Cytomegalovirus (CMV)

Cytomegalovirus (CMV) is a member of the herpes virus group. It is the most common viral infection transmitted to an infant before birth. Once infected, this virus, remains within the person for life, but usually stays dormant and rarely causes serious consequences unless the immune system is compromised. Most people don’t know they have CMV because it rarely causes symptoms. However, if you’re pregnant or have a weakened immune system, CMV is cause for concern. CMV usually remains dormant if you’re healthy.

Infectious CMV may be shed in the bodily fluids of any previously infected person sexually or after close contact through saliva (kissing), blood, tears, semen, cervical secretions, urine or also breast milk. The shedding of virus may take place intermittently, without causing symptoms, and without any noticeable signs. The risk of getting cytomegalovirus (CMV) through casual contact is very small. The virus is generally passed from infected people to others through direct contact with body fluids, such as urine, saliva, blood, semen or breast milk. CMV is sexually transmitted but can also be spread through transplanted organs and blood transfusions.

Although CMV can be shed in breast milk, infections that occur from breastfeeding usually do not cause symptoms or disease in the infant and there are no recommendations against breast feeding. Because CMV infection after birth may cause disease in very premature or low birth weight infants, mothers of these infants should consult their healthcare providers about breastfeeding.

A concern is though CMV is not highly contagious, it has been known to spread in households and among children in day care centers. Simple hand washing with soap and water can effectively remove the virus from hands, so good hygiene is should be practiced when handling children and items such as diapers. Healthy pregnant women are not at particular risk from CVM infection; the babies may be at risk, as CMV is the most frequently transmitted viral infection from birth in the United States. Complications for infants with congenital CMV, especially from mothers who become infected or have a recurrence during pregnancy, are associated with problems at birth and serious consequences later in life such as hearing loss, blindness, epilepsy, and varying degrees of mental retardation. Congenital CMV is the leading cause of progressive deafness in children. Infants who contract CMV after birth, even through cervical secretions at birth or breast milk, have little or no symptoms or complications.

There’s no cure for CMV, but drugs can help treat newborns and people with weak immune systems.

Newborns infected with CMV in the womb (congenital CMV), babies who become infected during birth or shortly after birth (perinatal CMV) — such as through breast-feeding — and people with weakened immune systems are more at risk of developing signs and symptoms than are healthy adults. CMV is mainly a problem for certain high-risk groups, including:

  • unborn babies whose mothers become infected with CMV during the pregnancy
  • children or adults whose immune systems have been weakened by disease or drug treatment, such as organ transplant recipients or people infected with HIV

Symptoms in babies

Pregnant women who become infected are at low risk of transmitting the virus to their babies. If it’s the first time you’ve had the infection (primary CMV), risk of transmitting the virus to the baby is higher than it is with reactivated infection. Transmission usually occurs during the first half of pregnancy, usually the first trimester.

Most babies who are infected before they’re born appear healthy at birth, but a few develop signs over time — sometimes not for months or years after birth. The most common of these late-occurring signs is hearing loss. A small number may develop vision impairment as well.

Babies with congenital CMV who are sick at birth tend to be very sick. Signs and symptoms include:

  • Yellow skin and eyes (jaundice)
  • Purple skin splotches or a rash or both
  • Small size at birth (or low birth weight)
  • Enlarged spleen
  • Enlarged and poorly functioning liver
  • Pneumonia
  • Seizures

Symptoms in people with compromised immunity

An illness resembling infectious mononucleosis is the most common presentation of CMV in people with weakened immune systems (immunocompromised). CMV also can attack specific organs. Signs and symptoms may include:

  • Fever
  • Pneumonia
  • Diarrhea
  • Ulcers in the digestive tract, possible causing bleeding
  • Hepatitis
  • Inflammation of the brain (encephalitis)
  • Behavioral changes
  • Seizures
  • Coma
  • Visual impairment and blindness

Test options

CMV/HHV6/EBV panel: Differentiation between these three Herpes family of Virus’s

 

Learn more about CMV

http://www.cdc.gov/cmv/index.html

http://kidshealth.org/parent/infections/bacterial_viral/cytomegalovirus.html

http://www.mayoclinic.org/diseases-conditions/cmv/basics/symptoms/con-20029514

http://www.nhs.uk/conditions/Cytomegalovirus/pages/introduction.aspx

http://americanpregnancy.org/pregnancy-complications/cytomegalovirus-infection/

Vagina Tidbits
In every healthy vagina, helpful bacteria such as Lactobacillus, which regulates normal vaginal pH, coexist with harmful bacteria in careful balance. But when harmful bacteria overgrow, infection occurs in the form of gardnerella.
Alexa Seleno
@alexaseleno