Congenital CMV Infection in the Neonatal Period

Hearing Loss in the Neonatal Period May Indicate Congenital CMV Infection!

Although affecting individuals of all ages worldwide, Cytomegalovirus (CMV), which is not well recognized, can particularly impact the baby when encountered during pregnancy. In such cases, Child Infectious Diseases Specialist Assoc. Prof. Dr. E. Manolya Kara emphasized that a condition known as "Congenital CMV infection" can occur, affecting various organs. She stated, "Children with congenital CMV infection may experience long-term health issues such as hearing loss, developmental and motor delays, vision impairment, and epilepsy seizures."

Congenital CMV infection, recognized as a significant global health issue, is observed at around 0.6% in developed countries. Child Infectious Diseases Specialist Assoc. Prof. Dr. E. Manolya Kara from Yeditepe University Kozyatağı Hospital mentioned that in the United States, it's known that about one in three children are infected with CMV by the age of five. She highlighted that infants infected with this virus during pregnancy, particularly, can experience serious issues starting from the early postnatal period.

This infection affects individuals of all ages.

CMV is a common virus that can affect individuals of all ages, but generally, the immune system of a healthy person prevents the virus from causing illness," explained Assoc. Prof. Kara. She continued, "In adulthood, more than half of the population has been infected with this virus. Once CMV enters a person's body, it remains there for life and can reactivate especially in situations where the immune system is suppressed, such as cancer, chemotherapy, and organ transplantation. Additionally, a person can be reinfected with a different strain of the virus. Most people with CMV infection either have no symptoms or experience mild viral infection symptoms, making them unaware that they are infected. Consequently, they can unknowingly spread the infection to others."

"Congenital CMV is a Significant Health Issue"

According to the data, Doç. Dr. Kara stated that approximately 1 in every 200 babies is born with congenital CMV and provided the following information about the possible symptoms in babies:

"In infants with congenital CMV infection, symptoms such as skin rash, jaundice, small head size (microcephaly), low birth weight, enlarged liver and/or spleen, vision problems, and seizures (convulsions) may be observed during the early postnatal period."

"Hearing loss can be the initial symptom."

Some babies may appear completely normal at birth, but hearing loss detected through screening tests can be the first sign of the disease, stated Assoc. Prof. Dr. Kara, and continued: "Even in a newborn period with normal hearing, hearing loss can still occur later. In approximately half of the newborns with clinical findings at birth, and in about one-fourth of asymptomatic babies, long-term hearing loss can occur. Conducting hearing tests in newborns and periodically checking suspicious babies is crucial for the early detection and treatment of hearing loss."

What to Do If Infected During Pregnancy?

Pointing out that most people with CMV infection do not exhibit clinical symptoms, and therefore are often unaware of the condition, Doç. Dr. Kara emphasized that pregnant women who become infected with the virus (often encountering it for the first time) can transmit the virus to their baby. Doç. Dr. Kara provided the following information on the subject: "Serologic tests conducted before pregnancy can indicate whether an individual has encountered this virus. However, it should be remembered that even in those who have previously encountered the virus, there is a risk of developing a new infection and the possibility of congenital CMV infection in the baby. Routine screening tests for CMV infection during pregnancy are not recommended. This is because laboratory tests cannot predict which babies will become infected with CMV or whether they will experience long-term health problems. When suspicions arise from ultrasound checks on the baby during pregnancy, diagnostic tests should be performed. Furthermore, it should be kept in mind that a baby with congenital CMV infection can have completely normal prenatal checkups."

Disease Spread: Be Cautious with Young Children!

Yeditepe University Hospitals Pediatric Infectious Diseases Specialist Assoc. Dr. E. Manolya Kara, emphasizing that by the age of 5, about one in every three children is infected with CMV, but they usually don't show symptoms. Therefore, she pointed out that young children are a common source of CMV in the general population. Especially individuals who are frequently around young children are at a higher risk of CMV infection, according to Assoc. Dr. Kara. She provided the following information regarding the precautions that should be taken: "The virus can remain in the child's body fluids such as saliva and urine for months after the infection. Therefore, parents and other caregivers of children (e.g. healthcare workers, teachers) can reduce the risk of contracting CMV, especially during pregnancy, by reducing the child's contact with saliva and urine. During this period, it is important not to share food and water containers with young children, and handwashing with soap and water after changing diapers or using the toilet is essential to prevent transmission."

Effective results can be achieved with early diagnosis and treatment

Antiviral drugs that can be used in CMV treatment, especially when started in the first month of life, can lead to effective results, according to Assoc. Dr. E. Manolya Kara. She stated, "This can reduce the risk of hearing loss; however, due to the potential side effects of the drugs, patients should be closely monitored during and after the treatment process through physical examinations and laboratory tests."