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A Few Facts About Cytomegalovirus

From the International Adoption Clinic, Minneapolis

What is cytomegalovirus?
Cytomegalovirus (CMV) is a common virus found among people worldwide. Infection rates are higher and exposure to the virus occurs at an earlier age in developing countries, in lower socioeconomic groups in industrialized nations, and in Asian populations. In many underdeveloped countries, virtually all of the people have had CMV, while in the United States, only 40-50% of women in upper and middle socioeconomic groups have had the infection by the time they reach their child-bearing years.

How does a person get CMV?
Cytomegalovirus is transmitted from one person to another through direct contact with bodily fluids. Urine may contain large amounts of the virus, which can also be found in saliva, tears, breast milk, semen and cervical secretions, and blood products.

How do you know when a person has CMV?
In the majority of children and adults, cytomegalovirus causes infection without any apparent illness. However, although the infected person remains well, he is still contagious to others. In patients on steroid therapy, and in patients with cancer or organ transplants, CMV infection may be life-threatening.

There is also great concern if a woman develops her first CMV infection during pregnancy. Even though the woman herself may not become ill, she may pass the virus to her unborn baby. This is called congenital infection. About one-fourth of congenitally infected infants will develop birth defects. In some infants, the signs of CMV infection are evident at birth; in others, consequences of CMV infection such as hearing loss or mental retardation may not become apparent until later in childhood. Each year in the United States, about 40,000 newborns are congenitally infected with CMV; 11,000 of these children will have permanent deficits.

What should I be concerned about if my child is excreting CMV?
Children from countries where CMV is very common, such as Korea and India, usually acquire the virus during birth. This is call perinatal infection. These children do not develop serious effects because their birth mothers also pass to them protective antibodies. However, although these children remain well, they may still excrete the virus for several months.

Close contact with young children in the home is the most common source of CMV infection for women of child-bearing age in our country. When a child who is excreting CMV is adopted by a North American family, the virus may be transmitted from the child to the adoptive mother. If the mother has not had CMV in the past, she may develop her first infection during pregnancy, and the unborn child is then at risk for developing the more serious consequences of congenital CMV. Therefore, if the adoptive mother of a child with CMV is able to become pregnant, she should be checked to see whether she has had CMV in the past. A simple blood test can be performed to check the level of protective antibodies in the mother.

Should a child with CMV attend daycare?
A child who is excreting CMV should NOT be excluded from daycare. In published surveys, more than 30% of children in daycare in the United States have been shown to excrete CMV. The toddler in daycare is a major reservoir for CMV transmission in the United States. Studies have also shown that occasional and non-intimate contact with such children rarely results in transmission of the virus from the child to an adult. On the other hand, parents of CMV-excreting children are at considerable risk of acquiring CMV infection.

Is there any way to prevent CMV?
There is no vaccine to protect yourself against CMV. The best way to limit the spread of the virus is by using good hygiene, such as thorough handwashing with soap and water after handling urine and oral secretions or changing and disposing of diapers.

International Adoption Clinic
Box 211 UMHC 420 Delaware Street SE
Minneapolis, MN 55455 612/626-2928 Fax: 612/624-8176

Children Youth and Family Consortium Electronic Clearinghouse. Permission is granted to create and distribute copies of this document for noncommercial purposes provided that the author and CYFCEC receive acknowledgment and this notice is included. Phone (612) 626-1212 EMAIL: cyfcec@maroon.tc.umn.edu

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