Contents
In line with its mission, the Editorial Board of MedTvoiLokony makes every effort to provide reliable medical content supported by the latest scientific knowledge. The additional flag “Checked Content” indicates that the article has been reviewed by or written directly by a physician. This two-step verification: a medical journalist and a doctor allows us to provide the highest quality content in line with current medical knowledge.
Our commitment in this area has been appreciated, among others, by by the Association of Journalists for Health, which awarded the Editorial Board of MedTvoiLokony with the honorary title of the Great Educator.
Should you be concerned about cytomegalovirus?
An infectious disease caused by infection cytomegalovirus (CMV). This virus belongs to a large family of viruses Herpes and it is widespread and its only host is man. The high prevalence of the virus is evidenced by studies which show that almost 70% of the population has positive antibodies that indicate an infection. The specificity of the virus is the ability to remain latent in the human body for many years after the initial infection. The virus may be activated in situations such as: immunosuppression, pregnancy.
How is it infected?
In a sick person, the virus is present in saliva, tears, urine, semen, vaginal discharge, blood and breast milk. The infection most often occurs as a result of direct contact with the patient’s saliva or urine and as a result of sexual contact.
In addition, infection can also occur as a result of blood or organ transplantation.
A specific route of infection is the vertical route – that is, the penetration of the virus through the placenta, which leads to congenital infection of the fetus. Due to the presence of the virus in breast milk, there is also a risk of infection of the baby during the breastfeeding period.
Should you be concerned about CMV?
The disease is especially dangerous for two groups:
- pregnant women – due to the risk of congenital cytomegaly
- people in states of immunosuppression, e.g. in the course of cancer, after organ or bone marrow transplants, HIV infection
On the other hand, in people with normal immunity, the disease is almost 100% imperceptible (asymptomatic) or very mild without any sequelae.
How is CMV infection manifested?
As mentioned above, in most cases we do not even know that we have had CME.
In symptomatic forms, the disease resembles an infectious mononucleosis or a flu-like disease: fever, joint and muscle pain, enlargement of the lymph nodes and the liver.
Due to the fact that cytomegalovirus shows tropism to the liver cells, the disease can also take the form of hepatitis (jaundice, epigastric discomfort, weakness, loss of appetite).
Serious cytomegalovirus infections include:
- infections after blood transfusion – fever that lasts for several weeks, interstitial pneumonia, hepatitis and mononukloeosis-like syndrome are observed
- infections in people with immunodeficiencies – symptomatic cytomegaly is most often the result of latent virus activation and the disease can take the form of: retinoblastitis and choroiditis, encephalitis, interstitial pneumonia, pancreatitis or gastrointestinal inflammation
- congenital cytomegaly – the risk of fetal infection exists at any stage of pregnancy, however, in the case of activation of a latent virus, the risk is only about 1%; on the other hand, infection is very dangerous in a pregnant woman who has not been infected before – then the risk of infection of the fetus reaches 50%.
Infection may result in spontaneous abortion, death of the fetus or the birth of a child with symptoms of congenital CMV disease. The classic symptoms of congenital cytomegaly are hepatosplenomegaly (enlargement of the liver and spleen), damage to the nervous system (paresis, brain damage, microcephaly or hydrocephalus), retinitis and choroiditis, jaundice, deafness; some symptoms, such as psychomotor impairment, may not appear until school age.
How to determine the disease?
Classic diagnosis of cytomegalovirus is the detection of the virus in urine, saliva, cerebrospinal fluid, respiratory and genital secretions, and in the amniotic fluid.
Most often, the first and basic tests are serological tests that detect IgG and IgM antibodies. The presence of IgM class antibodies indicates a recent infection.
If an infection is suspected during pregnancy, it is very important to distinguish an active infection from a latent infection – genetic testing (PCR) is helpful to determine the amount of virus in the amniotic fluid and to distinguish between the two forms of infection.
What is the treatment of cytomegalovirus?
In symptomatic CMV in patients with normal immune systems, treatment is symptomatic.
Antiviral treatment is used in cases of cytomegalovirus in people with immunodeficiency, after transplantation or after blood transfusion. The drug that affects the virus is ganciclovir, the use of which, unfortunately, is associated with numerous serious side effects, such as hepatotoxicity, bone marrow damage or gastrointestinal symptoms: vomiting, nausea.
How to avoid cytomegalovirus?
Unfortunately, there is no vaccine against CMV. Prevention comes down to compliance with the basic rules of hygiene.
Prevention of congenital cytomegalovirus is very important – a woman planning to become pregnant or just after learning about her pregnancy should have a cytomegalovirus test to find out if she has had an infection or not. Women who are seronegative (those who have not had CMV infection in the past) should be monitored.
Prevention of cytomegaly also means that infected women refrain from breastfeeding, and if possible, organ transplants or blood transfusions from seropositive donors should not be carried out.
Also read about purulent skin infections