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Congenital Cytomegalovirus (CMV) Infection: Causes, Symptoms, Risk factors, Diagnosis, Treatment And

National Cytomegalovirus (CMV) Awareness Month is observed in June every year to increase awareness about Cytomegalovirus (CMV) infection, which is the most common cause of birth defects. In most severe cases, it can cause the death of an unborn baby as well.

Cytomegalovirus (CMV) is a virus that belongs to the Herpesviridae family. The other members that belong to the Herpesviridae family are Epstein-Barr virus (EBV), herpes simplex virus 1 and 2 (HSV-1, -2), varicella-zoster virus (VZV), and human herpesvirus 6, 7, and 8 (HHV-6, -7, -8) [1].

Globally, cytomegalovirus (CMV) is the leading cause of congenital infections. It is a common cause of non-genetic hearing loss in children and delays neurodevelopment [2]. When a baby is born with cytomegalovirus (CMV) infection, it's called congenital cytomegalovirus (CMV) infection. Congenital cytomegalovirus (CMV) infection affects approx 0.7 per cent of newborns [3].

What Causes Congenital Cytomegalovirus (CMV) Infection?

Pregnant mothers seroconverting during pregnancy(primary infection) or an infection that is recurring in the pregnant mother(nonprimary infection) during pregnancy increases the chances of congenital cytomegalovirus (CMV) infection in her unborn baby [4]. The cytomegalovirus in the mother's blood can cross through the placenta and infect the baby.

There are various ways the CMV infection is transmitted from the mother to child [5].

• CMV is transmitted from the mother to foetus in 35 per cent of pregnancies due to primary infection. Maternal primary infection in the first trimester causes foetal disorders and results in disabilities due to hearing loss, vision loss or damage of the central nervous system. CMV infection can also be transmitted from mother to foetus if the mother had recurring CMV infection in the past.

• CMV infection can also transmit during birth, which occurs when the virus is present in the cervix or vagina.

• CMV transmission through breast milk is common. Infants who are breastfed by their mothers are CMV antibody positive and this spreads CMV in infants in the first year of life.

CMV can be present in a child's body fluids for months after they are infected. According to the American Pregnancy Association, there is an increased risk of CMV transmission from mother to the baby if she gets a primary CMV infection in the third trimester, which is about 40 to 70 per cent and the risk decreases in the first or second trimester, which is about 30 to 40 per cent [6].

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Symptoms Of Congenital Cytomegalovirus (CMV) Infection

Most babies infected with congenital cytomegalovirus (CMV) show no symptoms after birth. However, some babies show symptoms at birth. These symptoms are: [7]

• Rash
• Jaundice
• Low birth weight
• Seizures
• Microcephaly (small head)
• Hepatosplenomegaly (enlarged liver and spleen)
• Retinitis (damaged eye retina)

Some babies who show symptoms of congenital cytomegalovirus (CMV) infection at birth can have health problems for a longer period of time. These include:

• Hearing and vision loss
• Developmental and motor delay
• Seizures
• Microcephaly (small head)

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Risk Factors Of Congenital Cytomegalovirus (CMV) Infection

Women who have frequent contact with young children before delivery, especially if you are a childcare provider, women who became sexually active within the two years before delivery and women who have sexually transmitted diseases during pregnancy are at a greater risk of delivering their baby with congenital cytomegalovirus (CMV) infection [8].


Diagnosis Of Congenital Cytomegalovirus (CMV) Infection

According to the Centers for Disease Control and Prevention (CDC), the diagnosis of congenital cytomegalovirus (CMV) infection in newborn babies is done by testing the saliva, urine or blood within two to three weeks after the baby is born [9].

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Treatment Of Congenital Cytomegalovirus (CMV) Infection

Congenital cytomegalovirus (CMV) infection can be treated with antiviral medications such as valganciclovir that may help improve hearing and developmental problems in babies with symptoms of CMV infection. However, the use of valganciclovir has been shown to have serious side effects in babies [10].


Prevention Of Congenital Cytomegalovirus (CMV) Infection

• Wash your hands often with soap and water, especially if you have come in contact with young children or their diapers or saliva. This is important if you are a childcare provider.

• If you are pregnant avoid contact with tears and saliva when you kiss a child.

• Be careful when you dispose of diapers, tissues and other items that have been contaminated with bodily fluids.

• Practice safe sex.

• Clean toys and surfaces that may have come in contact with children's urine or saliva.

Common FAQs

Q. What does CMV do to a baby?

A. CMV can cause birth defects and delay neurodevelopment in babies.

Q. How common is congenital CMV?

A. According to the CDC, about one out of every 200 infants is born with congenital cytomegalovirus (CMV) infection. And around one in five babies will have long-term health problems.

Q. Does cytomegalovirus cause brain damage?

A. Yes, cytomegalovirus can cause damage to the brain.

Q. Is CMV dangerous?

A. Primary CMV infection poses serious problems during pregnancy than recurrent CMV infection. It can cause birth defects in some babies.

Story first published: Thursday, June 11, 2020, 12:11 [IST]