 Oct;56(4):529-35. Epub 2004 Aug 4.C

     Comment in:
         Pediatr Res. 2004 Oct;56(4):526-8.

     Cytomegalovirus (CMV) inactivation in breast milk: reassessment of 
pasteurization and freeze-thawing.

         * Hamprecht K,
         * Maschmann J,
         * Muller D,
         * Dietz K,
         * Besenthal I,
         * Goelz R,
         * Middeldorp JM,
         * Speer CP,
         * Jahn G.

     Institute of Medical Virology and Epidemiology of Viral Diseases, 
University Hospital of Tubingen, Elfriede-Aulhorn-Strasse 6, 72076 
Tubingen, Germany. [log in to unmask]

     Breast-feeding mothers frequently transmit cytomegalovirus (CMV) to 
preterm infants of very low birth weight. Current recommendations for 
prevention of virus transmission are based on data published 20 y ago in 
the context of human milk banking. Two recent clinical trials examined 
storage of breast milk at -20 degrees Celsius to reduce virus 
transmission. However, in both studies, CMV transmission occurred. Using 
sensitive tools like quantitative PCR, CMV pp67 late mRNA assay, and a 
high-speed, centrifugation-based microculture assay for quantification 
of CMV infectivity, we reassessed the virological and biochemical 
characteristics of freeze-storing breast milk at -20 degrees Celsius, 
compared it with traditional Holder pasteurization (30 min at 62.5 
degrees Celsius), and a new short-term pasteurization (5 s at 72 degrees 
Celsius) based on the generation of a milk film. Both heat treatment 
procedures were able to destroy viral infectivity and pp67 RNA 
completely. Preliminary results showed short-term heat inactivation 
below 72 degrees Celsius was less harmful in reducing the activity of 
marker enzymes than Holder pasteurization. Freezing breast milk 
preserved the biochemical and immunologic quality of the milk; however, 
late viral RNA and viral infectivity was also preserved. Compared with 
viral DNA, CMV-RNA more directly reflects infectious CMV in human milk 
samples. Further studies are necessary to evaluate short-term heat 
treatment below 72 degrees Celsius as an effective tool for prevention 
of CMV transmission.

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