By: Mary T. Caserta, MD, FAAP
Cytomegalovirus (CMV) is a common virus that is part of the family of herpes viruses. It is responsible for the most common infection at birth—known as a "congenital infection"—in the United States.
How does CMV affect children?
CMV infection is generally mild. Most newborns with congenital CMV infection are symptom-free and remain well. However, they are at risk of permanent deafness and developmental challenges beginning in infancy and childhood. CMV infection can also cause serious illness in people with immune compromise.
More than half of adults are infected by age 40. Once a person is infected, the virus stays in their body for the rest of their life—usually in a resting or inactive state. However, the virus can become active and can be detected in that person's spit, urine or other body fluids. If the virus reactivates, it can cause illness if a person's immune system becomes weakened by a disease or medicine.
Read on to learn how to recognize symptoms and protect your child and others from CMV infection.
CMV symptoms
In some cases, CMV infection can cause serious problems.
Babies born with congenital CMV infection may have hearing changes or a
learning disability. About 15% of newborns with congenital CMV infection may have low birth weight,
jaundice (yellowing of the skin and eyes), swollen lymph nodes, a small head compared to their body, an enlarged liver or a
skin rash. They may have problems throughout life such as deafness and other
special health care needs.
Infants with congenital CMV infection who do not show signs of infection at birth may develop deafness or other special health care needs in childhood, but this occurs infrequently.
Teens may have symptoms similar to infectious
mononucleosis, including fever that lasts more than a few days, sore throat, body aches and fatigue.
Children with
immune system compromise may have problems that affect their lungs, liver, kidneys, bone marrow or bowels. The infection also can cause problems for children who receive an organ transplant.
How CMV spreads
CMV infection spreads through body fluids such as saliva, tears, urine and blood. It causes infections in infants and children at home or
child care, including:
The infection can also pass from a pregnant person to the fetus through the placenta. CMV can pass from a pregnant person to their infant through fluids in the birth canal during childbirth and to babies through breast milk.
Children who have human immunodeficiency virus (HIV) infection or whose immune system is not functioning for another reason (for example, because of
cancer treatment) are at higher risk of problems if they are infected.
How is CMV diagnosed and treated?
To diagnose a CMV infection, a pediatrician or other health care clinician may order laboratory tests of urine, saliva, blood or other body fluids.
Medical treatment is recommended for newborn babies with congenital CMV who have symptoms of illness. Newborns with congenital CMV infection may have or develop hearing changes or other developmental challenges despite treatment.
Fortunately, most children with CMV do not need treatment. However, serious infections in children with immune system compromise, such as those with HIV infection or an organ transplant, can be treated with a medicine called ganciclovir or valganciclovir.
Remember
Many of us do not know we have a CMV infection. Even without symptoms, we can spread the virus through body fluids like urine and saliva. But there are ways to help lower the risk of spreading the infection to others, including:
Washing hands before and after feeding or wiping the noses/faces of infants and toddlers, changing diapers or touching objects such as pacifiers that were in contact with saliva.
Keeping a child's pacifier out of a parent, caregiver or other child's mouth.
Making sure that cups, utensils and toothbrushes are not shared with others.
Personal hygiene habits are the key to lowering the risk of spreading CMV and other infections to babies and others who are at risk of serious illness.
About Dr. Caserta
 Mary T. Caserta, MD, FAAP, is a Professor of Pediatrics in Infectious Diseases at the University of Rochester Medical Center (URMC) in New York. Her early research focused on human herpesvirus research. Recently, her research has focused on viral respiratory disease. For over 10 years, she also has conducted clinical trials, including on the treatment of congenital CMV infection. Dr. Caserta is a fellow of the Infectious Disease Society of America and member of the Pediatric ID Society. Dr. Caserta is a member of the American Academy of Pediatrics Committee on Infectious Diseases.
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