Cytomegalovirus (CMV) is a very common infection. It is a member of the herpes family. According to the Center for Disease Control (CDC), as many as 50%-85% of all United States adults have had a CMV infection by the time that they reach forty years old.
Environments where there are several children sharing a small space are the most likely places to become infected, such as daycare or preschool. CMV does not pose a serious threat to adults, or to most healthy children. The symptoms of CMV are similar to those of mononucleosis (mono), and they normally pass within a few weeks.
Communication
About 1% of the infants that are born in the United States will be infected with CMV before they are even born. If the mother has developed her first infection while pregnant, she can pass the infection to her child before or during childbirth, or through her breast milk.
Anyone that has, or has had, a CMV infection can pass on the virus even when they are not presenting any symptoms. CMV is transmitted by contact with the bodily fluids of the infected party. Saliva, semen, vaginal secretions, stools, urine, and blood are all possible vehicles to communicate CMV.
Risk Factors
Those with elevated risk associated with contracting CMV normally fall under one of two categories.
- Children or adults with compromised immune systems, such as those that are being treated for HIV, had an organ transplant recently, or are on immune-suppressing medications.
- Unborn children are the other high risk group. When a pregnant mother is infected with CMV, it is possible that the child can become seriously ill.
CMV will lie dormant in most people after an attack, but it can be reanimated. Those with compromised immune systems are more vulnerable to reactivation.
Symptoms
Depending on your age, or how you contracted a CMV infection, your symptoms may present differently.
- A newborn that contracted CMV through the birth canal or breast milk of an infected mother can show few or no signs. If signs do develop, they may present as pneumonia. If the child is premature, or if it was in less than perfect health when born and contracted it soon after, the child may be at risk for developmental or neurological problems.
- Infants that contract the CMV infection before they ever reach the birth canal will not normally show any signs of infection. They may develop problems with their vision, hearing, or have some neurological symptoms with time. Premature delivery, jaundice, seizures, rash, and difficulties with feeding can also present. Enlarged spleen or liver, or microcephaly (small head) may also be associated with a gestationally-transmitted CMV infection.
- After the infant stage through the toddler stage, a child that is sensitive to CMV will likely develop a rash, pneumonia, or hepatitis (liver inflammation).
- School aged children and teenagers will more likely show mono-like symptoms (headache, muscle aches, fatigue); they may also present with a fever. Their liver or spleen may become enlarged. The symptoms will likely last under 4 weeks.
- For persons with diminished immune systems (elderly; compromised by AIDS, HIV, or organ transplants) the infection may affect the gastrointestinal (GI) tract, the lungs, and the nervous system. In some cases it will have an effect on the eye and leave a patient blind.
Treatment
To diagnose CMV, the infected party’s throat is cultured. The stool, blood, or urine can also be tested for the presence of a CMV infection. The blood will be monitored for the infected party to measure the presence of certain antibodies. Alternatively, there is a viral DNA test that can help diagnose CMV. Testing for CMV is often only done if the symptoms are severe enough to treat.
There is no specific treatment for healthy persons that present with CMV symptoms. Patients that have an elevated risk, or to whom the infection can be life threatening (newborns, cancer patients, AIDS patients, etc.) may be given an antiviral medication via IV until the infection is under control. There can be serious side effects to the medication, so it is only given in the most dire of circumstances.
