Overview
Cytomegalovirus (CMV) is a common virus that can infect people of all ages. Once a person is infected with CMV, the virus remains in their body for life. In healthy individuals, CMV usually causes no symptoms or only mild symptoms. However, for pregnant women or those with weakened immune systems, CMV can be a concern. In such cases, the virus can be passed to the unborn baby or cause severe complications. CMV can spread through body fluids, such as blood, saliva, urine, semen, and breast milk. There is no cure for CMV, but medications can help manage symptoms.
Understanding the disease
Symptoms
The symptoms of CMV can vary depending on the individual's health status. For most healthy people, CMV infection may not cause any symptoms or only minor symptoms. However, if your immune system is weakened, you may experience symptoms such as:
- Fatigue
- Fever
- Sore throat
- Muscle aches
- Swelling of the liver (hepatitis)
- Inflammation of the esophagus, colon, or stomach
- Nervous system problems like brain inflammation (encephalitis) or pneumonia Pregnant women and infants can also be at risk for complications. Infants who have congenital CMV can experience vision loss, hearing loss, intellectual disability, seizures, lack of coordination, weakness, and problems using muscles. If you're experiencing any symptoms or have concerns about CMV infection, it's important to see your doctor.
Development
Cytomegalovirus (CMV) can develop in different ways depending on an individual's immune status and health. In general, CMV follows a cycle of dormancy and reactivation.
- Primary infection: When a healthy person is first infected with CMV, they typically develop symptoms similar to those of mononucleosis (mono), such as fatigue, fever, and swollen glands. The virus then remains in the person's body for life but usually remains dormant.
- Reactivation: In some cases, CMV can reactivate in the body, especially in people with weakened immune systems. This reactivation can cause the virus to multiply and cause symptoms again. This can occur during pregnancy, leading to congenital CMV infection in the baby.
- Congenital CMV infection: When a pregnant woman develops an active CMV infection, she can pass the virus to her unborn baby, leading to congenital CMV infection. Newborns who are infected with CMV during pregnancy may appear healthy at birth but may develop symptoms later, such as hearing loss, developmental delay, or vision problems.
- Perinatal infection: Some newborns can become infected with CMV during birth or shortly afterward, often through exposure to infected breast milk or other bodily fluids. These babies may also develop symptoms, including jaundice, liver damage, and skin splotches. The virus is spread through body fluids, such as blood, saliva, urine, semen, and breast milk. Casual contact does not typically transmit CMV. Remember that there is no cure for CMV, but medications can help treat the symptoms. If you have concerns about CMV infection, consult with your healthcare provider.
Assessment and Diagnosis
Triage
You should see a doctor if CMV infection is suspected, especially if you have a weakened immune system or if you are experiencing severe symptoms such as vision loss, digestive system problems, nervous system problems, pneumonia, or if you are an infant with congenital CMV. These cases may require medical attention and treatment.
Diagnosis
To diagnose Cytomegalovirus (CMV) infection, laboratory tests can be conducted on blood or other body fluids, or tissue samples. During pregnancy, testing can determine if the mother has ever been infected with CMV, and if the fetus has been infected. In people with weakened immunity, regular monitoring may be necessary. The type of treatment for CMV depends on the severity of symptoms and can include antiviral medications. To prepare for an appointment, it is recommended to write down any symptoms and questions to ask the doctor.
Management and Treatment
Complications
Potential complications of CMV include:
- Vision loss due to inflammation of the light-sensing layer of the eye (retinitis)
- Digestive system problems, such as inflammation of the colon (colitis), esophagus (esophagitis), and liver (hepatitis)
- Nervous system problems, including brain inflammation (encephalitis)
- Pneumonia
- Premature birth
- Low birth weight
- Yellow skin and eyes (jaundice)
- Enlarged and poorly functioning liver
- Purple skin splotches or a rash
- Abnormally small head (microencephaly)
- Enlarged spleen These complications can occur in people with weakened immunity or infants who have congenital CMV. Healthy adults generally experience few or no symptoms. It's important to practice careful hygiene to prevent the spread of CMV, such as washing hands frequently and avoiding contact with body fluids from infected individuals. If you have a weakened immune system and experience symptoms of CMV infection, consult your doctor.
Prevention
CMV can be prevented through careful hygiene practices, such as:
- Washing your hands often with soap and water for at least 15 to 20 seconds, especially after coming into contact with young children, their diapers, saliva, or other oral secretions.
- Avoiding touching your eyes, nose, or mouth after coming into contact with the body fluids of an infected person.
- Practicing safe sex by using condoms during sexual contact to prevent the spread of CMV through semen and vaginal fluids.
- Avoiding breast milk from an infected mother.
- Ensuring proper hygiene during organ, bone marrow, or stem cell transplantation, and blood transfusions. For pregnant women, taking precautions to prevent CMV infection can be crucial in reducing the risk of transmission to their babies. Pregnant women should maintain good hygiene and avoid contact with urine, saliva, blood, and other bodily fluids from infected individuals.
Treatment
Treatment for Cytomegalovirus (CMV) infection primarily focuses on managing symptoms. Since there is no cure for the virus, the goal is to alleviate the symptoms and support the body's natural defenses. Medications that may be prescribed for CMV infections include:
- Antiviral medications: These medications can help reduce the severity and duration of symptoms in people with weakened immune systems. Examples include valganciclovir, ganciclovir, and foscarnet.
- Pain relievers and fever reducers: Over-the-counter medications such as acetaminophen (paracetamol) or ibuprofen can help manage fever and discomfort.
- Supportive care: In cases where the infection causes complications, supportive care may be necessary. This can include fluids, nutrition support, and treatments for specific complications such as pneumonia or encephalitis. It's essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment plan, as the treatment options may vary based on individual factors such as age, overall health, and the severity of the infection. Remember to practice good hygiene to prevent the spread of CMV, such as washing your hands frequently and avoiding sharing food, drinks, or utensils with others.