INFECTIOUS DISEASES
Caroline
Diagnosed as a newborn,
Congenital cytomegalovirus (CMV)

Toddlers are anything but silent, yet they are major carriers of a “silent virus” that unknowingly infects 40,000 newborns each year.

Caroline, a high school junior, has spent an exciting summer in New York City taking college prep courses at Barnard College. No one could have predicted such a bright future when she was diagnosed in utero with congenital cytomegalovirus (CMV) 16 years ago.

CMV, a virus that silently infects most people at some point, can feel like flu and be just as short-lived. It is found in bodily fluids and spreads through person-to-person contact, blood transfusions and organ transplantations—or from a pregnant woman to her unborn baby.

Approximately 10 percent of CMV-infected infants have symptoms or abnormalities at birth.

CMV causes only minor illnesses in healthy children but can produce devastating, long-term effects in unborn children. Newborns born with symptoms of congenital CMV may suffer deafness, blindness, developmental and motor disabilities, and severe damage to the liver, kidney, spleen, lungs and bone marrow.

“We were told that Caroline would probably die, and if she lived, she’d have multiple severe, debilitative handicaps,” says Jennifer, Caroline’s mom.

When Caroline was born, she displayed numerous symptoms attributed to the disease, including skin lesions, an enlarged liver and spleen, fluid in her abdomen and bilateral nerve deafness. She immediately was referred to Dr. Gail J. Demmler of the Infectious Diseases Service, director of the Diagnostic Virology Laboratory at Texas Children’s and professor of Pediatrics at Baylor College of Medicine.

After a careful evaluation, Caroline became the first newborn at Texas Children’s to be treated by Demmler using a new antiviral drug, ganciclovir. Caroline responded immediately. All of her CMV-related problems receded, with the exception of profound deafness in both ears. Caroline’s development since then has been healthy.

Vaccines to prevent CMV infection are in the research and development stage. Until a vaccine is available, pregnant women can take steps to reduce their chances of contracting the virus and control the spread of germs by toddlers, who are common
carriers of the virus, in these ways:

• Wash hands often—yours and your youngster’s;
• Give young children a big hug or a kiss on top of the head instead of a kiss on the mouth or cheek;
• Avoid sharing food, drinks, utensils or toothbrushes; and
• Wash toys with soap and water, then rinse.
  
  “Caroline is a great example of what can be done when you know what options are available for babies born with congenital CMV disease,” says Demmler. “We’ve fought hard for this young lady, and she’s turned out amazingly.”