What is Congenital CMV Infection?
Congenital
Cytomegalovirus (CMV) infection occurs when a baby is infected with the CMV virus before birth. CMV is a common virus that infects people of all ages, and it is a member of the
Herpesvirus family. When a pregnant woman is infected with CMV, the virus can be transmitted to the developing fetus, leading to congenital CMV infection.
How Common is Congenital CMV?
Congenital CMV infection is the most common congenital viral infection worldwide. It affects approximately 0.5% to 1% of all live births. Despite its prevalence, public awareness about congenital CMV is relatively low compared to other congenital infections. What are the Symptoms and Complications?
While many infants with congenital CMV infection are asymptomatic at birth, approximately 10-15% will exhibit symptoms. These can include jaundice, petechiae, hepatosplenomegaly,
microcephaly, and intrauterine growth restriction. Long-term complications may include hearing loss, vision impairment, intellectual disabilities, and developmental delays.
How is Congenital CMV Diagnosed?
Congenital CMV infection is diagnosed by detecting CMV DNA in a newborn's saliva, urine, or blood within the first three weeks of life. This is typically done using a polymerase chain reaction (PCR) test. Early diagnosis is crucial for managing potential complications. What are the Risk Factors?
The primary risk factor for congenital CMV infection is maternal CMV infection during pregnancy, particularly primary infection. Women who work in environments with high exposure to young children, such as daycare centers, have a higher risk of CMV infection during pregnancy. Good hygiene practices, such as handwashing, can help reduce the risk.
What is the Treatment for Congenital CMV?
Treatment for symptomatic congenital CMV infection may involve antiviral medications, such as
ganciclovir or valganciclovir. These medications can help reduce the severity of symptoms and improve long-term outcomes, particularly for hearing loss. However, treatment is most effective when started early, ideally within the first month of life.
What are the Preventive Measures?
Preventing congenital CMV infection involves reducing the risk of maternal infection. Pregnant women can be advised to practice good hygiene, avoid sharing food, utensils, or drinks with young children, and to wash their hands frequently. Public health education and awareness campaigns can also play a significant role in prevention.
What is the Prognosis for Affected Infants?
The prognosis for infants with congenital CMV infection varies. Asymptomatic infants at birth generally have a good prognosis, although they may still develop complications such as hearing loss later in life. Symptomatic infants at birth are at higher risk for serious long-term health issues. Early intervention and regular follow-up can help manage and mitigate these complications. How Does Congenital CMV Compare to Other Congenital Infections?
Congenital CMV is part of a group of infections known as
TORCH infections, which also includes Toxoplasmosis, Other (such as syphilis), Rubella, and Herpes simplex virus. Among these, CMV is the most common and can lead to significant morbidity. Unlike some other TORCH infections, there is currently no vaccine for CMV, highlighting the importance of preventive measures and early diagnosis.
What Research is Being Conducted?
Research on congenital CMV is ongoing, with efforts focusing on developing a
CMV vaccine, improving diagnostic techniques, and finding more effective treatments. Studies are also exploring the role of maternal immunity and the potential use of immunoglobulin therapy to prevent fetal infection.
