The Varicella-Zoster Virus causes chicken pox and the painful rash, shingles. The Epstein-Barr Virus is associated with mononucleosis, an infection known as the kissing disease. Then there’s CMV, the lesser-known cytomegalovirus, which joins them as a herpes viruses. Most people who catch CMV don’t know they have anything, at least nothing more than a cold. It may surface when there are complications, sometimes to a baby.
“That’s the problem with this disease. The time comes for you to have a baby and you find out it was CMV,” explains Dr. Jana Kenaan, an obstetrician and gynecologist with Winter Haven’s Bond Clinic Women’s Health Center.
Most babies who have CMV at birth don’t have problems, the U.S. Centers for Disease Control and Prevention report. But when a pregnant woman has CMV, there is potential for birth defects and – in rare cases – infant death.
The mother can contract the disease through urine, saliva, or sexual contact and infect the fetus. During pregnancy, the most frequent cause is sex or contact with infected young children’s urine, the CDC reports.
Because there are no approved treatments for women who become infected while pregnant, prevention is the best strategy, Dr. Kenaan asserts. “Basically, prevention of CMV involves careful handling of infected articles like diapers, hand-washing around young children or immune-comprised individuals, avoidance of intravenous drug use, sharing of needles,” she says. “Condom use should be encouraged.”
Other precautions include not sharing food, drink eating utensils or toothbrush with young children, avoiding contact with children’s saliva while kissing, cleaning toys/countertops, and not putting a pacifier in your mouth, CDC officials say.
For most groups of people, no special precautions are necessary. Doctors don’t usually screen for CMV because not all infected babies become blind, deaf or mute, nor do they all suffer from mental or motor retardation, she says. “Why alert people when there’s no effective therapy, no predictability,” she asks, explaining there’s no way to be sure there’s a “bad outcome.”
CMV is the most common viral infection present at birth in the United States, the CDC reports, yet few women know about it. Every year about one in 750 babies in the nation are born with – or develop disabilities from – a CMV infection at birth. That’s actually a higher incidence than Down or fetal alcohol syndromes. Most babies with CMV survive with adequate care.
While about half of women at childbearing age are at risk for a first CMV infection, it occurs in only 1-4 percent of pregnant women, CDC officials say. Only one-third of those result in babies infected at birth. There appears to be little risk to the baby if the mother was infected six months or more before conceiving, which includes a majority of U.S. women of childbearing age. But once the virus is in the body, it stays there, CDC officials say.
Problems may surface months or years after birth; half of babies with CMV symptoms incur permanent health problems in their early years. Among those who show no symptoms at birth, about 10 to 15 percent of infected babies develop problems later — often with hearing.
Scientific advances may bring about a solution, Dr. Kenaan says. A vaccine is being developed, but there is concern the virus could reactivate and infect rather than protect, she explains. Studies do show promise for treating infected newborns through anti-viral medications.
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story by CHERYL ROGERS