Cytomegalovirus (CMV) In Babies: Symptoms & Causes

It spreads through bodily fluids, and the mother and baby may remain asymptomatic.

Medically reviewed by Dr. Regina A. Hardin, MD Dr. Regina A. Hardin Dr. Regina A. HardinMD facebook_iconlinkedin_iconinsta_icon Specialty: PediatricsExperience: 20 years
Written by Dr. Meenakshi Maruwada
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Babies Born With CMV: Symptoms, Causes And Treatment

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The infection of cytomegalovirus or CMV in babies happens when the little one contracts the virus from an infected person. The virus is a type of herpes virus. The mother may be asymptomatic, but the virus may stay dormant in the body (1). The virus might transfer from the maternal blood to the baby’s blood through the placenta.

Babies born with CMV infection are said to have congenital CMV infection. While most babies with CMV infection do not exhibit any symptoms, they might develop some health issues later (2).

Read this post to learn about the modes of transmission, symptoms, diagnosis, treatment, and prevention of CMV infection in babies.

Causes Of CMV Infection In Babies

CMV infections are contagious and can spread through bodily fluids. Below are the various ways a baby could catch CMV and develop an infection (3).

  • Transmission of the virus from the mother to the fetus through the placenta, causing congenital CMV infection. Around 40% of babies born to women with CMV infection during pregnancy will develop congenital CMV infection (4).
  • Transmission of the virus from the mother to the baby through vaginal fluids during vaginal delivery. It is called perinatal CMV infection.
  • Transmission of the virus from the mother to the baby through breast milk. It is also known as perinatal CMV infection.
  • Transmission at daycare or at home through the inhalation of expelled respiratory droplets of infected person or contact with objects contaminated by bodily fluids, such as saliva or urine. It is called acquired CMV infection and seldom causes symptoms.

Signs And Symptoms Of CMV Infection In Babies

About 80-90% of healthy full-term babies with CMV infections have no symptoms (5). However, some babies develop symptoms as they grow (3). Maternal antibodies are felt to be protective and thus most term babies who are exposed do not have symptoms or don’t become infected. However, premature babies are more at risk since they may not have antibodies to CMV. As stated, the risk is higher in babies born prematurely or full-term babies who develop other conditions, such as hepatitis or pneumonia, in the initial days after birth (6). The symptoms vary for congenital and perinatal CMV.

Symptoms of congenital CMV infection are:

  • Small head size
  • Jaundice characterized by the yellowish color of the skin
  • Enlarged liver and spleen
  • Eye problems, such as inflamed retina
  • Broken blood vessels under the skin
  • Skin rashes
  • CMV-related hearing loss
  • Low birth weight

Symptoms of perinatal CMV infection are:

  • Abnormal blood test results, such as low platelet count and high liver enzymes
  • Lung inflammation and infection
  • Enlarged spleen and liver

Acquired CMV infection may not usually cause symptoms. If symptoms do occur, they are similar to mononucleosis infections, causing low-grade fever, sore throat, swollen lymph nodes, fatigue, and loss of appetite. The symptoms may resolve in a few days to weeks.

How Is CMV Infection Diagnosed?

CMV infections are rarely diagnosed in the mother due to a lack of symptoms. However, if your baby’s doctor suspects CMV infection in your baby, they may run a few tests for a proper diagnosis (1).

  • Amniotic fluid is tested if CMV infection is suspected in a fetus
  • Urine and saliva cultures of a newborn within three weeks of birth
  • Specialized blood tests, such as TORCH screen
  • Antibody titer levels of mother and the infant
  • Hearing and vision examinations
  • CT scan of the brain
  • Chest X-ray

How Is CMV Infection Treated?

There is no definitive treatment for CMV infection in babies and adults. Babies with no symptoms may not be tested for CMV, thus, not requiring treatment at all. If the baby displays symptoms and is tested positive for CMV, primary treatment could be given for symptomatic relief. Treatment may focus on resolving symptoms or issues with the potential to cause long-term problems, such as poor growth (7).

Infants with severe symptoms, such as neurological issues or hearing loss, may receive intravenous antiviral medications after diagnosis for several weeks (3). Common antiviral drugs used are valganciclovir and ganciclovir. These can slow down the multiplication of the virus, giving the body time to fight the infection.

Complications Of CMV Infections

If a newborn or baby shows signs of CMV infection, they must be treated immediately to avoid complications. Possible CMV infection complications in babies include the following (1) (7).

  • Nervous system problems, such as seizures
  • Growth and developmental problems, including intellectual impairment
  • Hearing or vision loss
  • Feeding issues
  • Difficulty with movement, physical activities, and coordination

How To Prevent CMV Infections In Babies?

The best way to prevent a CMV infection in a baby is to prevent the infection in the mother before conception. Below are some ways to avoid the infection (4).

  • Observe good personal hygiene, such as washing hands often with soap and water for 15-20 seconds at a time
  • Avoid contact with tears and saliva
  • Avoid consuming food or drink from the same container or vessel as others
  • Clean surfaces, such as countertops, periodically
  • Observe safe sex practices

You may also test for the infection before conception and do so periodically during pregnancy. Newborns can be protected from acquired CMV infection through adequate hygiene, such as washing their hands after outdoor play and keeping their toys clean. You must also keep the baby away from unwell family members and have a cold, fever, or cough.

Prognosis Of CMV Infection In Babies

The outcome of a CMV infection in babies depends on whether the baby develops symptoms and their severity.

  • Babies born with symptoms at birth may have a higher risk of developing one or more neurological symptoms later in life.
  • Most asymptomatic babies at birth or those with asymptomatic acquired CMV infection do not develop long-term problems (7).
  • In some babies, the long-term complications may last for a lifetime (4).

Frequently Asked Questions

1. How long does congenital CMV last?

Once a baby is infected with CMV, the virus stays in the body forever. Although there is no cure, the baby may be treated to alleviate the symptoms and prevent complications. The virus usually remains inactive in healthy individuals but may become active if they contract another disease (8).

2. How common is CMV in babies?

According to the CDC, 1 out of 200 babies in the US has congenital CMV, which is one of the most common causes of congenital abnormalities (2).

Cytomegalovirus or CMV in babies may not have symptoms in most cases, and some may develop hepatitis and pneumonia. This infection can be transmitted perinatally through the placenta or breast milk after birth. Contacting an infected person’s body fluids or respiratory droplets can also spread CMV infection. Amniotic fluid testing and maternal antibody testing may help to diagnose perinatal infection. Specialized blood tests, Brain CT or MRI scans, and hearing and vision tests are recommended for babies to diagnose CMV and its complications. There are no particular medications to treat CMV, and symptomatic treatments are usually given.

Key Pointers

  • Cytomegalovirus (CMV) in babies may be caused by transmission from mother to fetus through breastfeeding or by coming in contact with an infected person.
  • Small head size, jaundice, inflamed retina, skin rashes, and low birth weight are a few symptoms of this infection.
  • Children with hearing loss or neurological issues may be given intravenous antiviral medications following diagnosis.

References

1. Cytomegalovirus (CMV) in Newborns; University of Rochester
2. Babies Born with Congenital Cytomegalovirus (CMV); CDC
3. Congenital Cytomegalovirus; Boston Children’s Hospital
4. Cytomegalovirus (CMV); Harvard Medical School
5. Diagnosis and Symptoms in Babies; CMV Action
6. Cytomegalovirus Infection; National Organization for Rare Disorders
7. Congenital cytomegalovirus; U.S. National Library of Medicine
8. CYTOMEGALOVIRUS AND PREGNANCY; MARCH OF DIMES
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Dr. Regina A. Hardin
Dr. Regina A. HardinMD, FAAP
Dr. Regina Hardin is a board-certified pediatrician with over 20 years of experience in outpatient and inpatient pediatrics. She also has extensive training in diagnosing and treating Attention Deficit Hyperactivity Disorder.

Read full bio of Dr. Regina A. Hardin
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