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Cytomegalovirus is a disease caused by the CMV virus, which most often affects the salivary glands. In healthy people, the infection is asymptomatic and the body gets rid of it on its own. One of the routes of infection may be blood transfusion or organ transplantation. The consequences of cytomegalovirus mainly affect people who have problems with immunity.
Cytomegaly – what kind of disease is it
Cytomegaly is a common viral disease. Its formation is caused by cytomegalovirus, which comes from the same category as the varicella-zoster virus, and herpes simplex virus. Only humans are the carrier of this virus. Cytomegalovirus is a disease that is often asymptomatic and mainly affects the salivary glands. This ailment is widespread all over the world. In addition, cytomegalovirus was first isolated from the salivary gland of a sick newborn in 1956. In most cases, cytomegalovirus is not a dangerous disease, but its treatment is imperative as it wreaks havoc on the body.
The causes of cytomegalovirus infection
Modern medicine identifies three main sources of the presence of cytomegalovirus in the body:
- blood and blood products transfusions and organ transplants,
- direct contact with body fluids such as urine, saliva, tears, milk (in nursing mothers) or through sexual contact
- from mother to fetus through the placenta or during labor.
The high prevalence of CML in humans is associated with the easy spread of the disease. Most often, the infection occurs during childhood, in nurseries, kindergartens or at school (adolescence).
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Types of cytomegalovirus infections
Primary infection: it happens very often in childhood, in people who have not had contact with the virus before. Primary infection causes immune proteins to be present in the blood that live in the body for life. This type of infection is especially dangerous for pregnant women and patients with very low immunity.
Chronic infection: is a consequence of a primary infection, does not give symptoms, sometimes a virus appears. After primary infection, this virus remains latent in the cells of the secretory glands, reticulo-epithelial lymph nodes, and kidneys. In this form, the virus remains in the body for life and reactivates when it feels favorable conditions.
Secondary primary infection: arises in the event of a decrease in immunity or the secondary catch of cytomegalovirus. A secondary infection generally causes no symptoms, but the patient can infect other people. Patients infected with cytomegalovirus can produce the virus with body fluids for several months to several years. Adults shed the virus for much less time than children.
Cytomegaly – symptoms
There are several possibilities of cytomegalovirus infection and we can divide them into congenital and acquired.
Primary infection The vast majority of cytomegalovirus is asymptomatic or manifests itself very gently: swollen lymph nodes, liver, spleen, pharyngitis, headaches and muscle aches. Primary infection is also characterized by increased temperature, coughing and fatigue.
Do secondary infections may occur during transfusion, transplantation, or direct contact with fluids of a person infected with cytomegalovirus.
Cytomegaly is dangerous especially for people with lowered immunity. The virus affects the parenchymal organs and can cause inflammation of the brain, lungs, liver and kidneys in patients.
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Cytomegaly and pregnancy
The fetus may become infected with cytomegalovirus from an ill mother during pregnancy or during delivery. This can lead to miscarriage, preterm labor, stillbirth or a baby with birth defects syndrome. In pregnant women, cytomegalovirus may be asymptomatic and therefore difficult to diagnose. Infection is most often caused by childbirth and breastfeeding, and complications depend on the time of infection. Children of women who are infected with cytomegaly from an early age have health problems. Often such babies are diagnosed with hereditary cytomegaly, which manifests itself with jaundice, pneumonia, and enlargement of the spleen. It happens that cytomegalovirus can make itself known after years! Such situations can cause the patient to lose his hearing completely or have visual disturbances.
The effects on your child depend on the period of CML infection:
- 20st trimester: there may be numerous birth defects, mainly in the urinary system, gastrointestinal tract, circulatory system, central nervous system or eyesight; in the first trimester, fetal death and miscarriage may occur (up to 30-XNUMX% of cases).
- The last stage of pregnancy: inflammation of the meninges or the brain, inflammation of the heart muscle, liver or interstitial pneumonia. Severe haemolytic anemia or thrombocytopenic disease may also occur.
A child born prematurely, diagnosed with an intrauterine infection, requires immediate hospitalization and treatment. Such patients are given preparations that inhibit the replication of the virus (mostly gancklovir). The therapy lasts about two weeks, but the child must be systematically checked by a doctor during the first year of his life.
Complications of cytomegalovirus may appear as the child grows. Then the parents may notice epilepsy, mental retardation, some kind of psychological or neuromuscular disorders. Babies diagnosed with cytomegaly at birth may have problems with learning, memory and concentration at a later stage.
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Cytomegaly – diagnosis
The diagnosis of cytomegaly is based on blood (serology) and urine tests. These are serological tests with IGg and IgM indicators that are performed to determine the antibodies. The sensitivity of the judging method is 99%. People infected with cytomegaly will have IgM antibodies and increased IGg levels.
Research Interpretation – Results
IgM (-) IgG (-) – no infection present;
IgM (+) IgG (-) – infection “fresh”;
IgM (+) IgG (+) – well-developed infection;
IgM (-) IgG (+) – state after a disease (dormant disease, acquired immunity).
Tests are performed mainly in pregnant women, as the cytomegalovirus infection is dangerous for the fetus. Otherwise, the human body produces antibodies on its own to fight the virus. The presence of antibodies in a woman who is a few months before pregnancy indicates that she has cytomegalovirus. The current antibodies therefore protect her against a recent infection and make the fetus unlikely to become infected. Therefore, it is good for pregnant women to remember about cytomegalovirus tests, even though they are not included in the basic package of tests for pregnant women. The test is performed in the first and third trimesters of pregnancy, when it is possible to identify possible consequences of the disease in the fetus.
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.
Newborn babies are tested for the virus when they have a skin rash, bowel problems, or disturbing jaundice. In infants, indications for CMV testing are poor weight gain, decreased muscle tone, and apathy.
Cytomegaly, is it possible to protect against infection?
There is really no vaccine that protects against cytomegalovirus. It’s hard to avoid the ubiquitous virus. Women who plan to become pregnant can have cytomegalovirus testing as part of the NHF pregnancy. Your doctor recommends a blood and urine test to assess your serology (levels of anti-cytomegalovirus IgG and IgM). If IgM antibodies are found in the blood and a high level of IgG is found, there is a primary infection. If these antibodies are present in the blood before pregnancy – it means that the woman has already had cytomegaly, and the antibodies in her blood are protection against infection. Studies show that about 80% of women of reproductive age have IgG antibodies, which means that they have had contact with this virus before, so they do not have to worry about infection during a possible pregnancy.
How to treat cytomegalovirus?
When CMV affects a healthy person, the body can deal with it on its own, and so it stops the disease from progressing. Infected immunocompromised people are treated, inter alia, virostatic drugsthat stop the virus from reproducing. Such drugs are most often implemented in newborns diagnosed with cytomegaly. In this case, the virostatic drug is most often gancyklovir. Your child should remain in the hospital during treatment. Thanks to the treatment, it is also possible to protect the little one from inflammatory changes in the brain or the retina of the eye. Sometimes an immune serum is given, especially in newborns, who additionally have very low immunity.
These types of preparations are certainly not intended for pregnant women, as they can permanently damage the fetus. It should also be remembered that drugs do not eliminate the virus, but only put it to sleep and prevent it from multiplying. So we cannot cure the disease like cytomegaly, we can only make it inactive.