How is it transmitted and what happens after infection?
The virus is transmitted through biological fluids: saliva, urine, breast milk, blood, and sexual contact. A common source for adults is young children attending nurseries, who can shed the virus for months. After primary infection, the virus remains in cells for life and can be activated when immunity decreases. Such reactivation usually goes unnoticed in a healthy person, but in a patient after a transplant or with HIV it can cause severe organ damage.
- Saliva and close household contacts
- Urine of small children
- Breast milk
- Sexual tract
- Blood transfusion and organ transplantation
- From mother to fetus via the placenta
Symptoms in adults and children
In adults with normal immunity, the infection most often does not cause any symptoms. Sometimes a mononucleosis-like syndrome develops: prolonged moderate fever, severe weakness, enlarged lymph nodes, muscle pain, a slight increase in liver enzymes. In contrast to classic mononucleosis, there is usually no sore throat or plaque on the tonsils. A congenital infection in a newborn can manifest itself as jaundice, enlarged liver and spleen, rash, low weight, and sometimes its only consequence is hearing loss, which is detected later.
- Asymptomatic in most adults
- Prolonged low fever and weakness
- Enlarged lymph nodes
- Increased ALT and AST
- In newborns - jaundice, rash, low weight
- Hearing loss in a child as a late manifestation
- Damage to the eyes and lungs due to immunodeficiency
How to read tests
Detection of IgG to cytomegalovirus only means that the person was once exposed to the virus; most adults are positive, and this is normal. IgM antibodies may indicate recent infection, but they are false positive and sometimes persist for a long time. Therefore, during pregnancy, an additional indicator is important - IgG avidity: high avidity indicates long-standing infection and practically eliminates dangerous primary infection. PCR detects the virus itself and quantifies its content, which is especially important in patients with immunodeficiency.
- IgG positive - encounter with the virus in the past
- IgM - possible recent infection, needs clarification
- High IgG avidity—long-standing infection
- Blood PCR - quantitative assessment of activity
- PCR of urine in a newborn in the first weeks of life
- Complete blood count and liver enzymes
Cytomegalovirus and pregnancy
The risk to the child is associated primarily with primary infection of the mother during pregnancy, especially in the first half. Reactivation of an existing infection is much less dangerous. If a woman's IgG antibodies were positive before pregnancy, there is usually no cause for alarm. If a primary infection is suspected, the examination is continued, and the tactics are determined by the obstetrician-gynecologist together with the infectious disease specialist. The most reliable thing an expectant mother can do is to follow simple hygiene measures when caring for small children.
- Primary infection during pregnancy is especially dangerous.
- IgG testing is advisable when planning pregnancy
- IgG avidity specifies the duration of infection
- Wash your hands after changing a diaper and feeding your baby
- Do not finish your child’s food or lick his spoon.
- Don't kiss a small child on the lips
- All decisions are made by the doctor; self-medication is unacceptable
Treatment
A healthy person with positive antibodies does not need treatment: it is impossible to remove the virus from the body, and the immune system itself keeps it under control. Antiviral drugs are used strictly according to indications - for severe infections in patients with immunodeficiency, after transplantation, for symptomatic congenital infections in newborns, and are prescribed only by a doctor. Immunomodulators and dietary supplements with unproven effectiveness are not indicated. Newborns with a congenital infection must have their hearing checked regularly in order to notice its decline in time.
- Healthy carriers do not require treatment
- Antiviral therapy for immunodeficiency and after transplantation
- Treatment of newborns with symptomatic congenital infection
- Observation and control of hearing in such children
- Refusal of unproven immunostimulants
- All medications are prescribed by a doctor