Let's talk about congenital CMV
Can pregnant women really protect themsleves?
Cytomegalovirus (CMV) is a common virus that infects people of all ages. In the U.S., nearly 1 in 3 children is already infected with CMV by age 5. Over half of adults have been infected with CMV by age 40. Once CMV is in a person’s body, it stays there and can reactivate. A person can also be re-infected with a different strain of the virus.
People at higher risk for complications from CMV are like those who are pregnant or have weakened immune systems. If you are pregnant and infected with CMV, you can pass CMV to your developing baby.
When a baby is born with a CMV infection, it is called congenital CMV. About 1 in 200 babies are born with congenital CMV infection. About 1 in 5 babies with congenital CMV infection will have birth defects or other long-term health problems.
Children are a common source of CMV. High amounts of the virus can stay in a child's body fluids, like saliva and urine, for months after the infection. Teachers, caregivers, and mothers with toddlers are more likely to get infected.
Pregnant women can lower their chances of getting CMV by reducing contact with saliva (spit) and urine from babies and young children. Make sure you: 1) Do not share food, utensils, cups, or pacifiers with a child. 2) Wash your hands with soap and water after changing diapers or helping a child to use the toilet.
Testing and diagnosis
Healthcare providers order blood tests to identify CMV infection in adults with symptoms. However, blood is not the best fluid to test newborns with suspected CMV infection. Saliva or urine tests are preferred for newborns and must be done within 2 to 3 weeks of birth to confirm if the baby has congenital CMV.
Medications called antivirals are available to treat: CMV infection in people with weakened immune systems and babies with signs of congenital CMV at birth. Valganciclovir is an antiviral that might improve hearing and developmental outcomes in babies. It can have serious side effects and has only been studied in babies with congenital CMV infection. There is limited information on the effectiveness of valganciclovir to treat infants with hearing loss alone.
Congenital CMV infection
CMV is most common infectious cause of birth defects in the U.S. However, most babies with congenital CMV never show signs or have health problems, but some do at birth or develop them later.
If you are often around young kids, you are more likely to get CMV. If you are pregnant and get infected with CMV, you can pass the virus to your baby during pregnancy. The virus crosses from your blood into your placenta. This can happen when you are infected with CMV for the first time or again during pregnancy. Most people with CMV infection have no symptoms and aren’t aware that they have been infected.
Signs of congenital CMV infection at birth
Some babies with congenital CMV infection have signs at birth, such as: rash, jaundice (yellowing of the skin or whites of the eyes), microcephaly (small head), low birth weight, hepatosplenomegaly (enlarged liver and spleen), seizures, retinitis (damaged eye retina)
Some babies with signs of congenital CMV infection at birth can have long-term health problems, such as: hearing loss, developmental and motor delay, vision loss, microcephaly (small head), lack of coordination or weakness, seizures.
Hearing loss is common in newborns with CMV. Some babies can have hearing loss at birth or can develop it later. This can happen even to babies who passed the newborn hearing test or didn't have any other signs at birth. Babies with congenital CMV infection should have regular hearing checks.
Current state of CMV screening
In 2022, Minnesota was the first state to enact universal newborn screening for CMV with the addition of CMV to its state bloodspot newborn screening program. Connecticut is set to become the second state to screen every baby in 2025.
Eight states - Illinois, Iowa, Kentucky, Maine, New York, Pennsylvania, Texas, and Utah require both education of pregnant women and targeted newborn screening (that means screening babies who fail their hearing screens).
Connecticut, Florida, Iowa, Kentucky, Louisiana, New York, Texas, Utah, and Virginia require each newborn that fails the newborn hearing screening to be tested for congenital CMV. Illinois requires that a CMV test be offered to the parents of every child who fails the newborn hearing screening.
A recent OnPoint (NPR) broadcast (a re-broadcast) From April 11, 2024 about congential CMV is helpful. Megan Nix’s book,“Remedies for Sorrow: An Extraordinary Child, a Secret Kept from Pregnant Woman, and a Mother’s Pursuit of the Truth” is a memoir about her experience with her daughter Anna, who has congenital CMV.
If you are a pregnant mom with a toddler, please listen to this broadcast
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