Congential CMV Infection

From the American Academy of Audiology

1 in every 200 babies are born with congenital Cytomegalovirus (CMV) infection._[1]

1 in 5 of these babies will have long-term health problems.₁

What is Cytomegalovirus (CMV)?

CMV is a common virus that can infect people of all ages.  It is a member of the herpes virus family. One-third of children are infected by 5 years, and half of adults are infected by 40 years.1  Usually there are no signs or symptoms.  In some cases, a mild illness including fever, sore throat, fatigue, and swollen glands may happen.  CMV infection is not usually a significant problem except for those with compromised immune systems, or if the infection is passed to a baby before he or she is born.  Infants with congenital CMV may be at risk for long-term health concerns.

Signs & Symptoms

Children with congenital CMV can be “asymptomatic” or “symptomatic” at birth.  Most children are asymptomatic, meaning that they do not have significant health problems.  Children with symptomatic CMV may have many symptoms present at birth or have symptoms that develop in early childhood.  Common signs include:

• Premature birth
• Problems with the liver, lungs, spleen
• Small size at birth
• Small head size
• Seizures

Additionally, children with congenital CMV may have long-term health issues that include:

• Hearing loss
• Vision loss
• Intellectual disability
• Lack of coordination, balance problems
• Muscle weakness

How is CMV diagnosed?

Children suspected of having congenital CMV can be evaluated at birth by testing their saliva, urine, or blood.  Since CMV is so common, it is important that testing is completed within 3 weeks to confirm congenital CMV.

Hearing loss in Children with Congenital CMV

CMV is the leading cause of non-genetic hearing loss worldwide.  Up to 20% of children with significant hearing loss is due to congenital CMV infection.2  Hearing loss in children with congenital CMV may be present at birth or may develop over time.  Routine audiology follow up is recommended for children with congenital CMV who passed their newborn hearing screenings.

Children with identified hearing loss should be referred to a pediatric audiologist for amplification.  Many children receive benefit from using hearing aids, while those with more significant hearing losses may be candidates for cochlear implants.  Your child’s audiology team will provide options as well as help your child access programs for early intervention.

How to reduce risk of exposure?₃

• Frequent hand washing, especially after contact with body fluids
• Do not share food, utensils, straws, drinks
• Do not put a pacifier in your mouth
• Avoid saliva when kissing
• Do not share a toothbrush
• Consider screening for CMV prior to pregnancy and talk with your doctor!

Role of Audiologists

Audiologists identify, diagnose, and provide treatment options for patients of any age with hearing loss.  They work closely with physicians, when necessary, and are an important part of the management team.

[1] www.cdc.gov/cmv/congenital-infection.html

[2] Grosse SD, Ross DS, Dollard SC. Congenital cytomegalovirus (CMV) infection as a cause of permanent bilateral hearing loss: a quantitative assessment. J Clin Virol. 2008; 41: 57-62.

[3] www.nationalcmv.org