Topic: Cytomegalovirus (CMV)
Description
Cytomegalovirus infection is a common viral illness. Infection in children and adults is usually without symptoms but occasionally, symptoms similar to glandular fever can occur. In patients who have a lowered immunity from some cancers, cancer treatment or AIDS, the infection can be more severe. The most severe form of the disease occurs in infants born to mothers who became infected for the first time while pregnant. The risk of babies developing the disease appears greater if the mother becomes infected in the first half of the pregnancy. These babies may have severe damage to the brain and liver with symptoms which may include an enlarged liver, jaundice, evidence of chronic liver disease, hearing loss, progressive visual loss, convulsions and mental retardation. Severely affected babies may die in-utero or soon after birth. In healthy adults, complications rarely occur.
Symptoms
Cytomegalovirus infection in healthy people often causes no symptoms. A small number of people will experience a glandular fever like illness with a sore throat, aches and pains and sore glands. The symptoms usually last two to three weeks.
Transmission
The infection spreads in different ways. Infants usually get the infection while in utero or during birth. Young children are frequently infected by contaminated saliva when sucking and sharing toys. People with weakened immune systems may have a return of a previous infection with CMV or may be infected with a new strain of the virus.
Illness following a transplant or transfusion with infected blood begins within three to eight weeks. Infections acquired by babies during delivery may not be evident for three to twelve weeks after birth. Babies that become infected early in life can have the virus in their urine or saliva for up to six years after the initial infection. Adults carry the virus for a shorter period of time but the virus can persist as a dormant infection.
Treatment
Usually no treatment is required. Antiviral drugs and/or human immune globulin have been used in some cases where the infection has been acquired after a transplant, or in the case of AIDS patients, with limited success.
Health Outcome
Cytomegalovirus infection is very common. By adulthood, 40% or more of the adult population have been infected. Most of these infections will have been acquired in childhood and many of the children would have had no symptoms. As cytomegalovirus is very common, it is likely that many people will be infected with the virus at some time in their life. Because most infections are not apparent, people may be infected or acquire the infection and not realise it. As the infection is never eliminated from the body, the symptoms from the virus can show years later if the person’s immune system is weakened, such as those with some cancers, those undergoing cancer treatment, or people with AIDS.
Prevention
Report any illness in children to the director of the child care centre or school. Children with CMV infection do not need to be excluded from child care or school as the virus may be present in saliva and urine for many years and it would not be possible to know when the child is clear of the disease. Practice good hygiene: wash your hands with warm soapy water before preparing food, after going to the toilet and after changing a nappy.
Help and Assistance
For further information, please contact your local doctor, community health centre or nearest public health unit.
Footnotes
Heymann, D. L. ed. Control of Communicable Diseases Manual, 18th edition. Washington, DC: A m e r i c a n P u b l i c H e a l t h Association, 2004: 142-146.
Office of Communications, National Institute of Allergy and Infectious Diseases, National Institute of Health. (March 1995).
Cytomegalovirus Infection, [Online]. Available HTTP: http://www.niaid.nih.gov/factsheet s/cmv.htm [1997, May 22].
National Health and Medical Research Council, 2003. The Australian Immunisation Handbook (8th Ed.) Canberra: National Capital Printing.
Last Updated: 9th August, 2010
Date Valid to: 31st December, 2010
