Cytomegalovirus or CMV

Cytomegalovirus or CMV is a common virus that infects almost everyone at some time in their life. Most infections with CMV are “silent” and cause no signs or symptoms.  If CMV causes symptoms it usually is fever, fatigue, and aches or a mononucelosis “mono”syndrome.  CMV may cause severe illness and damage to organs and vision in people whose immune systems are low. CMV in pregnancy poses a special risk because the virus may be passed to the unborn baby, especially if the pregnant mother catches CMV for the first time during her pregnancy. Babies born with CMV are called “congenitally infected with CMV”.  Most babies with congenital CMV appear normal and are just silently infected, and will live normal lives.  However, some babies born with CMV may have problems, including deafness, vision loss, rash, enlarged liver or spleen, and abnormalities of brain development.  

How does CMV spread?

CMV is a virus that is spread from person to person, through close contact such as kissing, or sharing food or drink or utensils.  Toddlers and young children commonly have silent CMV infections and may have CMV in their saliva and urine. CMV also is spread through blood transfusions and organ transplantation.

What are the symptoms of CMV?

Most people with CMV have no symptoms and never know they’ve been infected. Others have a mild flu-like illness or mononucleosis, with symptoms that may include:

• Fever
• Headache
• Sore throat
• Swollen lymph glands
• Muscle aches
• Tiredness
• Rash

What are the symptoms of congenital CMV?

Healthy babies may be born with silent congenital CMV and have no symptoms. Some babies with congenital CMV will have deafness at birth. More severely affected newborns with congenital CMV may have rash, enlarged liver and spleen, vision problems, or abnormalities of their brain development, such as microcephaly (small head), calcifications, or polymicrogyria (PMG).

How is CMV diagnosed?

Health care providers may ask for a simple blood test to determine antibody levels to CMV to diagnose a CMV infection in older children and adults.

Congenital CMV infection is diagnosed by detecting the virus in the urine or saliva or blood of the newborn. Since CMV is so common, congenital CMV must be diagnosed within the first month of life.

How is CMV treated?

There is no treatment needed for CMV in healthy individuals. Most people recover fully without treatment. When symptoms are severe, hospital care may be needed. CMV infections in people with abnormal immune systems or newborns with severe disease caused by congenital CMV, may be treated with antiviral medications, such as ganciclovir by intravenous infusions or valganciclovir tables or solution given orally. CMV infection in pregnancy may also be treated by CMV hyper immune globulin infusions in special cases. You may ask your doctor about these special treatments.

How can CMV be prevented?

CMV is common and usually not preventable. 

There is no licensed available vaccine against CMV.

However if you are pregnant, you should follow precautions to reduce your risk of catching CMV for the first time during pregnancy, to avoid the risk of congenital CMV infection in your baby.

 If you are pregnant and wish to avoid CMV infection, do this:

• Do not share food or drink with anyone, especially toddlers or young children.
• Wash hands carefully after changing diapers or wiping nasal secretions or drool from mouths of infants and young children.
•  Do not kiss young children on or near the mouth. Give them a big hug or a kiss on top of the head instead.

CMV Facts

Most CMV infections are silent and cause no symptoms

CMV can cause flu like illness or mononucleosis in some people

CMV can be serious in individuals with weakened immune systems or if they are pregnant

Most newborns with CMV are normal, but some newborns may have serious disease from CMV

Serious CMV disease can be treated with antiviral medications or immune globulin infusions

No CMV vaccine is available

CMV precautions to prevent CMV transmission between people are recommended for pregnant women –

   do not share food or drink with young children

   do not kiss young children on or around the mouth

   wash hands well after diaper changes and wiping runny noses and drool of children