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Topic of the Month : Cytomegalovirus (CMV) Disease

The Impact of CMV Infection

CMV is the most common congenital (present at birth) viral infection in the U.S. Each year, about 5,500 (1 in 750) children in this country are born with or develop disabilities that result from congenital CMV infection. More children have disabilities due to this disease than other well-known congenital infections and syndromes, including Down syndrome, fetal alcohol syndrome, spina bifida, and pediatric HIV/AIDS.

Babies with congenital CMV infection may develop hearing or vision loss, mental disability, liver problems, or growth problems. About half of infants with symptoms of congenital CMV infection will develop permanent health problems within the first few years of life. Sometimes, problems such as hearing or vision loss do not occur until months or years after birth; 10–15% of infected infants who show no symptoms at birth develop health problems later, most commonly hearing loss. With proper care, most infants with CMV disease survive.

People can be infected with CMV more than once. In the U.S., about 50–60% of women of reproductive age are at risk for a primary (first) CMV infection. Primary infections occur in 1–4% of pregnant women. About one-third of these primary infections result in a congenital infection in the fetus. In fact, congenital infection is most likely to occur following a primary CMV infection in the mother. Rates of infection are much higher among racial/ethnic minorities and people with a low household income.

Chart: U.S. Children Born with or Developing Long-Term Medical Conditions Each Year. Annual number of children affected. Cytomegalovirus (CMV): 5,500; Fetal Alcohol Syndrome (FAS): 5,000; Down Syndrome: 4,000; Spina Bifida/Anencephaly: 3,000; Pediatric HIV/AIDS: 200; Invasive Haemophilus Influenzae Type B: 60; Congenital Rubella Syndrome (CRS): 10.Chart: Women's Awareness of Conditions Affecting Children. Percentage of women who had heard of these diseases Cytomegalovirus (CMV): 22%; Parvovirus B19: 32%; Congenital Toxoplasmosis: 37%; Congenital Rubella Syndrome (CRS): 53%; Group B Strep (GBS): 59%; Spina Bifida: 76%; Fetal Alcohol Syndrome (FAS): 83%; Sudden Infant Death Syndrome (SIDS): 94%: Down Syndrome: 97%; HIV/AIDS: 98%.


Few Women Know about CMV

In one survey, only 22% of women in the U.S. had heard of CMV, compared with 97% who had heard of Down syndrome and 98% who had heard of HIV/AIDS (Jeon 2006). A more recent study found that only 14% of women in the U.S. had heard of CMV (Ross 2008). In addition, research indicates that fewer than half of obstetricians talk to their pregnant patients about CMV (MMWR, Jan. 25, 2008). 

CMV Transmission during Pregnancy

CMV is spread from person to person by close contact with body fluids, such as blood, urine, saliva, semen, vaginal fluids, and breast milk. Once CMV is in a person's body, it stays there for life. Most people who become infected with CMV have mild, flu-like symptoms or no symptoms at all; the exceptions are infants with congenital infection or people who have weakened immune systems.

For pregnant women, sexual contact is a common source of CMV infection. Limiting sexual partners and practicing safe sex may reduce the risk of catching CMV.

Another common source of infection for pregnant women is contact with the urine or saliva of young children who are infected with CMV and are shedding the virus. (When virus is "shedding," it is moving from the body of an infected person into the environment.) Parents of young children who are shedding CMV virus are several times more likely to catch CMV than are parents whose children are not shedding virus. Even so, CMV does not spread easily. In fact, fewer than 1 in 5 parents whose children are shedding CMV become infected over the course of a year.

While a pregnant woman cannot completely eliminate the risk of catching CMV from young children, she can help reduce the chances of infection by not getting children's urine or saliva in her eyes, nose, or mouth.

Graphic: Ways a pregnant woman may help reduce her exposure to CMV. Washing hands frequently with soap and water, especially after changing diaper, feeding a child, wiping a child's nose or drool, or handling children's toys. Not sharing cups, plates, utensils, food or toothbrushes. Not sharing towels or washcloths. Not putting child's pacifier in her mouth. Cleaning toys, countertops, and anything else that comes into contact with children's urine or saliva.


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