Cytomegalovirus (CMV) infection - Symptoms, causes & Treatment

Paediatrics | Posted on 09/06/2024 by RBH

Have you recently given birth, but your joy was dampened by the news that your child has Cytomegalovirus (CMV)? Most parents find themselves in a similar situation when a child is diagnosed with this condition. It’s a common virus that is a member of the herpesvirus family. It affects people of all age groups, however, it might cause health complications for infants, expectant mothers, and those with compromised immune systems.

According to the estimates of the National Institute of Health, it affects 83% of the general population, 86% of women of childbearing age, and 86% of donors of blood or organs globally. CMV is still a little-known but significant viral infection that can have major health effects, even with its high prevalence. If you or your loved one are diagnosed with CMV, book your appointment with one of the best Pediatrics at the CK Birla Hospitals in Jaipur to receive the best course of treatment.

This blog involves important aspects of CMV such as symptoms, types, causes, risks, diagnosis, treatment options, and precautionary measures. The aim is to offer CMV patients the understanding and resources they require to manage this condition with the proper care and attention.

What is Cytomegalovirus?

Cytomegalovirus (CMV) is one of the herpes virus types that is common around the world. It is related to the varicella-zoster virus, causing chickenpox and shingles, and the herpes simplex virus, which causes cold sores and genital herpes. 

Although anyone can contract CMV, the virus does not fully mature in the body for a very long time after the original infection. The majority of people with strong immune systems remain unaware after contracting CMV as they rarely experience any symptoms.

CMV can reactivate in people who have weak immune systems including organ transplant recipients, HIV/AIDS patients, and babies whose mothers got infected with the virus while they were pregnant.

Cytomegalovirus Symptoms

Some of the common cmv symptoms are age, immunological condition, and whether the infection is primary or reactivated. The main symptoms are as follows:

• Fatigue and fever: The two most prevalent symptoms, which might last for several weeks.
• Sore throat: It is often confused with mononucleosis or a viral sore throat.
• Inflamed Glands: Involves enlarged lymph nodes, especially in the neck area.
• Muscle Aches: Pain in the muscles that is widespread and resembles the flu.
• Jaundice: A yellowing of the eyes and skin, especially in infants who have congenital CMV.
• Hearing Loss: Infants born with CMV are at high risk for progressive hearing loss.
• Seizures: Seizures are an outcome of the central nervous system involvement in complex cases, mainly in infants.

What are the Types of Cytomegalovirus?

Depending on when and how the infection develops, CMV can show up in different forms. The primary types consist of:

• Congenital CMV: It occurs when a mother contracts CMV during pregnancy Severe complications of this type involve loss of hearing, eyesight damage, and growth delays.
• Primary CMV Infection: Children or young adults are typically the ones who contract the infection. Symptoms are often minimal or don’t even exist in healthy people.
• Reactivated CMV: It occurs in people with weak immune systems, which might lead to problems like pneumonia or gastrointestinal ulcers.
• CMV in Immunocompromised Patients: This type can lead to fatal diseases such as retinitis, encephalitis, or colitis in people who have impaired immune systems drastically impaired, for instance, patients receiving chemotherapy.

What are the Causes of Cytomegalovirus?

Direct contact with bodily fluids that are infected with CMV can spread the infection, including:

• Saliva: Kissing or sharing cutlery can spread the infection.
• Urine: Especially a problem in places like daycare facilities.
• Blood and Blood Products: Organ transplants or blood transfusions from a CMV-positive donor have the potential to transmit the virus.
• Vaginal secretions and semen: The most common cause of CMV by coming in contact with an infected person sexually.
• Breast milk: A mother can spread the infection to the baby during nursing.
• Transplacental Transmission: A mother can transmit the infection to her unborn baby during pregnancy.

What are the Risks and Complications of Cytomegalovirus?

CMV is usually safe in healthy people, but it presents serious risks or complications to the following groups:

• Congenital CMV in newborns: CMV is the most common cause of non-genetic hearing loss and can also cause catastrophic side effects such as seizures, microcephaly, visual loss, and delays in developmental milestones.
• Immunocompromised: CMV can cause serious side effects in those with damaged immune systems, including pneumonia, gastrointestinal ulcers, hepatitis, and retinitis, which can result in blindness.
• Pregnant Women: Congenital CMV may result from a woman contracting CMV during her pregnancy, as the virus can pass through the placenta and infect the developing foetus.
• Organ Transplant Recipients: CMV infection or reactivation can occur which might lead to organ rejection or other serious complications after organ transplantation.

How is Cytomegalovirus Diagnosed?

A healthcare expert involves the combination of testing and medical assessment is used to confirm the diagnosis of CMV. Here are some of the important diagnostic approaches involved:

• Serological tests: These involve blood examinations to determine CMV antibodies (IgM and IgG), indicating the existence of an infection either now or in the past.
• Polymerase Chain Reaction (PCR): This is a sensitive test that helps determine CMV DNA in bodily fluids through blood, saliva, or urine and indicates an existing infection.
• Urinal or Saliva Tests: This test can be carried out on newborn babies in the first three weeks through their urine or saliva to confirm the infection.
• Biopsy: A tissue biopsy may often be performed to identify CMV in the affected organs such as the lungs or digestive system.
• Imaging Tests: These tests involve ultrasound, MRI, or CT scans to detect the level of organ involvement.

What are the Treatment Options for Cytomegalovirus?

The treatment course for CMV is identified by the patient's immunological condition and the severity of the infection. Here are some of the involved treatment options:

• Antiviral Medications: Medications like cidofovir, foscarnet, ganciclovir, and valganciclovir are often recommended to treat CMB. It is especially prescribed to people with impaired immune systems, as these help control symptoms and reduce the virus load.
• Immunoglobulin Therapy: Intravenous immunoglobulin (IVIG) may be involved in certain cases to strengthen the immune system, mainly in transplant recipients.
• Supportive Care: This involves rest, fluids, and pain medication and is often recommended to people with mild symptoms, especially in healthy people.
• Hearing Aids and Cochlear Implants: Early interference with cochlear implants or hearing aids can broadly enhance the results for children with congenital CMV linked to hearing loss.
• Monitoring and Frequent Check-Ups: Regular monitoring and follow-up care with a healthcare expert must be ensured to reduce the risk of complications.

What are the Prevention Tips for Cytomegalovirus?

Preventing CMV infection, particularly in high-risk groups, involves several strategies:

• Good Hygiene Practices like regular handwashing with soap and water
• Using condoms and practising safe sex 
• Avoid sharing utensils, food, or drinks with others
• Pregnant females must be aware of CMV risks and discuss screening and monitoring options with their healthcare experts.
• Blood and organ donors should be screened for CMV before blood transfusions or transplants.
• People with weak immune systems should avoid close contact with active CMV infection.

Conclusion

Most people will at some point in their lives come into contact with the cytomegalovirus, which usually has no lasting effects. Still, CMV can be extremely dangerous for high-risk groups, including infants, expectant mothers, and people with compromised immune systems. To effectively manage this condition, one must have a thorough understanding of its symptoms, types, causes, risks, and prevention techniques. 

Initial diagnosis and prompt treatment can alleviate difficulties while maintaining proper hygiene and taking preventive steps can drastically lower the chance of infection. Speak with a healthcare professional to determine the best course of action if you or a loved one has been diagnosed with CMV or is at risk for it.

FAQs

Is CMV Contagious?

Cytomegalovirus (CMV) is transmissible. Bodily fluids like blood, urine, semen, saliva, and breast milk are the primary sources of transmission. The virus can be transmitted by close contact, such as kissing or coming into contact with an infected person sexually. However, even when sick, healthy people frequently don't exhibit any symptoms.

Who is at Higher Risk for CMV?

People with compromised immune systems such as individuals living with HIV/AIDS, organ transplant recipients, expectant mothers, and neonates, are more prone to severe complications that result from Cytomegalovirus (CMV). Healthcare professionals and daycare providers are also at a higher risk of contracting the virus.

How is Cytomegalovirus Transmitted?

Coming into contact with infected bodily fluids, such as saliva, blood, urine, semen, and breast milk, is how cytomegalovirus (CMV) is transmitted. Pregnant women should be concerned about it since it can be transferred from a mother to her unborn child during pregnancy, childbirth, or breastfeeding. 

Is Cytomegalovirus Curable?

There is no known cure for cytomegalovirus (CMV), antiviral drugs can be used to treat its symptoms and consequences, particularly in those with compromised immune systems. Treatment is rarely necessary for healthy individuals because the virus usually remains dormant and causes no problems. 

Is Cytomegalovirus Dangerous?

Cytomegalovirus (CMV) infection can be harmful, especially to young children, expectant mothers, and those with compromised immune systems. Serious health concerns, including organ damage in immunocompromised people and developmental difficulties in babies, can result from it.

How to Test for Cytomegalovirus?

The usual method for diagnosing cytomegalovirus (CMV) is blood testing that looks for the virus's DNA or CMV antibodies. Samples of tissue, saliva, or urine may also be analysed in specific circumstances. If CMV is detected, pregnant patients and babies may be subjected to more focused testing.