What Is Cytomegalovirus?

Cytomegalovirus or CMV is a group of viruses that can infect humans and cause disease. Cytomegalovirus infection is usually not dangerous and does not cause health problems because the immune system can control the infection of the virus. However, once the body is infected with the CMV virus, the virus can last a lifetime in the patient's body, and serious health problems can occur in people with a weakened immune system, such as organ transplant patients or HIV patients, and babies exposed to this virus from water mother's milk.

Cytomegalovirus infection can be transmitted through the patient's body fluids, such as saliva, blood, or urine. Transmission occurs when the virus is active, for example pregnant women infected with active CMV virus can transmit this virus to the fetus. This condition is called congenital CMV.

Until now, there are no drugs that can cure cytomegalovirus infection. However, giving drugs, such as antiviral drugs, can relieve symptoms that occur in patients.


Symptoms of Cytomegalovirus
Cytomegalovirus infection generally does not cause serious symptoms and is not recognized by the sufferer. Mild symptoms can be seen in people who are infected with this virus, such as a fever of more than 38 degrees Celsius, the body feels tired, pain in the muscles and throat, and swollen lymph nodes.

Meanwhile, pregnant women who are infected with the CMV virus can transmit this infection to the fetus or baby with worse symptoms, including:

• Fetal death in the womb.
• Preterm birth with low birth weight.
• The size of a small baby's head or microcephaly.
• Skin and eyes are yellow.
• The liver enlarges and does not function properly.
• Spleen enlargement.
• Purple spots or skin rashes .
• Newborn death due to bleeding, anemia , and disorders of the liver or brain.
• Delay in baby growth.

Symptoms in infants with CMV virus infection can be detected after birth or several years later.

More serious symptoms are also shown in patients with a weak immune system. These symptoms are in the form of eye disorders (retinitis), lungs ( pneumonia ) of the liver, esophagus, stomach, intestines, and brain ( encephalitis ).


Causes of Cytomegalovirus
Cytomegalovirus is a group of herpes viruses, a group of viruses that cause chickenpox or herpes simplex. This virus can survive in the body even though it is not active, but can be reactivated at any time. When a virus is active, the person can transmit the virus through:

• Direct contact with body fluids, for example holding the eyes, nose, or mouth after direct contact with body fluids with CMV infections.
• Sexual contact. Couples can contract CMV virus infection after sexual intercourse.
• Through transplant organs or blood transfusions.
• Giving breast milk. A mother who is infected with CMV can transmit this virus to the baby while breastfeeding.
• During labor. Mothers infected with CMV can transmit this virus to the baby during labor. The risk of transmission to newborns is higher when first active than when the virus is active again.

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Diagnosis of Cytomegalovirus
Often a diagnosis for cytomegalovirus (CMV) is not needed, especially in adults and children with a good immune system, because no treatment is needed for cytomegalovirus infection. Cytomegalovirus also cannot be detected easily because the symptoms experienced by the patient, such as fever or fatigue, are similar to other viral infections. When a patient is suspected of having a CMV infection, the doctor will conduct an examination to detect this virus from body fluids or tissues. Blood tests in the laboratory can also confirm CMV infection through examination of CMV antibody content. In addition, blood tests also show how many viruses are present in the body.

Sometimes antibodies that are detected in patients with a low immune system cannot prove that CMV is active, so a biopsy of infected tissue is needed, in addition to examination of the organ, for example if suspected retinitis will be done by examining the structure of the eye with an ophthalmoscope. This eye examination will be found abnormalities if there are abnormal conditions.

In addition to people with a weak immune system, pregnant women suspected of being infected with CMV need an examination to ensure the presence of CMV. Sometimes blood tests alone are not enough, so examination is needed through amniocentesis. When the fetus is suspected of having CMV infection, it is necessary to examine the baby within 3 weeks after delivery. For newborns, a diagnosis of CMV can be ascertained through urine.


Cytomegalovirus treatment
Treatment is not needed in healthy people despite infection with the CMV virus. Meanwhile, patients with CMV infection with mild symptoms can usually recover by itself within 3 weeks. However, treatment needs to be done for patients with CMV infection with a weak immune system or CMV-infected infants. This treatment aims to weaken the virus and reduce the risk of more serious health problems, because there is no cure for CMV infection.

Treatment is carried out based on the severity and symptoms experienced by the patient. Drugs that can be given for CMV infection are antiviral drugs that can slow down the reproduction of this virus. Examples of antiviral drugs for CMV infection in the eye are valganciclovir or ganciclovir. Antiviral drugs are also given to patients after organ transplantation to prevent CMV infection.


Cytomegalovirus complications
Cytomegalovirus complications generally vary and can occur to anyone, depending on the patient's health when infected and the patient's overall condition. Complications usually occur in patients with CMV infection with a weak immune system, including loss of vision, digestive system disorders (inflammation of the large intestine, esofagits, and hepatitis ), nervous system disorders (encephalitis), and pneumonia.

Complications may also occur in infants with congenital CMV infection. Forms of complications that can occur include hearing loss, visual disturbances, seizures , lack of body coordination, muscle disorders, and decreased intellectual function.

In rare cases, cytomegalovirus can increase the risk of mononucleosis in healthy adults. Other types of complications that may occur in healthy people include disorders of the digestive system, liver, brain, and nervous system.


Prevention of Cytomegalovirus
Prevention of CMV infection can be done by maintaining cleanliness. Some efforts to maintain cleanliness include:

• Wash your hands often with soap and water for 15-20 seconds. This effort is important, especially when you are in contact with a small child or when children are deposited in a daycare or school.
• Avoid direct contact with other people's body fluids, such as kissing the lips, especially for pregnant women.
• Avoid using the same eating and drinking equipment as other people.
• Cleaning tables, chairs, or toys regularly, especially things that children often touch.
• Be careful when disposing of garbage, especially garbage that has been contaminated with body fluids, such as diapers and tissues. Make sure you don't hold your face or eyes before you wash your hands.
• Conduct safe sexual intercourse by using condoms to prevent transmission of CMV.

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