Cytomegalovirus (CMV) infection

Cytomegalovirus (CMV) is a common, widespread virus. Related to the viruses that cause herpes simplex, chickenpox and glandular fever (mononucleosis), it spreads through bodily fluids, such as saliva, blood, urine, semen, vaginal fluids and breast milk. 

A Cytomegalovirus blood sample

People are usually infected by the time they are two years old or during their teenage years, and carry the virus for life – but it generally goes undiagnosed, as CMV doesn’t typically cause symptoms. Most adults carry the virus by the time they are 40 years old. 

Rarely, CMV can cause a healthy person to become sick and could cause liver, lung, intestinal and nervous system complications and CMV mononucleosis.

Newborn babies, organ transplant recipients and those with weak immune systems such as HIV/AIDS patients are at risk of developing serious conditions due to this virus, such as pneumonia, gastrointestinal disease and many other serious illnesses.  

If a woman gets CMV during pregnancy, she could possibly pass it on to her baby. When it affects a baby in the womb, it’s known as congenital CMV. This may lead to birth defects or conditions such as hearing loss, mental disability, seizures and even death. 

What are the symptoms?

As CMV is a widespread and common virus that can infect almost anyone, there are no specific risk factors. Most cases of CMV don’t cause symptoms, which is why it often goes undiagnosed, but when they do, these include:

  • Sore throat
  • Swollen lymph nodes 
  • Fever
  • Headache
  • Fatigue
  • Weakness
  • Muscle aches
  • Loss of appetite

Newborns infected with CMV in the womb can be very sick when they are born. 

Symptoms at birth may include:

  • Jaundice 
  • Enlarged liver
  • Pneumonia
  • Low weight
  • Seizures
  • Enlarged spleen

How is it diagnosed? 

As there are no symptoms in most cases, a CMV diagnosis can be difficult. 

Doctors may order a blood test for a baby with the symptoms of congenital CMV. The diagnosis needs to be confirmed by testing blood or tissue within three weeks of birth.

Healthy young adults usually recover within a few weeks and do not need to be tested specifically for CMV. As similar symptoms can be caused by the Epstein-Barr virus (EBV — one of the eight viruses in the herpes family that causes glandular fever) and the HIV/AIDS virus, blood tests may be done to confirm the cause of the illness.

Tests may also be needed to monitor blood levels and liver inflammation. 

Ultrasound testing may be needed to monitor the liver or spleen in some cases.

For people with HIV/AIDS who have a severely weakened immune system, or for people who have had an organ or bone marrow transplant, a CMV diagnosis typically involves a detailed physical examination and blood tests. 

A biopsy of the affected organ, such as the lung or colon, may be needed to confirm the diagnosis.

What are your treatment options? 

The treatment of babies infected with CMV depends on the type and severity of symptoms. Treatment should be provided on an individual basis.

Healthy people generally do not need any specific treatment for CMV.

Although there is no cure for CMV, organ transplant recipients, people with HIV/AIDS and others immune disorders may need treatment to suppress the infection such as antiviral medication. 

Treatment for CMV may include trying to treat the underlying immune disorder. Experience in treating people with AIDS, for example, shows that when a person’s immune system improves, CMV-related diseases can improve.

Can it be prevented? 

There is no cure for CMV and prevention of a CMV infection is not always possible. There are steps you can take to reduce the risk though. These include:

  • Practising good hygiene, such as regularly washing your hands with soap and warm water. This is important after changing nappies.
  • Try to avoid coming into contact with the saliva of young children.

IMAGE CREDIT: 123rf.com

The accuracy of this information was checked and approved by physician Dr Thomas Blake in June 2016