Cytomegalovirus is generally passed from infected people to others through direct contact with body fluids, such as urine or saliva. CMV can also be found in tears, blood, and semen.

Most healthy children and adults infected with CMV don't feel ill so they don't know that they have been infected; others may have mild flu-like symptoms such as fever, sore throat, fatigue or swollen glands.  The only way to know for sure that you have CMV is to have your medical provider test you for it.

CMV is a member of the herpes viruses so once you have been infected, it remains in your system, and can re-activate in the future. When someone catches CMV for the first time, it is called a primary infection. When someone who already has had the virus gets infected with another strain, or their current strain becomes active again, this is called a nonprimary or secondary infection.

• 1-4 out of 100 women will experience a primary infection during pregnancy
• 1 in 1000 women will experience a secondary infection during pregnancy

Although it is more likely that the fetus will be affected by a primary infection, a secondary infection may still cause harm to the baby.

There is currently no vaccine available to prevent CMV. Research is on-going for the development of a vaccine.

If you're pregnant or planning a pregnancy, the best way to protect your baby from CMV is to protect yourself.

1. When you kiss a young child, try to avoid contact with saliva. For example, you might kiss on the forehead rather than the lips.
2. Try not to put things in your mouth that have just been in a child’s mouth. For example:
   • Cups
   • Forks or Spoons
   • Pacifiers
3. Try not to share food, drinks, or a toothbrush with a child.
4. Wash your hands after touching a child’s saliva or urine, especially after:
   • Wiping a child’s nose, mouth, or tears
   • Changing diapers
5. Use soap and water or a disinfectant to clean toys, countertops, and other surfaces that may have a child's saliva or urine on them.
6. Act as if everyone around you has a cold or a stomach bug and practice the same prevention strategies!

Pregnant women should avoid getting body fluids in their eyes, nose or mouth. One of the most common exposures is through contact with saliva or urine of young children who recently had the virus.

Research shows that women who work closely with small children in settings such as child care facilities or have other children in the home while pregnant may be at greater risk.

Women can also be exposed to the CMV virus through body fluids during sexual activity. Those who participate in high-risk behaviors are at greater risk.

The Centers for Disease Control and Prevention states that the risk of getting CMV through casual contact, such as hugging, is very small.

If you're pregnant or planning a pregnancy, the best way to protect your baby from CMV is to protect yourself.

• Don't share food, drinks, or eating utensils with a child.
• Do not put a child's pacifier in your mouth.
• Do not share a toothbrush with a young child.
• Use soap and water or a disinfectant to clean toys, countertops, and other surfaces that may have a child's saliva or urine on them.
• Avoid contact with a child's saliva when kissing or snuggling.
• Wash your hands often with soap and water for 15-20 seconds, especially after:
  • changing diapers
  • feeding a young child
  • wiping a young child’s nose or drool
  • handling children’s toys

When infected with CMV, most women have no symptoms, but some may have symptoms resembling mononucleosis or influenza. Women who develop a mononucleosis or flu-like illness during pregnancy should be tested for CMV. Testing should also be considered for women who have close contact with children or adults with known CMV infection. CMV can cause fetal abnormalities that are visualized by ultrasound. If abnormalities are detected during routine fetal ultrasonography, CMV testing may be important and should be discussed with a high-risk obstetrician (Maternal-Fetal Medicine physician).

For more information on a suspected maternal CMV infection and how to test for it see CMV for Obstetrical Health Care Providers.

In order to identify infants at risk for congenital CMV-associated progressive hearing loss, infants who fail the second hearing screening, unilaterally or bilaterally, should be tested for CMV no later than 3 weeks of age. This can be performed with a PCR assay for CMV on urine or saliva. After 3 weeks of age, these tests cannot differentiate between congenital CMV and CMV acquired postnatally.

These infants should undergo a complete diagnostic audiologic evaluation as soon as possible. Frequent audiologic re-assessment is also needed to promptly identify and treat progressive hearing loss. The frequency of this testing should be determined by the child’s audiologist.  A general recommendation for all babies with congenital CMV (regardless of their newborn hearing screening results) is to have a hearing re-assessment every 3 months in the first three years of life, and then every six months through age six years.

A referral to the Baby Watch Early Intervention Program should also be made. A CMV positive diagnosis is an automatic qualifier for Early Intervention

To date, there is no FDA approved drug to treat congenital CMV infection. There is limited data on the use of antiviral medications in infants with symptomatic congenital CMV infection. Studies are ongoing to determine what types of therapy are of greatest benefit to CMV-infected infants. Infants with suspected congenital CMV infections should be evaluated by physicians who specialize in these infections.

CMV Newborn Hearing Screening (NBHS) and PCP Flowchart

Baby Watch Early Intervention