Cytomegalovirus: What You Need To Know
When we think of viruses, we think of an illness that makes us feel unwell. However, there is a virus that over 50% of adults carry that many times exhibits no signs or symptoms whatsoever. While this isn’t a problem for most healthy adults, for women who become pregnant and have cytomegalovirus, the impact on their baby can be quite severe. We break down what you need to know and how you can protect your future child from this silent illness.
What is Cytomegalovirus?
Cytomegalovirus, otherwise known as CMV, is a common virus that is related to both the chickenpox and herpes simplex viruses. Just like these infectious agents, it remains dormant most of the time. However, when the immune system is weakened, a person’s CMV can reactivate and be spread to healthy people through the exchange of bodily fluids. This can include saliva, vaginal fluids, semen, blood, and breast milk.
Therefore, sexual contact, having a vaginal birth, and nursing can all spread this illness. This makes newborns extremely susceptible. Less commonly, organ transplants and blood transfusions can also lead to the spread of this virus.
If an infant contracts CMV in the womb or during delivery, it is referred to as a congenital CMV infection. While some babies remain perfectly healthy, others can have detrimental health conditions at birth or they can develop them later on in life.
Symptoms of Cytomegalovirus
As mentioned, most adults show little or no sign of having CMV. If you do have symptoms, they can include fatigue, sore throat, muscle aches and pains, fever, and swollen glands. In rare cases, this virus can also lead to hepatitis, mononucleosis, nervous system issues (like encephalitis), and the inflammation of the esophagus and colon.
What is more concerning is if a pregnant woman contracts the virus. This can cause her unborn baby to develop microcephaly (a small head) and have a low birth weight. They can also have rashes, jaundice, retinitis, and seizures at birth. Furthermore, even if they exhibit no symptoms of CMV initially, young children can have long term health problems that can include vision loss, hearing loss, developmental delays, and even learning disabilities.
Prevalence of the Virus
According to the Centers for Disease Control and Prevention (CDC), “in the United States, nearly one in three children are already infected with CMV by age five.” Moreover, by the age of 40, they report that over half of adults will have contracted this infection. Interestingly enough, individuals who work in child care fields have a much higher risk of catching this virus.
Research shows that “risk factors for seropositivity [a positive result] were older age, nonwhite race, foreign birth, birth in a low- or middle-income country, diaper changing, having children at home, and a child to educator ratio greater than 6:1 in children 18 to 35 months of age.”
CMV spreads in daycare centers much more rapidly because children have a propensity to put their fingers where they don’t belong — in their mouths, noses, and eyes. They then touch everything around them, making it much easier to come in close contact with the virus. Hand washing and rigorous cleaning practices are the best way to limit the spread of CMV in these types of environments.
How is CMV Diagnosed?
Diagnosis is as simple as conducting a blood test or retrieving a sample of urine or saliva. During testing, doctors will look for antibodies from a current or past infection. If an infant is suspected of having a cytomegalovirus infection, these tests will be conducted within the first few weeks after delivery.
Additionally, during routine ultrasounds, the fetus can also show signs of this infection. These will include an enlargement of the organs, liver, and spleen as well as an abnormally low head circumference and issues with the amniotic fluid. If your healthcare provider suspects an infection, they will recommend an amniocentesis to confirm your child’s diagnosis.
How to Reduce the Chances of Getting Cytomegalovirus During Pregnancy
As if you didn’t have enough to worry about during pregnancy, expectant mothers should make a habit of being extra cautious around infants and young children, especially those who attend daycare programs. This means not kissing babies on the mouth, never sharing food or drinks with a small child, and regularly washing your hands after diaper changes.
For those mothers who are not in committed relationships, it is also important to avoid unsafe sex practices. Additionally, since a weakened immune system can trigger the reactivation of the virus, an infected person is most likely to spread CMV when they are ill. Therefore, try to steer clear of sick individuals who may inadvertently expose others to bodily fluids through sneezing and coughing.
What To Do If You Think You Have CMV
If you think you have CMV, or have come into contact with someone who has the virus, talk to your doctor about getting tested. It can take a few weeks for a positive test result to show up so don’t be surprised if they delay testing. Moreover, unlike the incubation periods for flu and COVID, it can take up to 12 weeks for symptoms of cytomegalovirus to appear.
Unfortunately, once you have contracted a cytomegalovirus infection, you will have it for life. Most individuals will not require treatment and when active, the side effects usually only last a few weeks. Treatment is normally reserved for those with a weakened immunity, pregnant women with an active form of the virus, and newborns.
These interventions will involve antiviral medicines such as valganciclovir and ganciclovir. These will normally be administered for anywhere between six weeks to six months time. Thankfully, if the virus is addressed early, it can greatly diminish the chances of serious side effects and detrimental health conditions from developing.
Parent to Parent Support Network is a program that offers help and support to families impacted by congenital CMV. Their National Congenital CMV Disease Registry facilitates an exchange of information and allows for continued research on this virus. Additionally, the National CMV Foundation also strives to educate the public on this illness in order to limit its spread and they work to provide resources to those who are impacted.
Finally, if you or your child contract CMV, it is important to know that you are not alone. One third of women will pass this virus onto their child and “one in 200 children are born with congenital CMV each year”. Since most women do not exhibit any symptoms, try to not place blame on yourself for your baby’s diagnosis.
Instead, pay extra attention to signs or symptoms as they occur and advocate for yourself and your child when it comes to talking to health professionals. This will help to ensure that early interventions are made and that the wellbeing of you and your baby is prioritized.