Cytomegalovirus (CMV) is a virus that can be transmitted to a developing fetus before birth. While CMV infections are generally harmless and rarely lead to serious illness, they can pose risks in certain situations. For healthy individuals who contract CMV after childbirth, symptoms are typically mild, and there are usually no long-term health effects. Once someone is infected, the virus remains in their body for life, often in an inactive state.
There are two primary types of CMV infection: primary CMV infection and recurrent CMV infection. Primary infections can lead to more significant issues during pregnancy compared to recurrent infections. If a person’s immune system is severely compromised, the virus may become active and cause disease. However, for the majority of those with CMV, it is not a severe concern.
Symptoms of CMV
Most children and adults infected with CMV do not show any symptoms. However, some individuals may experience:
- Fever
- Swollen glands
- Fatigue or malaise
- Muscle aches
- Loss of appetite
- Weakness
- Joint stiffness
Characteristics of CMV
CMV belongs to the herpes virus family and is known for its ability to remain dormant in the body for extended periods. The infectious form of CMV can be shed in bodily fluids such as urine, saliva, blood, tears, semen, and breast milk intermittently, often without any detectable signs or symptoms.
Prevalence of CMV
By the age of 40, more than half of all adults have been infected with CMV. Its prevalence is higher in developing countries and among populations with lower socioeconomic conditions. Certain at-risk groups include:
- Fetuses in utero
- Childcare providers
- Immunocompromised individuals, such as organ transplant recipients and those living with HIV
How CMV Spreads
CMV is transmitted from person to person and is not linked to food, water, or animals. While it is not highly contagious, it has been shown to spread within households and among young children in daycare settings. The virus spreads through close contact with someone shedding the virus in their saliva, urine, breast milk, or other bodily fluids.
Diagnosing CMV
Most CMV infections go undiagnosed due to the lack of symptoms. However, individuals who have been infected develop antibodies that remain in their system for life. Blood tests can detect these antibodies, and a follow-up test can be done within a couple of weeks. The virus can also be cultured from urine samples, throat swabs, and tissue samples, though these tests can be expensive and are not widely available.
If a pregnant woman is diagnosed with a CMV infection, several methods can be used to check for infection in the fetus. Amniocentesis can be performed to analyze amniotic fluid or blood for signs of infection. Symptoms indicating a potential infection may include low amniotic fluid levels, intrauterine growth restriction, and enlarged tissues in the brain. After birth, testing can be done using saliva, urine, or blood from the newborn.
Treatment for CMV
While vaccines for CMV are still in research and development, some treatment options exist. One study found that hyperimmune globulin, administered to pregnant women with CMV, may help prevent transmitting the infection to the fetus. Although no medication can completely eliminate the symptoms and long-term effects of congenital CMV, antiviral drugs such as ganciclovir and valganciclovir can address certain aspects of congenital CMV. These treatments may even support brain development and prevent hearing loss. If you are dealing with CMV during pregnancy or your baby has congenital CMV, be sure to discuss treatment options with your healthcare provider.
Preventing CMV
CMV transmission is often preventable, as it primarily spreads through infected bodily fluids coming into contact with hands and then being absorbed through the nose or mouth of a susceptible person. Those who work closely with children should practice good hygiene, including thorough handwashing and using gloves when changing diapers. Washing hands with soap and water is effective in preventing the spread of CMV.
Impact of Pregnancy on CMV
Healthy pregnant women are not at a particularly elevated risk for CMV infection. While pregnant women infected with CMV typically experience few symptoms, their developing babies may be at risk for congenital disease caused by CMV. The transmission rate from a mother who contracts CMV during pregnancy to the fetus is estimated to be between 30% and 50%, according to the Organization of Teratology.
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In summary, while cytomegalovirus is a common virus that can pose risks during pregnancy, understanding its symptoms, transmission, and treatment can help manage its impact. Taking proactive steps in hygiene and healthcare discussions is key for those who may be affected.