The infection of cytomegalovirus or CMV in babies happens when the little one contracts the virus from an infected person. The virus is a type of herpes virus. The mother may be asymptomatic, but the virus may stay dormant in the body (1). The virus might transfer from the maternal blood to the baby’s blood through the placenta.
Babies born with CMV infection are said to have congenital CMV infection. While most babies with CMV infection do not exhibit any symptoms, they might develop some health issues later (2).
Read this post to learn about the modes of transmission, symptoms, diagnosis, treatment, and prevention of CMV infection in babies.
Causes Of CMV Infection In Babies
CMV infections are contagious and can spread through bodily fluids. Below are the various ways a baby could catch CMV and develop an infection (3).
- Transmission of the virus from the mother to the fetus through the placenta, causing congenital CMV infection. Around 40% of babies born to women with CMV infection during pregnancy will develop congenital CMV infection (4).
- Transmission of the virus from the mother to the baby through vaginal fluids during vaginal delivery. It is called perinatal CMV infection.
- Transmission of the virus from the mother to the baby through breast milk. It is also known as perinatal CMV infection.
- Transmission at daycare or at home through the inhalation of expelled respiratory droplets of infected person or contact with objects contaminated by bodily fluids, such as saliva or urine. It is called acquired CMV infection and seldom causes symptoms.
Signs And Symptoms Of CMV Infection In Babies
About 80-90% of healthy full-term babies with CMV infections have no symptoms (5). However, some babies develop symptoms as they grow (3). Maternal antibodies are felt to be protective and thus most term babies who are exposed do not have symptoms or don’t become infected. However, premature babies are more at risk since they may not have antibodies to CMV. As stated, the risk is higher in babies born prematurely or full-term babies who develop other conditions, such as hepatitis or pneumonia, in the initial days after birth (6). The symptoms vary for congenital and perinatal CMV.
Symptoms of congenital CMV infection are:
- Small head size
- Jaundice characterized by the yellowish color of the skin
- Enlarged liver and spleen
- Eye problems, such as inflamed retina
- Broken blood vessels under the skin
- Skin rashes
- CMV-related hearing loss
- Low birth weight
Symptoms of perinatal CMV infection are:
- Abnormal blood test results, such as low platelet count and high liver enzymes
- Lung inflammation and infection
- Enlarged spleen and liver
Acquired CMV infection may not usually cause symptoms. If symptoms do occur, they are similar to mononucleosis infections, causing low-grade fever, sore throat, swollen lymph nodes, fatigue, and loss of appetite. The symptoms may resolve in a few days to weeks.
How Is CMV Infection Diagnosed?
CMV infections are rarely diagnosed in the mother due to a lack of symptoms. However, if your baby’s doctor suspects CMV infection in your baby, they may run a few tests for a proper diagnosis (1).
- Amniotic fluid is tested if CMV infection is suspected in a fetus
- Urine and saliva cultures of a newborn within three weeks of birth
- Specialized blood tests, such as TORCH screen
- Antibody titer levels of mother and the infant
- Hearing and vision examinations
- CT scan of the brain
- Chest X-ray
How Is CMV Infection Treated?
There is no definitive treatment for CMV infection in babies and adults. Babies with no symptoms may not be tested for CMV, thus, not requiring treatment at all. If the baby displays symptoms and is tested positive for CMV, primary treatment could be given for symptomatic relief. Treatment may focus on resolving symptoms or issues with the potential to cause long-term problems, such as poor growth (7).
Infants with severe symptoms, such as neurological issues or hearing loss, may receive intravenous antiviral medications after diagnosis for several weeks (3). Common antiviral drugs used are valganciclovir and ganciclovir. These can slow down the multiplication of the virus, giving the body time to fight the infection.
Complications Of CMV Infections
- Nervous system problems, such as seizures
- Growth and developmental problems, including intellectual impairment
- Hearing or vision loss
- Feeding issues
- Difficulty with movement, physical activities, and coordination
How To Prevent CMV Infections In Babies?
The best way to prevent a CMV infection in a baby is to prevent the infection in the mother before conception. Below are some ways to avoid the infection (4).
- Observe good personal hygiene, such as washing hands often with soap and water for 15-20 seconds at a time
- Avoid contact with tears and saliva
- Avoid consuming food or drink from the same container or vessel as others
- Clean surfaces, such as countertops, periodically
- Observe safe sex practices
You may also test for the infection before conception and do so periodically during pregnancy. Newborns can be protected from acquired CMV infection through adequate hygiene, such as washing their hands after outdoor play and keeping their toys clean. You must also keep the baby away from unwell family members and have a cold, fever, or cough.
Prognosis Of CMV Infection In Babies
The outcome of a CMV infection in babies depends on whether the baby develops symptoms and their severity.
- Babies born with symptoms at birth may have a higher risk of developing one or more neurological symptoms later in life.
- Most asymptomatic babies at birth or those with asymptomatic acquired CMV infection do not develop long-term problems (7).
- In some babies, the long-term complications may last for a lifetime (4).
Cytomegalovirus (CMV) infections in babies are usually congenital due to transmission of maternal CMV infection. Most babies may not develop any symptoms, while some may develop symptoms a few days or weeks after birth. You may stay alert to any possible signs of infection, including low-grade fever. Timely diagnosis and treatment could prevent any long-term complications in babies.
2. Babies Born with Congenital Cytomegalovirus (CMV); CDC
3. Congenital Cytomegalovirus; Boston Children’s Hospital
4. Cytomegalovirus (CMV); Harvard Medical School
5. Diagnosis and Symptoms in Babies; CMV Action
6. Cytomegalovirus Infection; National Organization for Rare Disorders
7. Congenital cytomegalovirus; U.S. National Library of Medicine