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Very widespread and usually without consequence — it matters with weakened defence and in pregnancy.
Also known as: cytomegalovirus · CMV · HHV-5
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A very common herpesvirus (HHV-5), usually latent and harmless in healthy people. Serious in congenital infection (the leading infectious cause of hearing loss and developmental problems) and immunosuppression (post-transplant: retinitis, colitis). Diagnosis by serology (IgG/IgM) and PCR.
The infection usually runs like a mild illness or entirely unnoticed, and the virus then stays resting in the body. It is looked for and treated only where it has consequences.
The commonest source is small children. Washing hands after nappy changes, not sharing a spoon or dummy, not kissing on the mouth — that clearly lowers the risk and is the only effective measure one holds oneself.
If a child is born with this infection, the commonest consequence is a hearing loss that only shows later. So regular hearing tests in the first years belong to it.
Under strong suppression of the defences the resting virus can become active again. So the viral load is measured at fixed intervals and treated early, before complaints arise.
The leading infectious cause of congenital hearing loss — hygiene in pregnancy lowers the risk.
Stays latent lifelong; reactivates mainly under immunosuppression.
Sometimes fever and fatigue in young adults — like glandular fever (EBV).
In a healthy person there is no treatment; the virus then stays silent in the body for life. Antivirals such as ganciclovir and valganciclovir are used with weakened defences and after transplants — they hold the virus down, they do not remove it. In a newborn with symptoms, six months of treatment can protect hearing; starting within the first month of life is what decides.
About fifty to eighty in a hundred adults carry the virus. It is the most common infection passed from mother to child: about one in two hundred newborns is affected, and of those about ten in a hundred show signs at birth. Hearing loss can appear only in the first years of life — which is why hearing is checked over years in affected children. Toddlers shed the virus in saliva and urine for months.
Most infections pass without any sign. When signs do appear they resemble glandular fever: fever over one to two weeks, tiredness, aching limbs — but with less sore throat.
A mild involvement of the liver is common and is often found by chance in a routine blood test while one only feels tired.
A first infection during pregnancy is the situation that matters. The most common route is contact with saliva and urine of small children — washing hands after nappies and not sharing cutlery are the simple levers.
Too small a head circumference, lasting jaundice, pinpoint bleeding in the skin, and above all a hearing loss that only shows up over time. That is why hearing is checked repeatedly.
A mononucleosis-like picture with atypical lymphocytes is possible at first infection.
The most important point: a first infection in pregnancy can pass to the child — CMV is the most common congenital infection of all and the most common non-hereditary reason for hearing loss in childhood. Transmission mostly happens through the saliva of small children.
With healthy defences the virus stays quiet. Under cortisone, after a transplant or with a weakened immune system it wakes up — that is the actual risk point and not a first infection in a healthy person.
CMV passes through saliva and body fluids, not through food. In pregnancy hand hygiene around small children therefore counts more than any dietary rule.