FREQUENTLY ASKED QUESTIONS ABOUT CMV

What Is CMV?

Cytomegalovirus, or CMV, is a common virus that infects people of all ages. Once CMV is in a person's body, it stays there for life. Most infections with CMV are "silent," meaning most people who are infected with CMV have no signs or symptoms. However, CMV can cause disease in unborn babies and in people with a weakened immune system.

CMV is a member of the herpesvirus family, which includes the herpes simplex viruses and the viruses that cause chickenpox (varicella-zoster virus) and infectious mononucleosis (Epstein-Barr Virus).

Who Is at Risk for CMV Disease?

Anyone can become infected with CMV. Most healthy adults and children who have a CMV infection will have few, if any, symptoms. However, certain groups are at higher risk of getting CMV disease. These groups include:

· Unborn babies who are infected during pregnancy

· People with a weakened (immunocompromised) immune system

Risk of CMV infection is likely to be reduced by careful attention to good personal hygiene, such as hand washing.

How Is CMV Spread?

· Person-to-person contact (such as, kissing, sexual contact, and getting saliva or urine on your hands and then touching your eyes, or the inside of your nose or mouth).

· Through the breast milk of an infected woman who is breastfeeding.

· Infected pregnant women can pass the virus to their unborn babies.

· Blood transfusions and organ transplantations.

CMV is sometimes found in body fluids, including urine, saliva (spit), breast milk, blood, tears, semen and vaginal fluids. A person can become infected with CMV when they come in contact with infected body fluids. However, people who are CMV-positive (have been infected with CMV sometime in the past) usually do not have virus in these fluids, so the chance of getting a CMV infection from casual contact is very small.

Contact with the saliva or urine of young children is a major cause of CMV infection among pregnant women.

Women who are pregnant or planning a pregnancy should follow hygienic practices (e.g., careful hand washing) to avoid CMV infection. Because young children are more likely to have CMV in their urine or saliva (spit) than are older children or adults, pregnant women who have young children or work with young children should be especially careful.

What Are the Signs and Symptoms of CMV?

Most healthy children and adults infected with CMV have no symptoms and may not even know that they have been infected. Others may develop a mild illness. Symptoms may include fever, sore throat, fatigue and swollen glands. These symptoms are similar to those of other illnesses, so most people are not aware that they are infected with CMV.

Most babies born with CMV (in other words, "congenital" CMV) never develop symptoms or disabilities. When babies do have symptoms, some can go away but others can be permanent.

Examples of symptoms or disabilities caused by congenital (meaning present at birth) CMV:

In some children, symptoms do not appear until months or years after birth. The most common of these late-occurring symptoms are hearing loss and vision loss. Children with congenital CMV are more likely to have permanent disabilities and symptoms that get worse if they had symptoms of CMV infection at birth. But, some children who appear healthy at birth can develop hearing or vision loss over time due to congenital CMV. For this reason, if you know your baby was born with CMV, it is important to have her or him hearing and vision tested regularly.

What Health Problems Does CMV Cause in Babies?

· Hearing loss

· Vision loss

· Mental disability

· Lung problems

· Bleeding problems

· Spleen problems

· Liver problems

· Growth problems

CMV can cause symptoms when the baby is born or later in the baby's life. Most babies born with CMV never develop symptoms or disabilities. In some infants, hearing or vision loss occur months or years after birth.

How Do I Know If I Have CMV?

Most CMV infections are not diagnosed because the infected person usually has few or no symptoms. However, persons who have been infected with CMV develop antibodies to the virus, which may stay in a person's body for their lifetime. Antibodies are immune proteins that are the body's response to infection.

A blood test can tell a person if they have CMV, but this test is not commonly performed. Laboratory tests can detect the virus in a person's body fluids (blood or urine) or by a tissue biopsy (a small piece of the body's tissue). CMV also can be detected in the body by measuring the antibodies (immune proteins) in the blood targeted against CMV. This is called serologic testing.

Congenital CMV disease is most likely to occur when a woman is infected for the first time during a pregnancy. This is known as a primary CMV infection. Primary infections occur in 1 percent to 4 percent of seronegative (have no CMV antibodies) pregnant women and lead to fetal infection in one-third of these pregnancies. In women who are already infected before becoming pregnant (CMV seropositive women), CMV reactivation or reinfection leads to fetal infection in less than 1 percent of pregnancies. Approximately 10 percent of congenitally infected infants who have symptoms at birth, and of the 90 percent who have no symptoms, 10 percent to 15 percent will develop symptoms over months or even years.

How Do You Prevent CMV During Pregnancy?

No actions can eliminate all risks of becoming infected with CMV, but there are measures that can reduce spread of the disease:

· Wash hands often with soap and water, especially after changing diapers. Wash well for 15 to 20 seconds.

· Do not kiss young children under the age of 5 or 6 on the mouth or cheek. Instead, kiss them on the head or give them a big hug.

· Do not share food, drinks or utensils (spoons or forks) with young children.

· If you are pregnant and work in a day care center, reduce your risk of getting CMV by working with children who are older than 2 ? years of age, especially if you are CMV seronegative (have never been infected with CMV) or are unsure if you are seronegative.

If I Have a Baby With Congenital CMV, Will My Next Baby Also Have Congenital CMV?

Nearly all women who have one baby with congenital CMV will be protected from future CMV infections because they have developed immunity. There have been few reports of mothers who gave birth to more than one baby with congenital CMV. However, these cases are rare.

Is There a Treatment for CMV?

Currently, no treatment is recommended for CMV infection in the healthy individual, including pregnant women. However, antiviral drugs ganciclovir and valganciclovir are being used for patients with weakened immune systems. Antiviral drugs are being tested in infants born with congenital CMV. Because of its strong side effects, ganciclovir should only be considered for infants with severe congenital CMV disease.

Vaccines for preventing CMV infection are still in the research and development stage.