Cytomegalovirus infection
Cytomegalovirus (CMV) infection is a widespread viral infection caused by a herpesvirus, primarily transmitted through the exchange of body fluids, such as saliva, urine, and breast milk. While most individuals infected with CMV remain asymptomatic, the virus can lead to symptoms similar to those of mononucleosis, including swollen lymph glands, fever, and fatigue, particularly in those with weakened immune systems. High-risk groups include children, childcare providers, organ transplant recipients, and individuals living with HIV/AIDS. CMV can also pose significant risks to fetuses, potentially resulting in congenital CMV, which affects about 0.5% of newborns in the U.S. and may lead to hearing loss and developmental issues. Diagnosis often involves blood tests or specific laboratory tests for newborns. Although there is no vaccine to prevent CMV, practicing good hygiene, such as frequent hand washing and safe disposal of diapers, can help reduce transmission. In cases where treatment is necessary, antiviral medications may be prescribed, particularly for high-risk populations. Overall, while CMV is common, awareness and preventive measures can help manage its impact.
Cytomegalovirus infection
- ANATOMY OR SYSTEM AFFECTED: All
Definition
Cytomegalovirus (CMV) infection is a common viral infection. It can cause swollen lymph glands, fever, and fatigue. Most people with CMV do not show symptoms of infection and are not aware they have it. CMV infection rarely causes health problems, except for people with compromised immune systems and for fetuses.
Causes
A herpesvirus causes CMV. The disease is passed by an exchange of body fluids with an infected person. A person can be exposed through kissing, sexual intercourse, breastfeeding, and changing the diaper of an infected infant. The virus is found in saliva, tears, blood, urine, semen, stool, vaginal fluids, and breast milk.
Risk Factors
This virus is common throughout the United States. Everyone is considered at risk for CMV. However, people with the highest risk of acquiring this virus include children and childcare providers in daycare and preschool because of their frequent exposure to body fluids that carry the infection; people with suppressed or impaired immune systems; transplant recipients; persons with cancer undergoing chemotherapy; and persons with human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS). Fetuses are at high risk, too. Exposure in utero can result in congenital CMV (congenital means born with the condition). About 0.5 percent of babies born in the United States are born with congenital CMV.
Symptoms
The virus often remains inactive in the body, and there are often no symptoms. Sometimes, the virus is activated. The virus can reactivate if a person’s immune system becomes impaired. This can happen because of medication or illness. In this case, symptoms can occur.
The symptoms are like those of mononucleosis, another herpesvirus infection, and include swollen lymph glands, sore throat, fever, and fatigue. People with suppressed or impaired immune systems can also develop pneumonia, colitis (inflammation of the large intestines), retinitis (an eye infection that can cause blindness), and chronic liver disease.
Babies born with congenital CMV infection often have hearing loss, deafness, blindness, congenital disabilities, developmental problems, and chronic liver disease. Infants who get a CMV infection after birth rarely have any symptoms or complications.
Screening and Diagnosis
CMV infection is not often diagnosed because the virus rarely produces symptoms. If CMV is suspected, it can be diagnosed through a blood test to detect CMV antibodies (disease-fighting proteins in the blood) and a laboratory test of fluid samples. Not all laboratories are equipped to perform this test, however. The diagnosis of congenital CMV in newborns is usually done through a Polymerase Chain Reaction (PCR) test of urine or saliva in the first three weeks of life. Other tests include amniocentesis for pregnant women to check for signs of infection in the fetus and a biopsy of any affected organ.
Treatment and Therapy
Most people will not need specific therapy for CMV infection. Once a person has this virus, they have it for life. No vaccine exists to prevent the spread of this disease. For people undergoing organ transplants, people living with AIDS, and other persons with immunosuppression, specific antiviral drugs may be used, such as ganciclovir and valganciclovir.
Prevention and Outcomes
There is no definitive way to prevent CMV. One should, however, wash hands frequently, dispose of diapers properly, and avoid intimate contact with people known to have a CMV infection.
Bibliography
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Brazier, Yvette. "Everything You Need to Know about Cytomegalovirus." Medical News Today, 24 Apr. 2023, www.medicalnewstoday.com/articles/173811. Accessed 4 Nov. 2024.
Martin, Richard J., Avroy A. Fanaroff, and Michele C. Walsh, editors. Fanaroff and Martin’s Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 2 vols. 8th ed., Mosby/Elsevier, 2006.
Morgan, Kendall K., and Zilpah Sheikh. "Cytomegalovirus (CMV)." WebMD, 7 Mar. 2024, www.webmd.com/hiv-aids/aids-hiv-opportunistic-infections-cytomegalovirus. Accessed 4 Nov. 2024.
Roizman, Bernard, Richard J. Whitley, and Carlos Lopez, editors. The Human Herpesviruses. Raven Press, 1993.
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Wagner, Edward K., and Martinez J. Hewlett. Basic Virology. 3rd ed. Blackwell Science, 2008.