CMV Infection

1 What is Cytomegalovirus (CMV) Infection?

People who harbor CMV do not show symptoms of any kind as long as they are healthy. But CMV can turn lethal if you're pregnant or have a weakened immune system.

CMV can hang on for a lifetime once you become infected. Human transmission through body fluids, such as blood, saliva, urine, semen and breast milk.

CMV found in mother’s milk doesn’t harm the baby. A pregnant woman with active infection can transfer the virus to the baby.

There is no known cure for CMV; however, drugs may help babies and those with weakened immunity.

2 Symptoms

Signs and symptoms of cytomegalovirus (CMV) infection may vary depending on its type.

The high risk population consists of babies born with CMV, those who acquired the virus during or after birth and people with weakened immunity.

Symptoms in babies

Transmission from mother to the baby usually occurs during the first half of pregnancy. Signs may develop later, may be after months or years while most babies appear healthy at birth. Hearing loss is the major sign that develops over time while some may develop vision impairment as well.

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 (splenomegaly)
  • Enlarged and poorly functioning liver (hepatomegaly and hepatic impairment)
  • Pneumonia
  • Seizures

Symptoms in people with compromised immunity

Immunocompromised patients show mononucleosis-like symptoms.

Some signs are:

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

When to see a doctor

Seek medical help if you are immunocompromised or pregnant and show mononucleosis-like symptoms. People who are on immunosuppressant after bone marrow or organ transplant are at the highest risk. If you have CMV infection but are otherwise healthy you may not need to see your doctors as long as the symptoms remain mild.

Inform your baby’s doctor if you were infected during pregnancy. Your doctor can check your baby for visual or auditory impairment. Healthy newborns do not usually develop life-threatening disease later.

3 Causes

Cytomegalovirus infection is caused by contact with infected body fluids such as saliva, semen, breast milk, blood, and urine.

Once infected, the virus can hang in your body for a lifetime but is generally dormant. It reactivates when your immunity is weakened. The virus is spread body fluids including blood, urine, saliva, breast milk, tears, semen and vaginal fluids.

CMV is absorbed through:

  • Mucous membrane
  • Sexual contact with an infected person
  • Breast milk of an infected mother
  • Organ transplantation or blood transfusions
  • Placenta from an infected mother to her unborn child, or during birth

4 Making a Diagnosis

If you have symptoms of cytomegalovirus (CMV) infection, tests can diagnose the disease.

Be prepared before visiting your doctor. Follow these tips to make the conversation clear and concise:

Make a list of questions to ask your doctor.Mention any sign you are experiencing even when minor, like a low grade fever.

Questions to ask your doctor

  • What could be possible cause for my symptoms or condition?
  • What tests do I need?
  • Will I spread it to others?
  • How can I manage this illness and other pre-existing health conditions?
  • Are there brochures or other printed material that I can have?
  • What websites do you recommend?

What to expect from your doctor

Your doctor may ask you questions like:

  • How long have you had your symptoms?
  • Any blood transfusion or organ transplant recently?
  • Do you have medical conditions like HIV or are you on chemotherapy?
  • Are you pregnant or breast-feeding?

If you suspect exposure during pregnancy, the doctor may ask:

  • When do you think you may have been exposed?
  • Have you had symptoms? Have you been tested for CMV before?

Blood tests can detect antibodies produced against CMV. Alternately, tests like cultures or polymerase chain reaction can detect virus in blood, other body fluids or a tissue biopsy.

Screening and testing for your baby

Testing is very important if you are pregnant. Your doctor may consider Amniocentesis if new infection is detected during pregnancy. If a new born baby is suspected to carry CMV (congenital CMV), he or she be tested within the first three weeks of birth.

Screening and testing if you're immunocompromised

If you have a weakened immunity, perhaps due to conditions like HIV-AIDS or administration of immune suppressing drugs, you need to be on regular monitoring to avoid complications like vision and hearing problems.

5 Treatment

Treatment for cytomegalovirus (CMV) infection is necessary if symptoms are seen in newborns and people with compromised immunity.

There's no cure for CMV. CMV remains dormant in healthy children and adults who require no medical interventions.

Antiviral agents may be used only when necessary.

The choice of drug depends upon disease severity.

Research is on the way to develop new treatments including a vaccine for CMV.

6 Prevention

Scientists are working on to develop vaccines may be useful in preventing cytomegalovirus (CMV) infection in mothers and infants. If you are immunocompromised, talk to you doctor on taking antiviral drug.

Disease risk is significantly lowered if you follow proper hygiene. Following tips might be useful:

  • Wash your hands often: Use soap and water for 15 to 20 seconds, especially after contact with young children or their diapers, drool or other oral secretions.
  • Don’t share food or drinks
  • Wash your hands properly after touching diapers, tissues and other contaminated items.
  • Clean toys and countertops.
  • Practice safe sex, use condom during sex

7 Risks and Complications

In rare cases, cytomegalovirus (CMV) infection may produce complications like:

  • CMV mononucleosis: A condition similar to infectious mononucleosis caused by Epstein-Barr virus (EBV). If you present with symptoms like sore throat, swollen glands and tonsils, fatigue, and nausea, your doctor will test you for the antibody to rule out EBV.
  • Intestinal complications: Diarrhea, fever, abdominal pain, colitis and bloody stool might be caused by CMV.
  • Liver complications: CMV can cause abnormal live function test results.
  • Nervous system complications: CMV might cause inflammation of your brain (encephalitis).
  • Lung complications: CMV can cause inflammation of lung tissue (pneumonitis).

Newborns with CMV can experience:

  • Hearing loss
  • Eye abnormalities including central vision loss, scarring of retina, an inflammation of retina (retinitis), and swelling and irritation of the eye (uveitis)
  • Mental disability
  • Lack of coordination
  • Seizures
  • Death