Cytomegalovirus (CMV) infection: cytomegaly

Cytomegaly is an infection with CMV, the cytomegalovirus. The infection can be asymptomatic or cause a number of symptoms. What are these symptoms? How is cytomegalovirus transmitted? For some groups, infection with CMV can be dangerous; it can make them seriously ill. And how is an infection with the cytomegalovirus diagnosed?

What is cytomegaly?

The infectious disease cytomegaly is caused by the cytomegalovirus (CMV) and occurs all over the world. However, the disease is more common among people living in poor social and economic conditions and in less developed countries. On the other hand, the virus is the main cause of congenital infections in developed countries.

About the cytomegalovirus

The cytomegalovirus belongs to the herpes viruses. The virus can be found in urine, saliva, blood, tears, breast milk, cervical mucus and semen.

How is cytomegalovirus transmitted?

The virus can be transmitted via the above-mentioned body fluids. After someone has been infected for the first time, the virus remains latent (hidden) in the body and can become active again. This is common; Virus is also excreted, which can infect others. Almost everyone comes into contact with the virus at some point. The cytomegalovirus becomes inactive outside the body quite quickly; this means that it is only transmitted through close physical contact, through bodily fluids.

Pregnant women infected with the virus can infect the baby through the placenta during pregnancy. In that case, cytomegaly is congenital. The pregnant woman may be infected with the virus for the first time; the chance that the virus will then be transmitted via the placenta is approximately 50%. There may also be a reactivation of the virus already present; in that case, the chance of the virus being transmitted via the placenta is very small. It can also happen that the baby becomes infected during delivery due to transmission of the virus through the cervix. The baby can also be infected through breast milk.

What are the symptoms of cytomegaly?

The majority of people who become infected with the cytomegalovirus experience little or no symptoms; the infection then progresses mildly. Complaints that may occur (whether or not together) are:

  • fever
  • headache
  • heavy fatigue
  • feeling of being ill (malaise)
  • muscle strain

The spleen and lymph nodes may be enlarged and liver function may be impaired. This case concerns otherwise healthy adults and children.

Increased risk of serious infection by the cytomegalovirus

There are groups in whom an infection with the cytomegalovirus can be serious and even cause permanent damage:

Newborn babies

Infection with the cytomegalovirus during pregnancy can infect the unborn baby. The baby’s infection is then congenital. The severity of the disease can vary from no symptoms to multiple disabilities. Some of these conditions are only discovered in the first years after birth. Neurological problems, mental retardation, eye disorders and hearing loss may occur.

People whose immune system does not work properly

People whose immune systems are compromised are more likely to develop serious symptoms and complications when infected with the cytomegalovirus. This may be the case, for example, in people with AIDS or people who have undergone an organ transplant. This may involve a first infection with the virus, but also a reactivation of the latent virus, i.e. from a previous infection.

How is cytomegaly diagnosed?

There are various methods to detect the cytomegalovirus. A few examples:

Blood tests

There are two types of antibodies that are formed after infection with the virus. The IgM antibodies are made first; these can be demonstrated for a few months. Shortly after the formation of IgM antibodies, IgG antibodies are produced. These remain detectable in the blood for life. The disadvantage is that the results of these tests are sometimes difficult to interpret. Other laboratory tests are done if necessary.

Virus breeding

A cell culture can be done from infectious material (usually blood or urine) in which the virus can be detected. The disadvantage of this is that the results may take up to four weeks to arrive.

PCR

The DNA of the virus can be demonstrated with the PCR (Polymerase Chain Reaction) test. This test is very sensitive, which means that very few virus particles can be detected. This can also be the disadvantage of the test: it can also detect a latent virus, which can complicate the interpretation of the result. Especially in patients at risk, it is important that the treating physician makes the diagnosis based on various laboratory tests. The general clinical picture is of course also important.

Is there a treatment for cytomegaly?

In people with a normal defense against infections, cytomegaly resolves on its own; it is then a matter of getting sick. There is also no specific treatment. People with cytomegaly who belong to one of the risk groups can be treated with antiviral drugs.

How can infection with the cytomegalovirus be prevented?

At home

There is (yet) no vaccine against the cytomegalovirus. Good hand hygiene is necessary to prevent contamination at home: wash with soap and water. This is especially important after contact with young children, for example when changing a diaper. In general, it is necessary to wash hands thoroughly after contact with bodily fluids. However, it remains difficult to prevent the virus from being transmitted when there are young children in the house.

Hopital

In hospitals, the advice is to disinfect the hands with hand alcohol or wash with disinfectant soap, especially after contact with body fluids. Furthermore, it is important that when using donor blood and organs, they are tested for the cytomegalovirus before they are used.

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  • Less chance of illness by washing hands properly