Cytomegalovirus
Cytomegalovirus (CMV) is a group of herpes viruses that can stay in the body for life. Most people don’t know they have CMV because it rarely causes problems in healthy people.
CMV can be a condition that requires attention. Pregnant women who develop an active CMV infection during pregnancy can pass the virus to their baby, who may then develop symptoms.
For people with weakened immune systems, especially those who have had organ, stem cell, or bone marrow transplants, CMV infection can be fatal.
Cytomegalovirus Symptoms
In some cases, infection in healthy people can cause mild illness that includes:
- Fever.
- Sore throat.
- Fatigue.
- Swollen glands.
- Occasionally, CMV can cause mononucleosis or hepatitis (liver problems).
People with weakened immune systems who get CMV can develop more serious symptoms that affect the eyes, lungs, liver, esophagus, stomach, and intestines. Babies born with CMV can have problems with the brain, liver, spleen, lungs, and growth.
The most common long-term health problem in babies born with congenital CMV infection is hearing loss, which may be detected immediately after birth or may develop in childhood.
One of the symptoms of cytomegalovirus is fever.
Causes of Cytomegalovirus
CMV is related to viruses that cause conditions such as chickenpox, herpes simplex, and mononucleosis. When the virus is active in your body, you can pass it to others.
The virus is spread through bodily fluids, including blood, urine, saliva, breast milk, tears, semen and vaginal fluids. Ways of transmission of the virus include:
- Touching your eyes or the inside of your nose or mouth, after coming into contact with the body fluids of an infected person.
- Sexual contact with an infected person.
- Breast milk from an infected mother.
- Organ, bone marrow or stem cell transplant or blood transfusion.
- An infected mother can pass the virus to her baby before or during birth. The risk of transmitting the virus to the baby is higher if the mother is first infected during pregnancy.
Cytomegalovirus Risk Factors
CMV is a common virus that can infect almost anyone. However, there are other risk factors for cytomegalovirus infection, namely:
- Weakened immune system. Cancer patients or those who have undergone organ transplants are often more susceptible to CMV infection.
- Organ transplantation. Recipients of organs from donors infected with CMV are at high risk of developing the infection.
- Pregnancy. Pregnant women who are infected with CMV can transmit the virus to their fetus, which can lead to serious complications.
- Age. Newborns and older adults are at higher risk of becoming infected and developing complications from CMV.
- Contact with young children. Young children, especially those in daycare settings, can carry the virus and pass it on to adults.
Cytomegalovirus Diagnosis
A blood test can be used to diagnose CMV infection in adults who have symptoms. However, blood is not the best fluid to test for a newborn with suspected CMV infection. A saliva or urine test is more appropriate for newborns.
Cytomegalovirus Treatment
More medications are needed to treat CMV infections in people with weakened immune systems, and infants with signs of congenital CMV.
Cytomegalovirus treatment methods depend on the condition and severity of the infection. Here are some common treatments:
1. Antiviral
Antiviral drugs can be used to treat cytomegalovirus. Doctors will give antiviral drugs such as ganciclovir and foscarnet. Especially in patients with weak immune systems, such as people with HIV/AIDS or those who have undergone organ transplants.
2. Symptomatic treatment
For mild symptoms, treatment may focus on symptomatic care such as analgesics, to manage the pain and fever that arise as symptoms of CMV.
For infants with signs of congenital CMV infection at birth, antiviral drugs, especially valganciclovir, can improve hearing and developmental delays. Valganciclovir can have serious side effects and is only given to infants with signs of congenital CMV infection.
3. Immunomodulatory therapy
In some cases, immunomodulatory therapy may be used to help improve the immune response in CMV patients.
4. Monitoring
For high-risk patients, doctors usually closely monitor the development of the infection.
Complications of Cytomegalovirus
Complications of CMV infection vary, depending on your overall health and when you were infected. CMV rarely causes mononucleosis in healthy adults. Other rare complications for healthy adults include problems with the digestive system, liver, brain, and nervous system.
People with weakened immune systems may experience complications from CMV infection, such as:
- Loss of vision, due to inflammation of the light-sensing layer of the eye (retinitis).
- Digestive system problems, including inflammation of the colon (colitis), esophagus (esophagitis) and liver (hepatitis).
- Nervous system problems, including inflammation of the brain (encephalitis).
- Pneumonia.
Babies whose mothers were first infected with CMV during pregnancy are more likely to experience complications. Complications for the baby can include:
- Hearing disorders.
- Intellectual disability.
- Vision problems.
- Seizures.
- Lack of coordination.
- Weakness or problems using muscles.
Cytomegalovirus Prevention
Implementing clean and healthy living habits is the best prevention against CMV. Some efforts that can be done to prevent cytomegalovirus infection are:
1. Wash your hands regularly
Use soap and water for 15 to 20 seconds, especially when:
- Before, during, and after preparing food.
- Before and after meals.
- After having direct contact with a sick person.
- Before and after cleaning or touching a wound.
- After using the toilet.
- Before and after helping children to go to the toilet or change diapers.
- After coughing, sneezing, or blowing your nose.
- After having direct contact with sick people or animals.
- After touching dusty objects.
- When hands look dirty.
2. Avoid contact with tears and saliva when kissing your child.
Instead of kissing a child on the lips, for example, kiss them on the forehead. Kissing a child can be a source of infection caused by tears and saliva. Make sure you reduce contact this way.
3. Avoid sharing eating or drinking utensils
Sharing glasses and kitchen utensils can cause CMV transmission. Saliva can stick and remain on the cutlery you use. Make sure you have your own cutlery and do not lend it to others to avoid CMV transmission.
4. Be careful with disposable items
When disposing of diapers, wipes, and other items that have been contaminated with bodily fluids, wash your hands thoroughly before touching your face. It is best to use a special disposal bin for disposable items to avoid contaminating other items.
5. Clean the toys and table
Clean all surfaces that come into contact with children’s urine or saliva. This is to avoid any sources of CMV transmission that may be around.
6. Practice safe sex
Wear a condom during sexual contact to prevent the spread of CMV through semen and vaginal fluids. If you have a weak immune system, you can take antiviral drugs to prevent CMV.