What is cytomegalovirus (CMV)?
Cytomegalovirus (CMV) is a common virus that can affect anyone. In the United States, almost 1 in 3 children have CMV by age 5, and more than half of adults have CMV by age 40.
Some people have symptoms when they are first infected, but many do not. CMV stays in your body for life. It usually does not cause problems. But if your immune system is weak, the virus can become active again and cause illness. This is known as reactivation. Bone marrow (stem cell) transplant patients have a high risk of problems due to CMV.
Doctors may use blood tests to monitor CMV if your child has a weak immune system.
Symptoms of cytomegalovirus
Most people with CMV have no signs or symptoms and do not know they have the virus. Some people with CMV may have:
- Fever
- Sore throat
- Fatigue or loss of energy
- Swollen lymph nodes in the neck
- Body aches
Some babies born with CMV (congenital CMV) may show signs such as jaundice, swollen lymph nodes, a small head, an enlarged liver, or a skin rash.
Less common symptoms of CMV include:
- Blurry vision
- Diarrhea
- Belly pain
- Trouble breathing
- Cough
CMV sometimes affects the eyes, liver, stomach, or lungs. These problems are more likely to happen in patients with weak immune systems.
Diagnosis of cytomegalovirus
Health care providers can do a blood test to look for the virus. Since most people with CMV do not have symptoms, care providers can only find it by doing a test.
If symptoms are more severe, your care team may order other tests to check the lungs or other parts of the body.
Your child does not need to isolate (stay away from other people) if a blood test shows that CMV is present.
Talk to your care team about testing for CMV.
Treatment of cytomegalovirus
Most people with healthy immune systems do not have problems with CMV. People at higher risk for illness with CMV include:
- People with weak immune systems or who have a serious illness like cancer, blood disorder, or HIV
- People who have had bone marrow or organ transplant
- Women who are pregnant
- Babies
Your health care provider may prescribe medicines called antivirals to fight the virus. Medicines used to treat CMV include:
Children with congenital CMV infection are at risk for developmental delays and other long-term health problems. These children should have regular vision and hearing screenings. They may need services to help them with language and communication skills.
Your child’s care team will decide what treatments are needed.
How cytomegalovirus spreads
CMV spreads through direct contact with an infected person or body fluids such as urine, saliva (spit), breast milk, tears, semen, and vaginal fluids. It can also spread through blood transfusion or organ transplant.
In some cases, CMV can spread to babies during pregnancy if their mother has an active CMV infection. There is a greater risk of CMV-related complications in babies if the mother was first infected with CMV during pregnancy.
CMV does not spread as easily as some other germs. But it is very common and can spread through close contact. CMV is common in areas where young children are present, such as homes and childcare centers.
Cytomegalovirus and bone marrow transplant
Transplant patients are at higher risk for illness due to CMV infection. A healthy immune system usually keeps CMV from causing problems. During transplant, your child gets immunosuppressive therapy. It involves high doses of chemotherapy and other medicines to keep the body from rejecting a transplant. This treatment weakens the immune system so the body cannot fight infections. CMV may become active and cause sickness affecting the lungs, stomach, eyes, liver, and other organs.
- Before a bone marrow transplant, your child and the donor will be tested for CMV. This helps the care team know your child’s risk of getting sick during transplant. Patients who already have CMV have a higher risk of getting sick from CMV.
- After the bone marrow transplant, your child will have blood tests to monitor CMV at least once a week through day 100 or longer. The test measures the amount of virus in the blood.
- Your doctor may suggest treatment based on the test results.
When to call your care team
CMV may cause serious health problems in patients with weak immune systems. These problems include low blood counts, pneumonia (lung infection), and encephalitis (brain inflammation).
Emergency warning signs include:
- High fever
- Trouble breathing
- Severe headache
- Nick stiffness
- Confusion or memory problems
- Extreme tiredness that does not go away
- Seizures
- Yellow color of the skin or eyes (jaundice)
- Changes in vision
Call your care team right away if:
- You or your child has a weak immune system and develops CMV symptoms
- You are pregnant and have symptoms such as fever, tiredness, sore throat, or swollen glands
- Your baby has any symptoms of CMV
How to prevent cytomegalovirus
To help avoid spreading CMV and other illnesses:
- Wash your hands often or use an alcohol-based hand sanitizer.
- Do not share food, drinks, utensils, or toothbrushes.
- If your child has CMV, wear gloves when you change diapers or touch body fluids such as urine (pee), vomit, or saliva.
- Do not touch your face after changing a diaper or being in contact with an infected person.
- If you are sexually active, use a condom each time you have sex.
Questions to ask your care team
