About CMV

Only 9% of women have heard of CMV.¹ As parents, daughters, sisters, partners, and friends who are all
at risk – we deserve to know more.

Who can get CMV?

Anyone. CMV infection is common and affects people of all ages.²
However, CMV has an unevenly high presence in communities of lower socio-economic status and minority populations, including African American and Latinx.^6,7

How is CMV infection spread?

There are different ways that people can get CMV infections, and CMV can affect different types of people. What is the one thing that all CMV infections have in common? People get CMV through contact with other people.²

Primary CMV Infection⁸

This is when a person is infected with CMV for the first time.

Reactivated CMV Infection²

This is in people who already have the virus and the virus goes from inactive to active. People who have had organ transplants or weakened immune systems (for example from AIDS) can develop this type of infection.^9,10

Congenital CMV Infection^2,3,11

The virus is passed from a pregnant mother to her unborn baby. Congenital CMV can occur when the mother has a primary CMV infection during pregnancy, but can also happen if she has a reactivated CMV infection.

Signs and symptoms of CMV infection

Healthy People

People with healthy immune systems who have a
primary CMV infection usually do not have any notable
symptoms, but may spread the virus to others.²

The following are common symptoms of primary CMV infection:²

A graphic with common symptoms of primary CMV infection: fever, swollen glands, sore throat, feeling tired

Immunocompromised People

In people with weakened immune systems,
CMV may cause severe symptoms that affect
their organs such as:¹²

A graphic that shows how CMV can affect different organs: inflammation of the brain - encephalitis, lungs - pneumonia, liver - hepatitis or liver inflammation, gastrointestinal tract - GI symptoms include inflammation, bleeding, ulcers, nausea, and vomiting

Infants and Children

Newborns with severe congenital CMV may exhibit symptoms at birth including:^3,11

A graphic showing symptoms that newborns with severe congenital CMV may exhibit at birth: small head size, seizures, liver, spleen and lung problems, rash.

Long-term health conditions associated with congenital CMV infection may include:³

Hearing loss

Vision loss

Intellectual disabilities

Seizures

Lack of coordination/weakness

People with healthy immune systems who have a
primary CMV infection usually do not have any notable
symptoms, but may spread the virus to others.²

The following are common symptoms of primary CMV infection:²

In people with weakened immune systems,
CMV may cause severe symptoms that affect
their organs such as:¹²

Newborns with severe congenital CMV may exhibit symptoms at birth including:^3,11

Long-term health conditions associated with congenital CMV infection may include:³

Hearing loss

Vision loss

Intellectual disabilities

Seizures

Lack of coordination/weakness

Who is at risk for serious effects
of CMV infection?

Infants and children who were exposed during pregnancy are at risk for potentially serious issues as the result of the infection.^3,5 In fact, CMV infection is the #1 cause of non-genetic hearing loss.¹³ People with weakened immune systems have the highest risk of serious complications.¹⁴

1 out of every 200

babies is born with congenital CMV infection³

CMV is associated with a

50% increased risk

of organ rejection after a transplant¹²

How does CMV spread?

People with CMV may pass the virus to others through bodily fluids, such
as saliva, urine, blood, tears, semen and breast milk.² CMV is spread from
an infected person in the following ways:²

Direct contact with saliva or urine, especially from babies and young children

Through breast milk to nursing infants

Sexual contact

Through transplanted organs and blood transfusions

CMV infection is especially common among babies and young children,
and CMV is most commonly spread through urine and saliva.^2,3,5

Immunocompromised People

People with illnesses that weaken the immune system and people with bone marrow or organ transplants are at risk for more severe disease and complications caused by CMV infection.^9,14

Infants and Children

One out of 3 women who have primary CMV infection during pregnancy will pass CMV on to their unborn child.¹⁵ After a baby is born, CMV can also be spread to, or from, the baby through close contact, including:^2,3,5

Kissing on the lips – CMV can spread through saliva
Sharing utensils, cups, and food
Breastfeeding

Children in group childcare settings are at higher risk for CMV infection and spreading CMV to those who care for them. Diaper changes specifically are a time that the spread of CMV in an infected child can happen through:^3,16,17

Urine
Stool

How is CMV diagnosed ?

If your doctor suspects that you have a CMV infection, you will be given a blood test that looks for antibodies that are a part of the immune system’s response to a CMV infection.²

Testing for CMV infection in pregnant women is not commonly done. Most often, CMV infections complicating pregnancy are discovered at the time the infant is born with congenital CMV infections.^3,8

Newborns who show signs of CMV infection may have saliva or urine tests to make the diagnosis.²

Investigational CMV vaccines that
are in clinical trials.

Currently, there is no vaccine available to prevent CMV. However, many experts believe
that a vaccine to prevent congenital CMV infection may have an impact on child health.
CMV vaccines are being researched and developed right now.^{18, 19}

It is important to continue to raise awareness and educate on the risks of CMV and encourage
people to follow proper hand hygiene guidelines to help prevent the spread of CMV.⁵

Help break the silence around CMV

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References

Doutre SM, Barrett TS, Greenlee J, White KR. Losing ground: awareness of congenital cytomegalovirus in the United States. J Early Hear Detect Interv. 2016;1(2):39–48. doi: 10.15142/T32G62

2. About cytomegalovirus and congenital cmv infection. cdc.gov. Updated August 18, 2020. Accessed December 7, 2020. https://www.cdc.gov/cmv/overview.html

3. CMV fact sheet for pregnant women and parents. cdc.org. Updated September 2018. Accessed December 7, 2020. https://www.cdc.gov/cmv/fact-sheets/parents-pregnant-women.html

4. van Zuylen WJ, Hamilton ST, Naing Z, Hall B, Shand A, Rawlinson WD. Congenital cytomegalovirus infection: Clinical presentation, epidemiology, diagnosis and prevention. Obstet Med. 2014;7(4):140-146. doi:10.1177/1753495X14552719

5. Cannon MJ, Davis KF. Washing our hands of the congenital cytomegalovirus disease epidemic. BMC Public Health. 2005;5:70. doi: 10.1186/1471-2458-5-7

6. Colugnati FAB, Staras SAS, Dollard SC, Cannon MJ. Incidence of cytomegalovirus infection among the general population and pregnant women in the United States. BMC Infect Dis 2007;7:71. doi: 10.1186/1471-2334-7-71

7. Lantos PM, Hoffman K, Permar SR, et al. Neighborhood disadvantage is associated with high cytomegalovirus seroprevalence in pregnancy. J Racial Ethn Health Disparities. 2018;5(4):782-786. doi: 10.1007/s40615-017-0423-4 Epub 2017 Aug 24

8. Davis NL, King CC, Kourtis AP. Cytomegalovirus infection in pregnancy. Birth Defects Res. 2017;109(5):336–346. doi: 10.1002/bdra.23601 PMID: 28398680.

9. Emery V C Investigation of CMV disease in immunocompromised patients Journal of Clinical Pathology 2001;54:84-88

10 .Effros RB. The silent war of CMV in aging and HIV infection. Mech Ageing Dev. 2016;158:46–52. doi: 10.1016/j.mad.2015.09.003 Epub 2015 Sep 25. PMID: 26404009; PMCID: PMC4808485

11. Babies Born with Congenital Cytomegalovirus (CMV). cdc.gov. Updated August 18, 2020. Accessed December 29, 2020. https://www.cdc.gov/cmv/congenital-infection.html

12. Luscalov S, Loga L, Dican L, Junie LM. Cytomegalovirus infection in immunosuppressed patients after kidney transplantation. Clujul Med. 2016;89(3):343–346. https://doi.org/10.15386/cjmed-587

13. Fowler, K.B. & Boppana, S.B. Congential cytomegalovirus (CMV) infection and hearing deficit. Journal of Clinical Virology. 2006;35(2). 226-231.

14. Cytomegalovirus (CMV) and Congenital CMV Infection. cdc.gov. Updated August 18, 2020. Accessed December 29, 2020. https://www.cdc.gov/cmv/index.html

15. Kenneson A, Cannon MJ. Review and meta-analysis of the epidemiology of congenital cytomegalovirus (CMV) infections. Rev Med Virol. 2007;17:253–276.

16. Pass RF, Anderson B. Mother-to-child transmission of cytomegalovirus and prevention of congenital infection. J Pediatric Infect Dis Soc. 2014;3(1 Suppl):S2–S6. doi: 10.1093/jpids/piu069 PMID: 25232473; PMCID: PMC4164178.

17. Ross DS, Jones JL, Lynch MF. Toxoplasmosis, cytomegalovirus, listeriosis, and preconception care. Matern Child Health J. 2006;10(5 Suppl):S187–S191. https://doi.org/10.1007/s10995-006-0092-0

18. Plotkin SA, Boppana SB. Vaccination against the human cytomegalovirus. Vaccine. 2019;(37):7437–7442.

19. Schleiss MR, Permar SR, Plotkin SA. Progress toward development of a vaccine against congenital cytomegalovirus infection. Clin Vaccine Immunol. 2017;24(12):e00268-17. doi: 10.1128/CVI.00268-17