This Virus With Flu-like Symptoms Can Be Fatal Among Newborns

Becoming a parent puts one's protective instincts on high gear immediately. Your baby is a tiny, defenseless human being after all. At birth, didn't the sight of your baby make you want to envelop him in your arms? Didn't you cringe when they had to poke him with the syringe, wishing it was you instead of him? You just want to shield him from anything or anyone that might cause him pain. Then again, there are worse things besides those mentioned above that could hurt your child, and these are real dangers that might cause illness or even death.

Recently, the term "cytomegalovirus" (CMV) became the topic of conversation among parents when it was pinpointed to be the cause of death of a young baby boy. To understand what CMV is, SmartParenting.com.ph sought the expertise of Dr. Nicole Perreras, a pediatric infectious disease specialist who holds clinic at the Asian Hospital and Medical Center in Alabang and the Makati Medical Center.

If it's the first time you're hearing about CMV, read on to learn how you can protect your children. 

What is cytomegalovirus (CMV)? How do you get it?

According to the Centers for Disease Control (CDC), cytomegalovirus is a common virus that infects people of all ages. 

Dr. Perreras says transmission usually happens from person to person via contact with infected secretions like saliva, breast milk, or urine.

"It may also be passed on by a mother to her child during pregnancy by blood, during delivery, or even after birth through CMV-positive breastmilk."

During pregnancy, the infection can occur in any trimester, but "the most severe infection occurs when a mother contracts CMV for the first time [within] the first half of her pregnancy," she adds. 

Furthermore, once a person gets infected with CMV, "it lies quiet and latent in the body and can be reactivated when a person’s immune system is low."

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Who is most at risk of CMV?

CMV only manifests in patients whose immune system is developing or weak. "Those most at risk for severe infection are newborns, premature babies, and those who are  immunocompromised — patients who are on chemotherapy, those who are transplant recipients, those with HIV." 

What are the symptoms of CMV in adults and children?

According to Dr. Perreras, CMV can be difficult to diagnose as it is usually asymptomatic. "A person may be infected with CMV and show no signs and symptoms at all."

Symptoms are vague and non-specific and are almost indistinguishable from the common flu or mononucleosis. 

Signs and symptoms of CMV vary with the age and immune status of the hos. Some patients may have a flu-like illness with fever, particularly in adolescents or adults.

Dr. Perreras says that in developing countries like the Philippines, children could have been infected by the virus by age 3 and have no symptoms. "In children who are immunocompromised, CMV may cause pneumonia, hepatitis, inflammation of the colon and retinitis of the eye," says Dr. Perreras. 

Among newborns, CMV may be suspected if there is a group of symptoms that suggest it, such as low birth weight, an unusually small head, distinctive skin lesions, pronounced jaundice, or a large liver. CMV may also cause anemia and retinitis.

Newborns who are born with CMV (congenital CMV) usually have developmental delays when they grow up. Most prominently, they are noted to have significant hearing loss.

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How is CMV diagnosed?

It is quite challenging to diagnose CMV because there are so many strains, and as we mentioned, many people may actually have no symptoms at all. A person may recover from CMV, develop antibodies to that strain, then get reinfected with another strain of the virus.

Says Dr. Perreras, "If your doctor suspects your newborn may have it, he may order the imaging of the brain to help make a diagnosis. He or she may also order titers (a laboratory blood test) in both the newborn and the mother to compare or to deduce whether or not the infection was transmitted during pregnancy. However, these titers are limited to until the child is about 21 days old, after which, the test will not be able to say if CMV was contracted after birth." 

CMV may also be isolated in urine, using a test called Polymerase Chain Reaction (PCR). In immunocompromised patients, CMV can have signs and symptoms affecting the liver or the eye. In such life-threatening conditions, treatment using a drug called ganciclovir can be started.

Patients are not routinely screened for CMV. However, if a patient has risk factors like being immunocompromised, or if a newborn has signs and symptoms indicative of CMV, then testing will be carried out.  

Is there a cure or a vaccine to prevent CMV? 

There are no vaccines to prevent CMV. However, in healthy individuals, it is assumed that the immune system can fight off the infection on its own. 

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