Mention Down syndrome or spina bifida and you’ll get signs of alarm from most parents. Concern about these birth defects has resulted in screening procedures during pregnancy. But almost no-one thinks about cytomegalovirus (CMV)?

What is CMV?

Cytomegalovirus (CMV) might not be a household name, but for expectant mothers, it warrants attention. It’s a common virus, a member of the herpes virus family and is carried silently by the majority of the population.

People with CMV don’t always show signs until they have a weakened immune system and many healthy children can be carriers of CMV. Cytomegalovirus can cause complications during pregnancy, potentially harming both the mother and the developing foetus. Understanding CMV and knowing how to reduce the risk of infection is crucial for safeguarding maternal and foetal health.

According to CMV Australia, about half of all young adults are carriers; the percentage rises to 85 by age 40. In the vast majority of cases the virus is dormant and there are no symptoms at all.

But sometimes, tragically, a perfect storm of circumstances occurs where the infection is passed from a pregnant woman to her unborn child, resulting in a condition called congenital CMV. This is associated with long-term health problems and a range of disabilities varying from vision loss or hearing impairment to cerebral palsy, intellectual disability and developmental delay. In some severe cases, it can cause death to the unborn baby.

About 1–2 in every 1000 babies born in Australia will have disabilities linked with congenital CMV. That’s about the same as the number of babies born with Down syndrome and twice the number born with spina bifida.

A lack of public awareness has meant that most pregnant women don’t know that they could be reducing their risk by being a bit more careful with their hygiene—taking simple steps that could make a lot of difference.

The causes of CMV

CMV has two modes: active CMV infection and dormant. A fresh infection is active. CMV may also come out of dormancy at other times—while the immune system is low, for example, or during pregnancy.

When a pregnant woman becomes infected with CMV for the first time, it’s called primary CMV infection. This primary infection can be passed to the foetus during pregnancy, leading to congenital CMV infection.

While the infection is active, it’s easily spread from person to person via bodily fluids and through direct contact—intimate contact such as kissing on the lips, sexual contact, sharing eating utensils or toothbrushes, wiping a child’s nose or from a child’s saliva (such as drooling while teething).

CMV appears to be active more often in toddlers. Children of this age are still learning about hygiene and usually love to be in close physical contact with their carers and playmates. If they’re regularly in daycare or other environments with a number of similarly aged children, CMV is easily shared among the group.

Young children pose a high risk to pregnant women. A fresh infection during the first half of pregnancy is the most likely scenario that will result in congenital CMV and its related birth defects.

How to reduce your risk of contracting cytomegalovirus

There is no vaccine for CMV. Here are six ways to help reduce your risk of contracting CMV in pregnancy.

1. Don’t share

Sharing food, drinks, eating utensils or toothbrushes, especially with young children (who are more likely to carry the virus), can increase the risk of CMV transmission.

2. Avoid contact with saliva and urine

Take precautions to avoid contact with urine in wet or soiled nappies, and young children’s saliva. This includes refraining from kissing children on the lips, avoiding contact with saliva when wiping noses or tears, and washing hands thoroughly after changing nappies.

3. Practise good hygiene

CMV spreads through bodily fluids such as saliva, urine, blood and breast milk. Practise good hygiene, including frequent handwashing with soap and water for at least 20 seconds, especially after changing nappies, feeding young children, handling children’s toys and dummies. Carefully throw away used nappies and tissues. Clean toys, countertops and other surfaces that come into contact with children’s urine, mucous or saliva with simple detergent and water.

4. Practise safe sex

CMV can be transmitted through sexual contact. Pregnant women should practise safe sex by using condoms consistently and correctly, especially if their partner’s CMV status is unknown. Your spouse can get a blood test to determine their CMV status.

5. Seek medical advice

You can be at a higher risk of CMV exposure due to your occupation (such as healthcare workers) or if you have been in close contact with someone who has recently been diagnosed with CMV. Consult your healthcare provider. Screening and monitoring may be recommended to detect CMV infection early and minimise risks to the foetus.

6. Educate yourself and others

Knowledge is key to prevention. Educate yourself about CMV and its risks. Share this information with family members, friends and caregivers to ensure everyone takes necessary precautions.

CMV and you

Life involves risk. There’s no way to completely avoid all the dangers lurking around us. But when it comes to cytomegalovirus, there are practical ways to reduce those risks and reduce the impact of long-term problems.

Spread the word to your friends to help reduce the risk of CMV spreading and impacting their family. A healthy immune system is important at all times but especially during pregnancy. Why not try our immune-boosting smoothie?

Read: “I would never take her life back, but I would also never knowingly let a child go through that.”

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