Cytomegalovirus Infection

Cytomegalovirus (CMV) is a common virus that infects people of all ages. Once CMV is in a person’s body, it stays there for life. Most infections with CMV are 'silent', meaning most people who are infected with CMV have no signs or symptoms. However, CMV can cause disease in unborn babies and in people with a weakened immune system.

CMV is a member of the herpesvirus family, which includes the herpes simplex viruses and the viruses that cause chickenpox (varicella-zoster virus) and infectious mononucleosis (Epstein-Barr Virus).

Symptoms

Most healthy children and adults infected with CMV have no symptoms and may not even know that they have been infected. Others may develop a mild illness. Symptoms may include fever, sore throat, fatigue, and swollen glands. These symptoms are similar to those of other illnesses, so most people are not aware that they are infected with CMV.

Most babies born with CMV (in other words, "congenital" CMV) never develop symptoms or disabilities. When babies do have symptoms, some can go away but others can be permanent.

Examples of symptoms or disabilities caused by congenital (meaning present at birth) CMV:

Temporary Symptoms Liver problems

• Spleen problems
• Jaundice (yellow skin and eyes)
• Purple skin splotches
• Lung problems
• Small size at birth
• Seizures

Permanent Symptoms or Disabilities

• Hearing loss
• Vision loss
• Mental disability
• Small head
• Lack of coordination
• Seizures
• Death

In some children, symptoms do not appear until months or years after birth. The most common of these late-occurring symptoms are hearing loss and vision loss. Children with congenital CMV are more likely to have permanent disabilities and symptoms that get worse if they had symptoms of CMV infection at birth. But, some children who appear healthy at birth can develop hearing or vision loss over time due to congenital CMV. For this reason, if you know your baby was born with CMV, it is important to have her or him hearing and vision tested regularly.

Transmission

• Person to person contact (such as, kissing, sexual contact, and getting saliva or urine on your hands and then touching your eyes, or the inside of your nose or mouth)
• Through the breast milk of an infected woman who is breast feeding
• Infected pregnant women can pass the virus to their unborn babies
• Blood transfusions and organ transplantations

CMV is sometimes found in body fluids, including urine, saliva (spit), breast milk, blood, tears, semen, and vaginal fluids. A person can become infected with CMV when they come in contact with infected body fluids. However, people who are CMV-positive (have been infected with CMV sometime in the past) usually do not have virus in these fluids, so the chance of getting a CMV infection from casual contact is very small.

Women who are pregnant or planning a pregnancy should follow hygienic practices (e.g., careful handwashing) to avoid CMV infection. Because young children are more likely to have CMV in their urine or saliva (spit) than are older children or adults, pregnant women who have young children or work with young children should be especially careful.

Treatment

Currently, no treatment is recommended for CMV infection in the healthy individual, including pregnant women. However, antiviral drugs ganciclovir and valganciclovir are being used for patients with weakened immune systems. Antiviral drugs are being tested in infants born with congenital CMV. Because of its strong side effects, ganciclovir should only be considered for infants with severe congenital CMV disease.

Vaccines for preventing CMV infection are still in the research and development stage.

References:

Centers for Disease Control and Prevention, USA.