INTRODUCTION

Common herpesvirus infection known as cytomegalovirus can cause a variety of

symptoms, ranging from no fever or tiredness to severe symptoms affecting the brain,
eyes, or other internal organs. The widely transmitted virus, cytomegalovirus (CMV) can
cause severe end-organ dysfunction in immunocompromised patients (with congenital CMV
illness). In people who are healthy, it could not show any symptoms. The body keeps the virus
after infection for the rest of the persons’ life. Since, CMV rarely causes problems for healthy
people, many of them are unaware that they have it. According to the Mayo Clinic
Organization, people who have weakened immunity, who have undergone stem cell or
organ transplant, and those unborn babies may be susceptible to CMV. In addition, about
one out of every 200 babies is born of the said infection. As revealed by the National
Institutes of Health, A systematic review of the current status of cytomegalovirus, an
omnipresent with a rate of about 100% in both Africa and Asia, and 80% in Europe and
North America.

Sources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6963600/
https://www.mayoclinic.org/diseases-conditions/cmv/symptoms-causes/syc-20355358
https://pubmed.ncbi.nlm.nih.gov/28719295/

FAMADOR PART
CAUSES (In general) Cytomegalovirus
How is it transmitted?
● Coming into contact with an infected individual's bodily fluids and subsequently
touching your eyes, nose, or mouth.
● Engaging in sexual activity with a person who is infected.
● Receiving an organ, bone marrow, or stem cell transplant, or undergoing a blood
transfusion.
In newborns/fetuses.
The virus can spread:
● To the unborn baby from the mother during pregnancy (congenital CMV)
● To the newborn from the mother during delivery (Perinatal CMV)
● Consuming the breast milk of a mother who is infected.
Cytomegalovirus (CMV) is not sexually transmitted but spreads from person to person through
droplet infection, such as occurs with sneezing. If a woman acquires a primary CMV infection
during pregnancy and the virus crosses the placenta, it called Congenital CMV. This can
lead to severe neurological challenges in the newborn, including hydrocephalus, microcephaly,
or spasticity, as well as eye damage like optic atrophy or chorioretinitis. The infant may also
suffer from hearing impairment or chronic liver disease. Additionally, the newborn's skin might
have large petechiae, commonly referred to as "blueberry-muffin" lesions.
Women typically experience minimal symptoms that they might not even be aware they have
been infected. Diagnosis of CMV infection in either the mother or the infant can be confirmed by
identifying CMV antibodies in blood serum. Even though others are not diagnosed with
congenital CMV, after birth, babies still remain susceptible to acquiring CMV. Some
babies with congenital CMV do not experience problems, but others may develop
illnesses and long-term issues.

Sources:
https://www.mayoclinic.org/diseases-conditions/cmv/symptoms-causes/syc-20355358
https://www.marchofdimes.org/find-support/topics/planning-baby/cytomegalovirus-and-
pregnancy
https://www.urmc.rochester.edu/encyclopedia/content.aspx?
contenttypeid=90&contentid=p02351
Book in MCN

SIGNS AND SYMPTOMS OF CONGENITAL CYTOMEGALOVIRUS(NEWBORNS) -

CASTROVERDE QT ew

CONGINETAL CMV
Most babies with CMV that is present at birth (congenital CMV) don’t have symptoms. If
present,
Signs and symptoms:
● Microcephaly
● Intrauterine Growth Restriction
● Hearing loss
● Vision problems
● Developmental delays
● Jaundice
● Hepatosplenomegaly
● Seizures
● Pneumonia
● Petechiae
● Intellectual disability
PERINATAL CMV
Signs and symptoms are usually seen only in very premature or sick newborns between 3
weeks and 6 months of age. They may include:
Signs ans symptoms:
● Hepatosplenomegaly
● Pneumonia
● Feeding difficulties
 ● Petechiae
● Jaundice
● Developmental days
● Hearing loss
● Vision problems
● Neurological complications
● Skin-rash

Signs and symptoms in babiesss

https://www.marchofdimes.org/find-support/topics/planning-baby/cytomegalovirus-and-
pregnancy
https://www.cdc.gov/cmv/congenital-infection.html
https://www.urmc.rochester.edu/encyclopedia/content.aspx?
contenttypeid=90&contentid=p02351

TREATMENTS (AMIGABLE)

HOW CYTOMEGALOVIRUS (CMV) IS TREATED

If CMV is not causing symptoms, you or your baby may not need any treatment. There's
currently no treatment for CMV in pregnancy, but in most cases the virus does not cause any
problems for your baby.

Antiviral medicine may be used to treat:

- babies diagnosed with congenital CMV after they're born

- people with a weakened immune system
- people who have had a stem cell transplant or an organ transplant

Treatment weakens the virus and reduces the chance of serious problems, but it does not cure
the CMV infection. Babies born with congenital CMV may have tests to check their kidneys,
liver, brain, eyes and hearing, and regular follow-up appointments until they're around age 5.

People with weakened immune systems may need treatment with an antiviral medicine. These
medicines kill infections caused by viruses. Medicines used to treat CMV include ganciclovir,
valganciclovir, cidofovir, and foscarnet.

● Ganciclovir - Ganciclovir is an antiviral that is used to treat infections caused by

viruses. Ganciclovir is used to treat the symptoms of cytomegalovirus (CMV) infection of
the eyes in people whose immune system is not working fully. This includes patients with
acquired immune deficiency syndrome (AIDS).
 ● Valganciclovir - Valganciclovir is an antiviral that is used to treat infections caused by
viruses. This medicine is also used to prevent CMV disease in patients who have
received an organ transplant (eg, heart, kidney, or kidney-pancreas transplant).
● Cidofovir - Cidofovir is an injectable antiviral medication employed in the treatment of
cytomegalovirus (CMV) retinitis in patients diagnosed with AIDS. It suppresses CMV
replication through selective inhibition of viral DNA synthesis. It was manufactured by
Gilead and initially approved by the FDA in 1996, but has since been discontinued.
● Foscarnet - Foscarnet is an FDA-approved antiviral therapy used to treat
cytomegalovirus (CMV) and CMV-associated ophthalmic retinitis in individuals
diagnosed with AIDS and who are unable to tolerate gancyclovir or as salvage therapy
for those who have drug-resistant CMV and fail gancyclovir.

Sources:
https://www.nhs.uk/conditions/cytomegalovirus-cmv/
https://go.drugbank.com/drugs/DB00369
https://www.marchofdimes.org/find-support/topics/planning-baby/cytomegalovirus-and-
pregnancy#:~:text=Babies%20who%20show%20the%20signs,can%20include%20ganciclovir
%20or%20valganciclovir
https://www.mayoclinic.org/drugs-supplements/ganciclovir-oral-route-intravenous-route/side-
effects/drg-20064078?p=1#:~:text=Ganciclovir%20is%20an%20antiviral.,immune%20deficiency
%20syndrome%20(AIDS).
https://www.mayoclinic.org/drugs-supplements/valganciclovir-oral-route/side-effects/drg-
20066642?p=1#:~:text=Valganciclovir%20is%20an%20antiviral.,or%20kidney%2Dpancreas
%20transplant).
https://www.ncbi.nlm.nih.gov/books/NBK556108/#:~:text=Foscarnet%20is%20an%20FDA
%2Dapproved,resistant%20CMV%20and%20fail%20gancyclovir.

PREVENTION - (LOGUE)

- CMV is mostly found at home and daycare settings. Therefore, the prevention strategies are
mostly accessible.

Common strategies to prevent CMV infection:

1. Avoid sharing food, straws, toothbrushes or drinking the same glass

• Glasses and kitchen utensils may carry CMV and can spread from person to another person.

2. Avoid contact with tears and saliva

•75% of toddlers have CMV in their saliva in studies at child-care settings.

• CMV is transmitted by direct contact with infectious body fluids (saliva, urine, nasal mucous,
or breastmilk)
3. Throw tissues and disposable items in the bin immediately

• When disposing of diapers, tissues, and other bodily fluid-contaminated materials, thoroughly
wash your hands before touching your face.

4. Clean toys and surfaces

• Other things like toys that come in contact with children's saliva, tears, or urine should be
cleaned often

• Cleaning or disinfecting surfaces or objects may lower the risk of spreading CMV infection.

5. Wash your hands with soap and water

•Especially when you have contact with children after changing diapers, feeding, handling toys,
etc.

• Washing hands often can reduce the risk of CMV because exposure to the saliva or other
body fluids of children is a major cause of CMV infection among pregnant women.

6. Practice safe sex

•Wear a condom during sexual contact to avoid CMV transmission by semen and vaginal
fluids.

Sources:

https://www.mayoclinic.org/diseases-conditions/cmv/symptoms-causes/syc-20355358

https://kiddipedia.com.au/how-to-protect-your-unborn-baby-from-cytomegalovirus-cmv/

https://babyyourbaby.org/preventing-cytomegalovirus-cmv-infection-during-pregnancy/