By Rebekah Hall
I would not be surprised if you have never heard of cytomegalovirus1 (CMV). The majority of individuals in the U.S. haven’t, even though most of us have been infected with it by the time we reach 40 years of age. CMV is typically harmless. If a healthy person has any symptoms of the virus at all, it is similar to a common cold.
However, CMV is one of few viruses that can cross the placental barrier, making it very dangerous if contracted by a pregnant woman. A baby who contracts CMV is at risk for microcephaly and other brain damage, hearing loss, vision problems, cerebral palsy, and death to name a few.
I’d like to tell you about my daughter, Keira. She is four years old, has an effervescent laugh and eyes that sparkle and light up a room. She is also the biggest challenge I’ve faced in my life. The condition she has is preventable and I am passionate about spreading awareness about CMV so that future moms may prevent their children from contracting it.
While pregnant with Keira in 2012, my doctor and I both believed that I was perfectly healthy, yet my baby was born with tremendous challenges. Born at 37 weeks, she was technically full term, but she weighed only 4 lbs., 13 oz. She also had microcephaly, an enlarged liver and spleen, petichiae on her skin, and cysts on her brain; all symptoms, I would soon learn from specialists, which were characteristic of CMV.
At my 6 week, postnatal follow up appointment, my OB/GYN attested that CMV had hardly been covered in medical school and after over a decade of practicing obstetrics, he believed Keira to be the first time he had encountered CMV. Unfortunately, my OB/GYN was not alone in believing that CMV is rare. I have since learned that only 13% of women have ever heard of CMV and fewer than half of all OB/GYNs are routinely educating their patients about CMV2.
Keira now has cerebralpalsy, vision impairment, and failure to thrive. She will never walk or talk and struggles to hold up her own head. She receives her nutrition entirely by G-tube. She is at high risk for hearing loss and seizures. It is very unlikely that she will outlive her parents or her brothers. Her life has not been easy. Since her birth, Keira has undergone 14 surgical procedures and spent over 100 days in the hospital. She is followed by 16 medical specialists and 7 types of therapists. She takes 7 medications on an ongoing basis. She averages 6 appointments per week, not including school.
The Center for Disease Control reports that 1 in 150 babies is born with CMV. Of those, 1 in 5 will have long-term problems because of it. This makes CMV more prevalent than Downs Syndrome, Spina Bifida, HIV/AIDS, and Zika virus. Most people have heard of each of those and may even know something about where it comes from and how to prevent it. CMV needs to join the ranks of Zika and Downs Syndrome to be something that women are aware of and informed about. For our babies’ benefit while pregnant, many of us gladly avoid certain types of fish, cheese, and lunchmeat. We even know to stay away from the cat litter box. All to avoid complications that are less common than CMV.
Here is the good news: CMV IS preventable. Multiple studies that show the overwhelming effectiveness of CMV awareness and hygienic precautions in preventing the transmission of CMV to babies in utero2. Understanding how CMV is contracted and how it can be prevented is critical information for pregnant women to have. Information and awareness will allow women to make informed decisions about whether or not to engage in behaviors that put them at higher risk for contracting CMV.
What are those behaviors? It is important to know that the virus is most readily transmitted from wet saliva to wet saliva. CMV is often contracted by a pregnant woman from her own toddler children or through working in a daycare center.
- Avoid direct contact with the saliva, urine, or mucus of young children.
- Wash your hands frequently, especially after changing diapers, wiping noses, or handling toys.
- Avoid kissing children on the lips. Opt for the cheek or forehead.
- Refrain from sharing food or drinks with young children.
- Do not put a child’s eating utensils, toothbrushes, or pacifiers in or near your mouth.
- Talk to your doctor about CMV. Tell your doctor about any cold symptoms you may have. Consider getting preliminary testing to check your CMV status.
Though I had had two children prior to Keira, had read many books about prenatal development, and visited my OBGYN regularly, I had never heard of CMV until it was too late for my daughter. Most likely, I caught CMV from my then toddler, by kissing him on the mouth or finishing his last bite of macaroni and cheese, or failing to wash my hands after wiping his runny nose. If my OB/GYN and I had been aware, we may have been able to prevent it and/or mediate its devastating effect on my daughter. Please share this information with friends and family who may be pregnant or planning on becoming pregnant.
For more information about CMV, visit nationalcmv.org or the Center for Disease Control website
Carlson, et.al, 2010 Reviews in Obstetrics and Gynocology, “Cytomegalovirus Infection in Pregnancy: Should All Women Be Screened?”
Stuart Adler, August 2015, EBioMedicine “Prevention of Maternal–Fetal Transmission of Cytomegalovirus”