CYTOMEGALOVIRUS INFECTIONS

INTRODUCTION

Cytomegalovirus (CMV) is a virus belonging to the Herpes-Virus family.

In an infected body it can be found in urine, sexual secretions (semen and vaginal secretions), saliva, sputum, breast milk and blood as well as affected organs.

The term cytomegalovirus is used because the virus causes lymphocytes (blood cells) to increase in size, a characteristic sign of CMV infection.

CMV is a normally harmless viral condition but can be serious for immunocompromised people. It is a virus that generally causes few symptoms in individuals with an efficient immune system, and causes fatigue or other weak and uncharacteristic symptoms such as pain or fever, but it can be severe in people immunocompromised or in pregnant women. The incubation is 20 to 40 days on average but it is very variable.

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Written and edited by DJIMA Rachidatou on 08/01/2022

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CMV symptoms

Sometimes, the affected individual may present with fever, and diffuse pain. In the HIV patient, on the other hand, it is a potentially serious infection often manifested by damage to the retina, and inflammation at the digestive or neurological level.

Symptoms of cytomegalovirus are usually mild or, in many cases, asymptomatic. If there is a manifestation of this infection, it is possible that it can be confused with any other pathology, so many people do not even know that they have been infected. These symptoms can be:

• Sore throat and headache.
• Fever.
• Fatigue and weakness.
• Swollen glands.
• Muscle aches
• Loss of appetite.

In contrast, in high-risk groups infected with cytomegalovirus or those with weak immune systems due to diseases such as HIV or who have recently had a transplant and are on medical treatment, symptoms of the virus may be more severe. :

• Loss of sight and hearing.
• Epileptic seizures.
• Mental handicap.
• Bleeding in the intestines.
• cogs transmission mode

CMV is excreted in the urine and saliva for months or even years after infection then it persists in a latent state, it can be excreted again in the event of immunosuppression.

Transmission occurs through direct skin or mucosal contact (urine, saliva, breast milk, vaginal secretions, semen), during pregnancy from mother to fetus, or blood transfusions or organ transplants. Children carrying the germ are very numerous these days.

Cytomegalovirus and Pregnancy

Cytomegalovirus infection is a viral disease that can have serious consequences if it occurs during pregnancy. Indeed, if the disease affects the fetus, many sequelae are possible ranging from psychomotor retardation, hearing sequelae, and growth retardation. In some cases, in utero death may occur. According to the High Council for Public Health, "most asymptomatic infected newborns at birth will not develop a disability, only 10% may develop deafness until the age of 5".

The rate of transmission increases with the term, but sequelae are more severe if transmitted during the first trimester. This is why it is important to confirm the infection in the mother and to estimate its age. For this, several biological examinations are possible.

People at risk
There are so-called at-risk populations where CMV can cause serious illness: immunocompromised patients, transplant patients, AIDS patients, and non-immune pregnant women. These pregnant women must be very vigilant if they are in contact with young children.

Caregivers and nursery staff may be in contact with carriers of CMV, and precautions to avoid transmitting the virus are important to know.

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Written and edited by DJIMA Rachidatou on 08/01/2022

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how to prevent a CMV infection IN A CHILD?

• Do not kiss the child on the mouth
• Do not taste on your plate, finish your dish
• Do not suck the baby's pacifier
• Don't kiss a crying baby on the cheeks
• Do not vacuum the nose of a baby with a cold without precautions (you must use handkerchiefs in particular and wash your hands)
• Do not take a bath with a baby who is likely to urinate in it
• Wash hands after touching toys, clothes wet with urine

In a press release dated December 3, 2019, the CNGOF (National College of French Gynecologists and Obstetricians) announces that it is aware of the danger linked to congenital infection due to CMV and its consequences. He recalls the need to inform future parents about the virus, and effective preventive measures to avoid contamination during pregnancy "as soon as possible, ideally before pregnancy". A serology to screen the mother can also be carried out before or at the start of pregnancy, "after information and discussion with a couple of the advantages and disadvantages, the consequences and possible difficulties in interpreting the serologies and taking care of them". No systematic screening, therefore, due to "the lack of sufficient evidence of the effectiveness of preventive treatment of mother-to-fetal transmission or curative treatment of infected fetuses" explains the CNGOF.

Useful tips against cytomegalovirus during pregnancy

For now, the only real way to guard against CMV is to adhere to the following hygiene recommendations:

- Avoid contact with saliva (including mouth kisses, urine, tears, and nasal secretions). If you are pregnant, avoid kissing a baby, or a child under the age of three, on the mouth or on the cheeks to console him when he is crying.

- Do not use the same spoon, eat from the plate or share the same glass with the child. It is recommended not to taste or finish the baby dish, nor to share the plate, the bottle or a cake.

- Don't put your pacifier in your mouth. Many mums tend to suck on the nipple to clean it or put the bottle in their mouth to check the temperature of the milk, but these "bad habits" increase the risks. Instead, you can test the temperature with the back of your hand, or if necessary taste his meal with another spoon.

- Avoid taking a bath with your baby (who may urinate in the water). The HCSP also advises pregnant women to avoid touching their child's wet pyjamas.

- If your baby has a cold, the HCSP recommends that parents do not kiss him on the cheeks or suck his nose carelessly. If using a baby nasal aspirator, for example, it is best to clean it immediately following the instructions. You can also use paper tissues, and throw them away immediately after use.

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Written and edited by DJIMA Rachidatou on 08/01/2022

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