CMV: Every Pregnant Woman Should Know About This Virus

Congenital cytomegalovirus (CMV) is the most common virus that most people haven’t heard of.

Most every one will catch CMV at some time in their life and never know they have it.

If a woman gets CMV for the first time while she is pregnant, she can be in a potentially dangerous situation. CMV infects almost 1 out of every 100 newborns in the country and is the most common congenital infection.

The virus is passed to the unborn baby from the mother and can cause serious complications in the newborn, like platelet problems, liver disease, and lung disease. It can also cause long-term effects on hearing, vision, growth, and development by invading the brain, eyes, and ears.

What makes CMV even more dangerous is that most people, including pregnant women, have never heard of CMV. And, since CMV does not cause a rash like its cousin chicken pox, you do not know who is infected and shedding the CMV.

The good news is, CMV infection is potentially preventable.

If a pregnant woman is aware of CMV, she can take simple hygienic precautions to reduce her exposure to the virus. Toddlers are a “hot zone” for CMV, and by slightly modifying your behavior while pregnant, you can reduce your risk of catching this silent virus.

CMV is present in saliva and urine, so…

  1. Do not share food or drink with your toddler — no more “one for mommy one for baby” mealtime games while you’re pregnant.
  2. Do not kiss your toddler on the lips or cheek, rather hug them and give them a loving kiss on the top of the head while you’re pregnant.
  3. Wash your hands carefully after changing diapers and wiping your toddler’s nose and face.

An ounce of CMV awareness and 3 simple hygienic precautions while you’re pregnant are all it takes to save your unborn baby from a potentially devastating infection.


Dr. Demmler-HarrisonDr. Gail Demmler-Harrison presented on September 27, 2014 at the CMV – Cytomegalovirus Public Health Policy Conference at the Little America Hotel in Salt Lake City, Utah during a topical session on use of social media to increase CMV awareness. For more information, visit here. Title: Global Response to CMV Awareness Through a Pediatric Hospital Blog Website.

The session was well received with many interesting and thoughtful questions from the audience. The conference brought together scientists, health care professionals, parents, non profit organizations, policy makers and legislators to discuss ways to increase CMV awareness, education, funding, and support about ways that are available to prevent CMV infections in pregnancy and treat congenital CMV infection in the fetus and newborn.

About Dr. Gail Demmler-Harrison, Infectious Diseases

I am a pediatrician at Texas Children's Hospital who specializes in infectious diseases in children.

I'm an expert in congenital cytomegalovirus (CMV) infection, with over 25 years of experience diagnosing and treating babies born with congenital CMV. I also do research on the long term effects of CMV on children as they grow. I'm an advocate for CMV Awareness in the community.

Posted in Motherhood, Pregnancy

655 Responses to CMV: Every Pregnant Woman Should Know About This Virus

  1. Tatiana Lanzieri says:

    Congratulations on your blog and all the wonderful work you have been doing!

    • Milda says:

      Thank You for the amazing article!
      I do have a related question noone answered me yet.
      I had an early pregnancy (up to 8 weeks) termination because of the nondeveloping fetus 1.5 months ago. Doctor couldnt say the reason. Recently I have checked CMV and it shows igm negative but igg very high -more than 250 (norm 1-6). Everywhere I find info, that igg positive is nothing serious, it shows that you had a virus and now it is in a latent (“slowly”) form. But doctor told me not to plan a new baby until my igg level falls down. No treatment, just to wait, eat well, sleep well ect. So i dont understand- if igg positive means i have lots of antibodies against the cmv virus why is it harmfull to plan a new baby? And what is a ‘healthy” number for igg positive? I never met anyone with such a high cmv igg. Whjat will happen if i get pregnant?

      • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

        Dear Milda,

        Thank you for your post.

        The presence of CMV IgG positive antibody, no matter what the level- high or low- usually should not be a consideration for becoming pregnant again. If the CMV IgM antibody is negative and CMV IgG antibody is high, then there is a resolved CMV infection, and it is now likely a latent CMV infection that is of minimal risk to a new pregnancy. It is therefore OK to plan another pregnancy.

        I hope this information is helpful. Best wishes for a healthy pregnancy.

        • Miren says:

          Dear Sirs,

          I am a 30 years old woman with a 18 months old child. We were planning to have a new baby for next year. As we have a congenital CMV infected niece (30 months old), we went to the doctor to have a blood sample before start trying again, just to check if I have been infected with the CMV. The test results says that I am experiencing a new infection (IgG=3.3, IgM=4.94).

          My doctor says that we need to control those values next month. However me and my husband have a lot of questions and doubts facing my next pregnancy. Knowing my niece´s case, we are really worried about infecting our new baby, that is why we started looking for more information.

          Here in Spain, it is no common to check CMV in pregnant women. In my first pregnancy I just did it on my own, when we noticed that my niece were deaf because of the CMV. Do you check CMV in all pregnant women in USA? Surfing by internet we found your great articule entitled “What Everyone Should Know About CMV”. It gave us another point of view about the matter, hence we decided to contact you in order to find some helpful data and recomendation for us. We would like to know when should be the correct moment to be pregnant again and how should we proceed before that.

          I look forward to hearing from you soon.

          Best regards,

          • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

            Hi, Thank you for your post on my CMV blog.

            It is recommended to wait until the CMV IgM antibody is negative to conceive a baby after a recent primary CMV infection. This usually takes 3 to 6 months for most women. Repeat testing for CMV IgM, CMV IgG, and CMV IgG avidity testing (if available) can be done every month to two months, to monitor for the trend.

            I hope this is helpful to you.

            Best wishes for a healthy pregnancy.

          • hena says:

            SIR,
            Am 22 years old.. recently i check my cmv level… my cmv level in igg is 153 and in igm is negative… but two months before am aborted… doctor said there is no problem with this… now i can plan for baby… this cmv infection i got with my husband?

          • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

            Dear Hena,

            Thank you for your post on my TCH CMV BLOG.
            A positive CMV IgG level and a negative CMV IgM level usually indiates a past CMV infection and it should therefore be safe to plan for another pregnancy from the CMV perspective.
            CMV is a virus that is very common and can be caught from close contact with family members, including the spouse, or children, or other people. It is not possible to determine from whom you acquired your CMV. Most people will acquire CMV at some time in their life, either as children, teenagers or adults.
            Best wishes for a healthy pregnancy !
            Take care.
            Dr Gail Demmler Harrison
            CMVDOC

        • sanchita says:

          I am an Indian 35years old woman. had two miscarriages in last two years,so doctor suggested me to go through “Torch” Test ,the results were as follows.

          1.CMV IGG 80(POSITIVE)
          2.CMV IGM 0 .12(NEGITIVE)
          3.RUBELLA IGG 176(POSITIVE)
          4. RUBELLA IGM 0.15(NEGITIVE)

          As I have rubella as well as CMV virus IGG positive with high value I am scared of having an abnormal child which I dont want. Now i have conceived again and this is my first month of pregnancy. so want to know what would be the chances of abnormalities in my baby. Should i continue my pregnancy or terminate it. Kindly advice with artifacts.

          • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

            Dear Sanchita,

            Thank you for your post on my CMV TCH BLOG.

            The “TORCH” serology values for rubella and CMV indicate past or resolved infections with these viruses and you are therefore “immune”. There is nil to no risk to your current pregnancy for your baby to be infected or affected from these two viruses. In fact, it is common to have CMV IgG antibody and rubella IgG antibody and it is not considered abnormal. Since your IgM levels to CMV and rubella are negative that means your infections are “old’ infections from a while ago and not current infections and not a risk to your current pregnancy.

            You should consult a specialist in high risk pregnancies to determine the reason for your recurrent miscarriages. It is likely your miscarriages are related to another process and not caused by these two viruses. A fetal ultrasound should be done also and may be reasuring to make sure your baby is developing normally and your pregnancy is proceeding normally. There is no indication at this time for a termination of your pregnancy, based on your blood test results.

            I hope this information is helpful. Best wishes for a healthy pregnancy.
            Dr Gail Demmler Harrison
            CMVDOC

        • Rebecca says:

          Dear Dr Demmler Harrison,
          Last year in Octtiber my daughter was presenting with swollen glands and tested pos for IgG and IgM and as we were trying for another baby I got tested and also tested pos to both markers. Luckily I wasn’t pregnant but we have waited six months and want to start trying again. I have tested pos to both markers 8 weeks ago and had another blood test today (still awaiting the results). My problem is this- I have had so much conflicting advice from specialists here in Australia about how long I have to wait to try and conceive. Firstly the drs in the womens and children’s hospital were saying wait one month and start trying. Then a specialist told me a few months. Then my GP told me to wait until my IgM was undetectable. Then another dr said 6 months. Then today another dr said 18 months! I’m beside myself with confusion! I’m in perfect health and am desperate to start trying for another baby but I in no way want to put them at risk either. My IgG has always been pos in these tests as has my IgM. I have no knowledge of previous tests or infections so can not be sure if it’s a primary one or not. The medical system here won’t allow me titres on my blood tests either. With all this inconsistent advice I’m starting to feel very unsure. I’m well read and researched in this subject but can not seem to come up with a conclusive answer as to how long I have to wait and whether my IgM also has to be negative. Please help me find some clarity! Thank you kindly!

          • Jacquie says:

            I am from Australia too and in a similar situation to Rebecca having seen a number of drs who have give different advice. I contracted CMV post pregnancy (luckily) when my daughter was 10 weeks old in oct 2012 but did not get a confirmed diagnosis until feb 2013 where I tested positive for both Igg and IgM. I had extreme fatigue, joint pain in hands and feet and was tested for all the autoimmune stuff which luckily came up negative. Anyway 18months later I am still testing positive to both IgG and IgM and still taking lexapro to ward off fatigue and joint pain but have been advised to ween off this in the next few months. I have been advised to wait 18months-2years from when I contracted CMV before trying to fall pregnant again which if this is right means I can start trying again this October however I am still testing positive to both IgM and IgG. One specialist told me my IgM status may never convert and the way to avoid risk to future pregnancy is to just to wait until October to start trying. Are there cases where people’s IgM status never converts? And what does this mean for future pregnancy?
            Jacquie

          • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

            Dear Jacquie,

            Thank you for your post on my TCH CMV BLOG.
            The persistent presence of a positive CMV IgM antibody test may mean a cross reaction or false positive CMV IgM test- this may occur in autoimmune conditions and other special conditions – do you also have rheumatoid arthritis or lupus or another autoimmune conditioin that may be evolving to account for your chronic symptoms in your joints, fatigue, etc. The abnormalities in serum seen in autoimmune disorders may cause a false positive CMV IgM result in some patients.
            The CMV IgM response after a primary CMV infection usually lasts 3-6 months, and rarely up to a year. Persistence beyond that time period due to the CMV alone is highly unusual and in fact something I have not seen, except in immune compromised patients who are receiving immune suppression drugs or chronic steroids or have received transplanted organs or have lupus and are on high doses of steroids.
            If you are otherwise well and not on immune suppression medications, the likelihood of having a healthy baby without effects of CMV disease are very good because you have waited so long after your diagnosed primary CMV infection. It is possible you may transmit CMV from a recurrent/reactivation of your own CMV infection, but these infections are unusual [ occur ,<1% of all CMV seropositive pregnant women] almost always benign and without symptoms. You may always have a positive CMV IgM antibody result but since we know it occurred over a year ago, the risk to your next pregnancy is low to nil.
            I hope this is is helpful information for you.
            Best wishes for healthy pregnancy.
            Dr Gail Demmler Harrison
            CMVDOC

          • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

            Dear Rebecca,

            It is best after a recent primary CMV infection to wait until the acute primary CMV infection has resolved before trying again to have another pregnancy.
            The markers for resolved primary CMV infection include a negative CMV IgM antibody and a high CMV IgG avidity index. The CMV IgG antibody will remain positive for your lifetime. The titer of the CMV IgG antibody is really not needed or necessary to help decide the timing of the next pregnancy, but the CMV IgM should be negative and the CMV avidity index should be high.
            It usually takes at least 3 to 6 months for most healthy woemn of child bearing age to resolve their primary CMV infeciton and revert a positive CMV IgM antibody to a negative CMV IgM antibody and to develope a high CMV IgG avidity index.
            Some women take longer however. The longest I have seen personally is 12 months.
            It is best to wait at least 6 months after your primary CMV infection before trying again for another pregnancy. Your CMV infection appears to have been around the month of October 2013, so it is likely, from the CMV infection perspective, you will be able to plan another pregnancy soon.

            I hope this information is helpful to you.
            Best wishes for a healthy pregnancy.
            The 5th International Congenital CMV Conference will be held in Brisbane April 20-24 2015. There are many excellent CMV experts in Australia you may be able to contact.

            Dr Gail Demmler Harrison
            CMVDOC

        • Brianne Hansen says:

          I located your contact information via the internet regarding your expertise with CMV. I recently lost my baby boy as a stillborn at 31 weeks. Autopsy results showed the cause of death to be CMV which resulted in large cerebral hemorrhage. I was very surprised to learn how common CMV was, and also concerned as to why not one of my doctors had ever mentioned the risk or prevention strategies to me (I have a two year old daughter at home who goes to daycare). I work in healthcare, and that is why it was even more surprising to me. Anyway, I have discussed with my OB, a perinatologist and an infectious disease doctor regarding my case. Unfortunately, no one has been able to tell me my risk with subsequent pregnancies, when I can/should get pregnant again, etc. I do not want to put another child at risk, but really want to have another baby.

          I requested that my OB order some labs for me to help determine risk. The results are as follows:

          CMV IgG – Positive (36)
          CMV IgM – Negative
          CMV Avidity – HIGH
          Serum PCR – Not Detected
          Urine PCR – Detected

          I understand the first three labs tell me that I am not currently experiencing active infection, and that my exposure was likely months ago. I do not know how to interpret the Positive Urive PCR test though, and unfortunately neither do my doctors. Should I be concerned about this viral load, or is the negative serum PCR enough to confirm a low viral load? Do I need to wait until my Urine PCR is not detectable prior to conceiving again?

          I sincerely apologize for this informal consult, however I am at a loss as to how to proceed. As a healthcare professional I rely on data to assess risk, and unfortunately cannot find specific numbers regarding my risk at this time. Therefore I am seeking expert advice since my physicians seem not to have a ton of experience with patients like me. I greatly appreciate your time and consideration regarding my questions.

        • waheeda says:

          i am an indian ,aged 32 years and and this is my second pregnancy, last issue born in late 2011. i did torch at 16 weeks gestation and it is showing raised igg for cmv(85), herpes(igg 15) with normal levels of igm for all of TORCH components. kindly suggest me what should i do.
          thanks

          • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

            The presence of positive CMV IgG antibody and negative or no CMV IgM antibody suggests a past CMV infection and immunity to primary CMV infection, which is the greatest risk for the fetus. There is a very small risk for recurrent/reactivation CMV infection, but the risk regarding CMV to another pregnancy is nil at this time. Please also consult your doctor about what is best for you and your particular situation.

            I hope this information is helpful to you.

            Dr Gail Demmler Harrison
            CMVDOC

    • Kristina chippington says:

      Hi Dr Gail,

      I am so glad I found your blog I have found it really informative.
      I am writing from sydney Australia and my name is Kristina.
      Less then 3 months ago we lost our baby boy at 30 weeks due to a cmv infection. It was the first time we had heard of this awful crippling virus. My main question for you is how long am I to wait to fall pregnant again? There has been so much conflicting advice from my dr’s and specialists. It looks as though I had either caught a new strain of the virus or reactivated it. My blood results at 28 weeks showed that I had had a past infection Igm negative for cmv but positive igG. So we thought baby was safe from cmv then results at 30 weeks after we had lost our boy showed IgM positive and increased affidity of igG to 90%. Very confusing to me. Our baby entered the world on July 21st sleeping and results in autopsy showed cmv all throughout him. When is a safe time to fall pregnant. Obviously want a healthy baby but desperate to get pregnant soon. Thank you ,
      Krissy.

      • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

        Dear Kristina,

        Thank you for your post on my TCH CMV BLOG.
        I am so sorry for your loss.
        This is of course a very difficult situation and it is very difficult for me to provide you with exact suggestions, but I will try and provide you with some facts and estimates that you and your doctors may work with to help you with the timing of your next pregnancy.

        Regarding timing for your next pregnancy, it depends on when you acquired CMV for the first time (primary infection). It is difficult to tell for sure and with certainty when you acquired CMV and transmitted it to your unborn baby, however, if at 28 weeks you were already CMV positive IgG and IgM negative, your primary CMV infection likely occurred early in the first trimester of your pregnancy. That is an estimate, based on averages, since most positive IgM levels after a primary CMV infection during pregnancy, last 3-4 months at least, some last for 6 to 12 months, some may be as short as 2-4 weeks, depending on the individual reponse and the type of test used for CMV IgM antibody determination. So, it is possible your CMV tests were done after your primary CMV infection of pregnancy had resolved but after CMV was transmitted to your baby. Your baby’s CMV results indicate an active CMV infection that probably occurred at least 4 months prior to the birth/delivery. It is possible but also very very unusual/rare for an inutero CMV infection to be symptomatic and fatal in a fetus as a result of a maternal recurrent or reactivation or reinfection with CMV. In these cases, there have usually been something wrong or deficient with the mother’s immune system. That is why I think it is more likely you acquired CMV for the first time early in your pregnancy. Once again, these are “best guess estimates” and no one can tell for sure, but I hope they help you understand the meaning of the tests and when CMV occurred in your pregnancy.

        If your CMV IgG is positive and your CMV IgM is negative then it is very unlikely you will transmit CMV to your next baby at this time. If you are healthy (and not immune suppressed from an illness) and you and your doctors feel you are ready for another pregnancy, and if you are CMV IgG positive and CMV IgM negative, I would recommend waiting 6 – 12 months from your delivery ( that is at least another 3 months or so) to try and conceive again. It is understandable to want another baby but it si also important to let your body heal from this event.

        During your next pregnancy, it would be wise to follow the recommended hygienic precautions outlined in my BLOG and recommended by the CDC to reduce your risk of acquiring a second strain of CMV, which, while unusual, may occur.

        I hope this information is helpful to you.
        Best wishes for a healthy pregnancy in the near future.

        Dr Gail Demmler Harrison
        CMVDOC

        • Kristina chippington says:

          Thank you so much for your reply.
          It has been very helpful for my partner and myself.
          We have an appointment with a sydney cmv expert in 2 weeks which I am very much looking forward to, we will work out a good plan for our future pregnancy.
          Thank you again, Krissy

  2. Holly says:

    This is exciting!! Keep spreading the word about CMV, hopefully we can see more about this in the general news and public health topics of today!

  3. Lisa Saunders says:

    Thanks so much for doing what you can to make women aware of CMV. I really hope someday that OB/GYNs will make a CMV prevention message a standard practice of care.

  4. Emily says:

    STOP CMV!!!!!

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thanks every one for your responses. It’s important for us to get the word out about CMV and how pregnant women can prevent it and keep their unborn babies healthy. I’ll be sure to create blog posts in the future with more details about CMV awareness and prevention. Stay tuned and thanks for reading!

      • Evonne Pavlides says:

        Hi doctor and thanks so much for the insight. Im 22 weeks preg with my second child,my first is 3 years old. My sister n law has twins 20 months old that go to daycare and had also caught the kawasaki syndrome. I saw the daycare the twins go to and didnt want my son to go, gave up my banking career to be at home as my son had asthma and was getting worse. Thank God he has recovered. Now my sister n law was told 2 weeks ago at 13 weeks preg that she has CMV and that her baby may have problems. Is it possible she caught through the twins who go to daycare? Should they be tested too? Im worried as we meet up often at my mother n law and my son always plays with them and they share toys. Could i catch it by being exposed to them at 22 weeks pregnant and pass it on now to my unborn baby?

        • Kasia says:

          Hello
          I’ m from Poland and we dont talk much about this virus in my country. I’m very concern about this problem. I’m 37 years old primary teacher. I work in small school, mainly with children 10-12 years old and I would like to ask If I can get this terrible ilness through sneezing and coughing. My life is a misery now because I’m tense and nervous all the time through school day. When one of my pupil come towards me Im avoiding contact and I’m stop breathing. Lots of this children are sneezing and coughing. Should I make a leave for the rest of pregnancy? I’m 20 weeks pregnant. I have also over 2 years old daughter at home and 8 years old son. My doughter doesnt attend to day care. How can I prevent catching this from children. Why I didnt get CMV earlier when working with children? Please, can You give me your answer.

    • Courtney says:

      i ust wish there was a way to prevent this horriable infection my best friends daughter passed away last year at 2 1/2 from complications to CMV is there any fundrasieres for this

      • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

        Dear Courtney,

        Thank you for your post on my blog.

        Condolences on the loss of your friend’s child due to congenital CMV. It is indeed a tragedy and more research and public health awareness are needed to help combat this disease.

        If you would like to donate to our CMV Research Programs here in Houston, please contact me at cmv@bcm.edu for more details.

  5. Ashley says:

    I think this site is great! Hopefully CMV will be more well-known this year! STOP CMV!!!!!! :)

  6. Kayl says:

    Thanks for all of your work! Everyone needs to know about CMV.!!!

  7. april meyer says:

    What a great way to spread the word, thanks!

  8. Felicia Johnson says:

    So for those that have CMV children, and there is such a wide array of health issues related to this disease, how do we start getting answers. My daughter has been such a mystery that I can’t find a doctor that seems to know much about how it will continue to affect her. I’m sure there are more knowledgeable docs out there, but how do we find them?

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      I agree with you! CMV can damage almost any organ system in the developing body and brain and every child with congenital CMV is different. Infants and children can have problems with their liver and spleen, their blood forming units, their growth and nutrition, their teeth, their hearing, their vision, their motor function, their neurological function, and their development and behavior and school performance. For that reason, we have a multidisciplinary team approach, with specialists in nutrition and feeding disorders, liver, spleen and blood disorder problems, developmental and neurological disorders, eye and hearing problems, as well as learning, behavior, and communication disorders, available to our patients who are seen in our CMV / Infectious Diseases Clinic here at Texas Children’s. You can contact us at (832) 824-4342 or cmv@texaschildrensblog.org for more information.

      • Heather says:

        Makes me want to move to Texas!

      • miriam horowitz says:

        Kudos to Dr. Gail on this excellent and informative article! As a young mom, 8 weeks pregnant, I recently discovered that I am CMV IGM positive. I was shocked to discover how common this virus is and how easy it is to catch it, yet how devastating the affects can be. There should be a vaccine against it!! Needless to say, I am worrying a lot about my unborn baby. It’s still too early to tell, but I am hearing from various sources that abortion is advised if serious damage is noted. For now, I only know that the CMV avidity test came out borderline. Is that good or bad news? Please reply with encouragement!! Badly needed right now!

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          A low avidity index indicates the CMV infection is very recent, a high avidity index indicates a longer time has elapsed, but this is in general. A borderline avidity probably indicates sometime in between. The avidity tests are often variable and difficult.

          If a pregnant women in first trimester of pregnancy had positive CMV IgG and positive IgM, then it is possible the CMV infection occurred within the last 16 weeks or so, during pregnancy or just a couple to a few months before pregnancy.

          It is IMPORTANT TO KNOW that only 40% and at most 50% of pregnant women who have a primary CMV infection during pregnancy will transmit CMV to their fetus. So more than half the time, CMV does not even infect the fetus. No blood test will predict this.

          Also, IT IS IMPORTANT TO KNOW that even if the fetus does get a CMV infection, symptoms develop in only 15% or so of the time. Many fetal CMV infections are “silent” or cause mild problems.

          The progress of pregnancy where CMV infection occurs should be closely monitored with fetal ultrasounds , placenta measurements, and amniocentesis to determine if CMV is present in the amniotic fluid and therefore the fetus.

          It is IMPORTANT TO KNOW that there is a CMV prenatal treatment — CMV hyperimmune globulin–that may reduce risk of transmission of CMV to the fetus and if fetal CMV disease is documented, will reduce and at some times reverse the effects of CMV on the fetus and the placenta. Please ask your doctors about this prenatal treatment to reduce transmission of CMV or treat fetal disease ASAP.

          Our Texas Children’s Fetal Center has an algorithm to help your doctors. The expert opinion from a fetal medicine expert may be of help. If you wish to discuss your case in detail you are welcome to send me an email at cmv@texaschildrensblog.org.

  9. Diana Roberts says:

    I was diagnosed with cmv years ago after my spleen enlarged and they couldn’t figure out what was wrong with me. I have 2 daughter in laws who are pregnant and worry about passing it to them. But I had it before any of my 7 grandchildren were born and never passed it to any of them inutero. I am still so confused about it. All I know is that it took my own research to finally find out what was wrong with me when I first got it. Now when I am stressed I lose red blood cells quickly which causes my spleen to enlarge,which is very painful, me to have night sweats and sleep a lot. My liver is also enlarged. All I have ever found is the horrible effects it has on unborn babies. What about adults who live with it is there a site for them to go to? Not saying I don’t appreciate the danger to babies and would lay down my life for my grandchildren.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      That is an excellent question! While I am not aware of a website specifically geared for individuals who acquire CMV as adults and experience long term problems, which is what you appear to have experienced, I am familiar with adolescents and adults who were born with congenital CMV. In fact, one aspect of our congenital CMV research program is the long term outcome in adolescents and young adults who were born with congenital CMV. We recently received funding from the Centers for Disease Control to publish our results on the long term effects of CMV we have documented through young adulthood. Adolescents and young adults have their own unique set of challenges, including progressive and late onset vision and hearing loss, developmental and behavioral issues, problems with feeding disorders and motor disabilities, scoliosis, and, of course puberty and social issues.

      • Darlene Rogers says:

        I am happy to finally see something on the internet that can potentially effect the spread of CMV. I still do not know why it is not publiczed on TV/radio or supported by a well know person. What has to be done to get the attention of the world?

  10. Gili's Mom says:

    We moved to Israel with our 2 month old and shortly after arrival, received the CMV result from our previous pediatrician in the states. It is amazing how much more advanced the screening and treatment is here in Israel. You can read our story at http://cmvgirl.blogspot.com/. I look forward to reading more of your posts!

  11. april meyer says:

    I have been telling my friends who are thinking about getting pregnant, to get tested to see if they have had CMV and if not, doctors suggest spending time with young children and then getting tested again. I have been told that once you have had the virus, you will no longer have to worry about getting pregnant and having your baby be at risk of the effects of CMV.

  12. Sheryl says:

    This will be a blog I will be reading often. Thanks!

  13. Harlisha says:

    Wow… what an interesting article. Four children into parenthood, I’ve never heard of CMV. I will share… Thanks for this information!

  14. Donna White says:

    Thank you for another avenue for information. I have custody of my 20 mth. old grandson, born with congenital CMV. We are learning something new everyday. We have found very
    few sources for information with regards to dealing with this illness, what to expect & what we can do to make each & every day the best we can for him. Will look forward to reading your blog!

  15. Anna Loughridge says:

    My husband and I have a healthy 4 year old son and a beautiful 20 month old daughter born with symptomatic congenital CMV. She was born with microcephaly, calcifications throughout her brain, cortical vision blindness, CP, and just had her first Grand Mal seizure in October 2010. We have had wonderful health care at All Childrens hospital in St. Pete, Florida, but have had challenges with “getting real answers” from health professionals… because so much is unknown about CMV and each case is so unique. Ella Joy is our joy and along with stopping cmv, our desire is to share the hope, joy and love there is to be found when parenting a special needs child. God Bless~ and Thank you Dr. Gail for your expertise, wisdom and passion for this cause.

  16. Lisa says:

    I someone had told me about CMV before I was pregnant…….It might have saved my baby’s life.~ Keep the CMV awareness GROWING!!!!

  17. Magdalena Smart says:

    Congratulations Dr.Demmler, Im soo lucky and pround that you turn out to be there when my baby was born and since then become more than his CMV doc!. Success and blessings… lets keep spreading the word..not the virus!

  18. Keri says:

    I wish I had known about this before my 3rd pregnancy. Having two perfectly healthy, normal pregnancies, I never thought I would have problems with my last. At my 20 week appointment, there was no heartbeat. My son, Michael, died between the 16th/17th week. The pathology report showed I had contracted CMV around that time. Apparently had never had it and it ultimately caused Michael his life. I have a toddler and a 7-year-old, certain that I picked the virus up from day care/school. WIsh I would have known about it before – so I could have been more careful.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thank you for your post. I am so sorry for your loss, but I hope, as you heal, you can help us spread the word to other pregnant women about how to prevent and treat CMV during pregnancy.

      • Rebekah says:

        I am also sorry about the loss of your baby, Keri. The same thing happened to me. We have three healthy boys, and were expecting a girl via scheduled c-section at 39 weeks, and ONE day prior, I went into labor, arrived at hospital and she did not have heartbeat. We are just heartbroken. I would like to know the risks of CMV transmission rates if I were to become pregnant again, but have not found a great deal of statistics on this. Could either of you answer this question or point me in the right direction? Thank you so much.

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          I am very sorry for your loss. Did your baby die from a proven CMV infection in the womb? If so, then it is very likely your experienced a primary (first) CMV infection during your pregnancy, likely your last trimester. Transmission of CMV to the fetus is more common and more often causes severe effects on the fetus than recurrent CMV infection in the mother.

          There are several very good studies done on the transmission of CMV in pregnant women who experience primary CMV infection during pregnancy (greatest risk to fetus) and those who experience reactivation or recurrent and transmit CMV to their fetus, or no reactivation of their CMV with no transmission of CMV to their fetus. The risk of transmitting CMV to your next baby is very low if you are already CMV IgG antibody positive and your CMV IgM antibody is negative before conception. This means your primary CMV infection is resolved. There is a <<1% chance your previous CMV infection will reactive and be passed to your next baby, but almost always (99%+ ) the baby is well at birth. There is a small chance of hearing loss, including progressive hearing loss, however. Re-infection may also rarely occur, but we do not know exactly how often it occurs.

          If your CMV IgG antibody is positive and your CMV IgM antibody is negative and your CMV avidity index is "favorable" and your CMV DNA levels are negative in your blood/plasma, then those tests indicate to the best of our knowledge your primary CMV infection is resolved and it is OK for you to try again with another pregnancy. Ask you obstetrician for these tests because your own doctor is the best person to know all your medical history. Consult a perinatologist or a maternal fetal medicine expert if your primary obstetrician is not comfortable interpreting the results of these CMV tests.

          I hope this helps.

          Dr Gail Demmler Harrison
          CMVDOC

  19. Mary Marino says:

    Gail – what a wonderful resource for families. Thank you so much for all you do for CMV awareness. We as a family are very grateful that our daughter, Kristen (age 28) was only mildly affected. We are here to help anyone else in any way we can.

  20. AA says:

    Thank you for this information. I am excited about the information becoming more widespread, especially among obs and pediatricians. When I requested testing during pregnancy, a few doctors suggested it was unnecessary. I tested negative (never exposed!) and was still told not to worry about it. Please let me know how I can help spread the information, even if it is just among my small community of moms.

  21. Diana says:

    Great info and so straight forward. This is a great post to share with every woman in their child bearing years.

  22. Patricia says:

    Thank you for getting the word out there. I didn’t hear about CMV until our daughter Lily was born 7 years ago. CMV has caused severe cerebral palsy and developmental delay for Lily. Our son was 18 months when I got pregnant and attending daycare in Madrid, Spain. He became very ill, high fever, and lathargic. I was in my first trimester and nursed him back to health, all the while exposing our unborn child. My husband also became very ill. I had NO symptoms of any kind. I thank you Dr. for mentioning ways to prevent the spread of CMV. If I may, I would also like to mention another way to prevent the spread. All pregnant woman should also follow preventative measures with their husband/partner as well as refrain from relations if he shows any signs of having the flu or any illness during the pregnancy. This has been my experience and I try to get the word out as much as I can. Thank you for your support.

  23. Bonnie Frantzen says:

    This is so exciting for me as a CMV parent to have the medical community talk about this. There are so many of us out here who need help, guidance and support. When I talk to other medical professional people, they really do not have a clue – even new nurses graduating. That is scary to me. As our society get more and more social, the chances of spreading this around are going to get greater. Even CMV kids could be the carriers because those parents a lot of times do not know their little ones are contagious to others. Our child went 8 months without being diagnosed from the medical world until I was finally able to get a diagnosis. He even had physical and major symptoms- microcephaly, jaundice, failed baby hearing test twice, petechiae, could not hold head up, etc. I fought hard to find someone to diagnosis. The failed baby hearing should have been enough to do the test…So, I am frustrated with our journey. The more people know, then maybe others will not have to endure what we did.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thank you everyone for your comments and suggestions. Part of what I will be doing with this blog is also educating doctors about how to diagnose and treat infants and children and their families affected by congenital CMV.

  24. Dr. Stanley A. Plotkin says:

    Dear Gail-

    I see that you are party to this blog created for parents of CMV damaged children. That’s great, and I just wanted to say that it might be useful if the parents pushed NIH to support vaccine studies. Also, IOM is doing a new review of vaccine priorities and we don’t want CMV to fall from first priority.

    Thanks and regards,
    Stanley A Plotkin, MD
    Emiritus Professor of Pediatrics, University of Pennsylvania
    Vaxconsult

  25. pankaj says:

    Thanks Dr Gail
    I will post this on my facebook

  26. Rebekah says:

    I want to address the comment from April Meyer who said, “I have been told that once you have had the virus, you will no longer have to worry about getting pregnant and having your baby be at risk of the effects of CMV.”
    A good friend of mine had CMV pre-pregnancy, but still passed it on to her unborn child. It’s true that the risk is lowered, but it is still a risk. So, exposing pre-pregnant females to CMV wouldn’t stop unborn babies from contracting CMV. It can still be transmitted.

  27. sara says:

    Thank you for such important information.
    I Had CMV during my 3rd pregnancy, probably during the first trimester. My daughter was born without congenital CMV. She is now 7 – she had CMV some time before she was 4, and also EBV. She is currently negative for both – but suffers from pallor, fatigue and irritability. All other tests are negative – could this be linked to the CMV?
    Thanks

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thank you for your post. It illustrates several important facts about CMV. First, not every woman who catches CMV while she is pregnant will transmit the virus to her fetus. Second, CMV is a common virus infection in toddlers and young children under the age of 5 years. Most of these infections are “silent” and do not cause symptoms in healthy children. However, if an infant or child has something wrong with their immune system, CMV may cause problems. Infection with CMV produces a lifelong positive CMV IgG antibody level. I am not sure which CMV test is “negative” now in your daughter. If she is otherwise healthy, CMV is not likely to be the cause of her symptoms. Her pediatrician should evaluate her for other causes. If you or your doctor need help with a referral, you are welcome to contact us here at Texas Children’s.
      I hope this information is helpful to you.

  28. Shannon says:

    Hi.
    I have been told I may have had primary Cmv infection in my first trimester. I am currently 15 weeks now – will have 17 week amnio to further test. I do have 2 yr old in daycare. My doctors are great but they have not had many cases they have treated because they are genetic and chromosomal focused rather than infectious disease. Are you aware of Doctor with good experience in Cmv infections in the Dallas area? I would like second opinion with more experienced doctors.

    Thank you!

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thank you for your post. I hope the information below is helpful to you and your baby.

      If you experienced a primary CMV infection, you may be at risk to transmit the CMV infection to your fetus. There are prenatal treatment options with CMV hyperimmune globulin that may reduce the risk of transmission of CMV to your fetus and that also may reduce the amount of CMV fetal disease if your baby is found to have symptoms from a congenital CMV infection.

      I have also contacted the Texas Children’s Fetal Center for names and contact information of maternal fetal medicine specialists with experience in prenatal evaluation and treatment of CMV in the Dallas area.

      I also urge you to contact our Fetal Center directly, as soon as possible, and they may be able to directly refer you to a maternal fetal medicine doctor in the area near you for advice. The link for the Fetal Center is: http://www.texaschildrens.org/carecenters/fetalsurgery/default.aspx

      The Texas Children’s Fetal Center email is: fetalcenter@texaschildrenshospital.org

      The Fetal Center phone numbers, which are answered 24/7, are:
      713-798-8621
      832-822-2229
      1-877-338-2579 (toll free)

      A Fetal Center algorithm for prenatal evaluationand treatment of CMV is available on the link below from the Texas Children’s Fetal Center website.

      http://www.texaschildrens.org/carecenters/FetalSurgery/pdf/Cytomegalovirus.pdf

      Please let us know we can help you further. Take care. Gail J. Demmler-Harrison, MD

      • Muddita says:

        Hello Doctor,I’m from India and my name is Muddita I’ve lost my Baby after 9 months carrying it,it is told to me due to my CMV(87) and Herpes simplex count of 7.5 after test I got to know.Baby delivered died in Fetus due to reasons unknown.This TORCH test was not recommended by any of my Gynaecologist.Can you please guide me further on this.It will be a great help.

  29. Tiffany says:

    Wow…I just found out that my 5 yr old grandson has Mono and CMV….very terrified lost and confused….glad I found this site.
    Can you please tell me what we should do next? Pediatrician did blood test last week, called us with results yesterday and told us we need to see a specialist. Thats all we were left with.
    We are devistated.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      CMV infection may cause mononucleosis in children, teenagers and adults. Almost all the time, CMV infection, including CMV mononucleosis, is self limited and will resolve on its own without any long term effects if your grandson has a normal immune system. CMV only causes problems to the unborn baby, newborn and individuals with an abnormal immune system.
      .
      He should do well, although I’d recommend a consultation with a pediatric infectious diseases doctor, which should be helpful and reassuring for you.

      I hope this helps.

  30. Gina Clive says:

    I have had two healthy pregnancies. My friend contracted CMV during her pregnancy, and her baby has had several problems. During my last pregnancy, I found out that I am not immune to CMV. MY doctor won’t test me now, before I want to get pregnant again, to find out if I have been exposed! I think it is ridiculous! If I want the test, give it to me! The last thing I want to do, is conceive having the virus.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      I am glad you are CMV aware! It is my opinion that all women should be aware about CMV and be aware of their CMV status. However, not all doctors share this opinion at this time. If your obstetrician will not test you, then perhaps one of your other doctors or internists would be willing to test you. In the meantime, assume you are antibody negative an not immune to CMV and practice the 3 simple hygienic precautions that will reduce your risk of catching CMV – as mentioned in my blog.

      Hope this helps.

  31. Kristi says:

    Hello,

    This is my 3rd pregnancy and I am early on. I have two 3 year olds and a 20 month old. I was tested for CMV and found to be negative for it during my last pregnancy. I am terrified of catching it and passing it to my unborn child. I know the precautions to take, but is there any advice on how to live with out worring that my child will be born with severe difficulties? I am driving myself mad with worry and my Dr. has never come across it so he is not that helpful. What are my actually chances and for those children that are born with it what are the treatments out there and do they help on the development?

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi,

      Your post brings up a very important point about CMV awareness and hygienic precautions – by educating women about CMV and ways to prevent it during pregnancy, will we be raising an undue amount of worry in an already stressed out pregnant mom? It is a valid point, but given the choice, I favor education and choice. Women welcome the opportunity to keep their unborn baby as healthy as possible during their pregnancy.

      Also, your comment shows that many health care professionals are still not educated and aware about the current issues surrounding CMV and its treatment and prevention.

      Through this blog and other activities, we are trying to educate professionals and the community about CMV.

      I am happy you are CMV aware and you are willing and able to do the 3 simple hygienic precautions that will reduce your risk of catching CMV while you are pregnant. CMV requires close intimate contact with body secretions for transmission from one person to another. Toddlers and preschool children often silently shed the virus in their saliva and urine, even though the toddlers themselves are well. As a pregnant woman with young children, you are exactly who should know about CMV!

      It is better to know about CMV and have the option and choice to practice hygiene precautions than to be unaware about CMV, and then possibly give birth to a baby with congenital CMV because you did not know about the virus and ways you could prevent its transmission. Women who have experienced having a baby with congenital CMV often say to me and other mothers “why did those of you who came before me not warn me and give me the choice to try and prevent catching the virus while I was pregnant?” Perhaps thinking about it from that perspective may be helpful. Some people, of course, are ‘worriers’ by nature, and all mothers will always worry about the health and well being of our children, before and after they are born.

      You also may find other mothers on social network pages, such as Facebook, who can help you by exchanging ideas and experiences. Also, there are websites run by mothers and professionals who have made CMV awareness part of their social mission (like http://www.stopCMV.org and http://www.CMVfoundation.org and http://www.congenitalCMV.org). Seeking them out also may be helpful to you, so you know you are not alone.

      My next blog will address the options a woman has if she does find herself infected with CMV and pregnant. But basically, there are potential treatments for the unborn baby that may help and there are treatments for the newborn with congenital CMV that may help. The best course of action, however, is to prevent CMV during pregnancy.

      I hope this helps. Try not to worry. You are doing the right thing through CMV awareness and hygienic precautions.

  32. rin says:

    I am so glad to find this site.

  33. rin says:

    I AM so glad to fnd this site.My daughter is 9 mnths old.She has bilateral hearing loss and litle developments delays.Last week all the results came and she was found cmv igg positive.
    She is not teething yet also.
    Can you lease give me some more information abt it whether her teething is delayed because of cmv?
    How can i protect my baby from the effects of cmv.?Is it true that by breastfeeding i can make her immune system sting so that the cmv doesnt effect her anymore??
    I am in terrible situation.PLEASE HELP.WAITING FOR YOUR REPLY.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi, thank you for your comment and for posting so many very good questions that I am sure other moms have wondered about.

      Your daughter will always be CMV IgG positive in her blood. Her CMV antibody levels remain in her system throughout her life. So that is normal and no cause for any special concern. You can find more information about congenital CMV by emailing us at cmv@bcm.edu, searching our website on google http://www.bcm.edu/pedi/cmv and by searching http://www.stopcmv.org. You also may find the new Facebook Group CMV Mommies very helpful, so you can ask other moms for their experiences and advice.

      Congenital CMV does not cause delayed teething and there is a wide variation of “normal” for teething. Some experts feel CMV may affect teeth, but it has not been proven definitely, and we are looking into that issue in our CMV research here. If you are concerned about your daughter’s teeth eruption, consult a pediatric dentist for advice.

      The long term effects of congenital CMV include progressive hearing loss, so be sure to stay in contact with an audiologist and hearing specialist. She may need hearing aids or even a cochlear implant at some point. Also, she may need speech and language therapy to keep her speech on track, so consult a speech/language specialist. A pediatrician who is also a developmental specialist will help you with overseeing developmental and learning problems she may have. And also, have her eyes checked on a regular basis for vision problems associated with CMV that can occur any time in her life.

      Breast feeding is definitely recommended for babies born with congenital CMV, for many reasons. I encourage you to continue breastfeeding as long as you and your baby wish to do so.

      I hope this helps.

      • rin says:

        Thanks for replying so prmpltly.She has biletral heraing loss so we are in the process for ci.She gets pt 1 x weel nand speech theray 1x week.
        I just had 1 question that if you had come across any case wher cmv has just affected hearing and little delay in gross motor skills but nothing to the brain,no retardation??I am so worried abt that part..I JUST HOPE AND PRAY THT IT DOESNT EFFECT HER ANYMORE.iS THAT POSSIBLE?
        s it posible tat by breast milk she fights out tat virus?

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          Yes, it is possible for children with congenital CMV to have hearing loss, even to have hearing loss severe enough to require cochlear implants, and have normal or near normal intelligence and normal development.

          I follow many such children in my CMV Program here at Texas Children’s Hospital in Houston. The hearing loss associated with congenital CMV occurs in both developmentally normal children with no CMV brain involvement and developmentally disabled children with CMV brain involvement. It is important to have your daughter’s hearing tested on a regular basis and to also have her developmental progress followed and for any problems she may have to be addressed promptly by trained professionals.

  34. christina liebler says:

    My 8 year old daughter just came home from the hospital after having a 105 fever for 6 days, swollen lymph nodes in throat, red/sore throat, high white blood cell and inflamation levels, conjunctivitis of the eyes and a massive outbreak of ulcers on her lips. She was diagnosed as having CMV while trying to rule out Kawasaki. As far as I know she does not have a compromised immune system. Should I be concerned that there is some underlying problem that caused her to have such a bad reaction to the virus? She also complained of chest pain, stomach pain and trouble breathing, but they were always at the times her fever was the highest. She if fine now and my pediatrician has set-up an appt. with an optomologist to check her eyes in a month. Anything else we should be concerned about?

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      I am glad to hear your daughter is now doing well. The signs and symptoms you described are seen with Kawasaki Disease and they are not typical for a primary infection with CMV. Other viruses or diseases may also cause these signs and symptoms. Most CMV infections are silent, however some children with CMV may have a mononucleosis-like syndrome, with or without fever. Since CMV is so common it is possible the positive CMV test was a coincidence or reflected a previous infection with the virus and not a recent one.

      If your pediatrician is not sure, he or she may wish to consult an infectious diseases expert to try and determine the cause of your daughter’s illness and whether or not it was caused by CMV.

  35. Carla says:

    I came across your site quite by accident. I am the mother of a 24 year old son, born with binaural sensorineural hearing loss, mental retardation and 6 diopters farsightedness. 2 genetic tests were completed, showing no abnormalities. His diagnosis is mental retardation of unknown etiology. Could CMV be the culprit? Is there anyway to test for it now? He does have two older brothers who could have had it as young children while I was pregnant. My son is otherwise a healthy, happy young man, but , I wonder often if things could have been different for him, or even prevented? Thank you for all you do for children!

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Yes, it is possible your son’s hearing loss and cognitive delays are due to congenital CMV. It is less likely his vision abnormality is associated with CMV, but I would need more information about his eye exam to be sure. It is also possible none of his disabilities are due to congenital CMV.

      One way to “rule out” congenital CMV as a cause of his disabilities is a CMV antibody test in his blood. If it is negative, CMV is ruled out. The antibody lasts a lifetime once someone is infected. If he is CMV negative, he never had CMV. If he is CMV positive, he caught CMV at some time, either congenitally, or later in life.

      It is likely many babies with congenital CMV go undiagnosed and grow up with disabilities without a confirmed diagnosis. This is one of the many reasons why I advocate we implement routine universal screening of newborns for congenital CMV. CMV is present in large quantities in the urine and saliva of congenitally infected newborns and CMV be easily detected by laboratory testing. We are moving forward in this arena, but newborn screening for CMV is not yet universal or routine.

  36. Brenda says:

    My son was born with congenital CMV where the viral loads in his first 6 months gradually decreased, leading me to believe we were fairly out of the woods. He subsequently had serious problems with his lungs and was treated at TCH (pneumonia and various complications that resulted in a partial lung removal at 2 and a half years old) Is it possible that these are related?

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      The lungs of children born with congenital CMV are usually not permanently damaged, so it is unlikely CMV was the cause for your child’s lung injury and need for surgery. Since congenital CMV is so common — it affects about 1 out of every 100 newborns — it is possible your child has had two disease processes.

      It is difficult for me to tell you anything more without knowing more clinical information about your child. You may contact my nurse Carol Griesser RN at (832) 824-4342 if you wish. I hope this information is helpful.

  37. Niki says:

    Hi, my 3 yr old daughter most probably was born with congenital cmv. Around my 8th month being pregnant, i switched my ob and the new doctor did a complete sono. There he realized that her ventricles were slighty dilated. I was followed up till i gave birth. When she was born they did a head ultrasound and saw that she had a grade1-2 brain hemorraghe and it looked like she had a mild hydrocephalus. We ended up doing an MRI at 6weeks and it showed that her hydrocephalus thank G-d arrested on it’s own and she didn’t need a shunt. However they saw white matter changes that were non-specific but was consistent with cmv. By the time we did a urine test to see if she had cmv- she was about 6months (and yes she was positive) but we are not sure if it’s congenital. At that time her hearing was normal and she just has some slight developmental delays.
    She was diagnosed with very mild cp at around 1. You can’t even tell by looking at her now because she’s thank G-d running, jumping, going up and down steps. She speaks in paragraphs and is very smart. But we just found out this past winter that she has a severe-profound hearing loss in her right ear, and borderline-mild in her left.
    Now i think that it most definetly was congenital because of the hearing loss which she definetly didn’t have at birth. Her neurologist doesn’t think it’s cCmv because she didn’t have the symptoms at birth, and (thank G-d) doesn’t have calcifications- and mostly cmv patients are more disabled.
    But reading more about it -i see that there are many outcomes of congenital cmv. I’m just not sure…
    I also looked back at my blood tests from when i was 3 months pregnant and it showed that my CMV IGM was negative and the IGG was positive- 6.10 IU/ML. And my bloodwork from a week after i gave birth – my CMV IGM negative and IGG 6.90 IU/ML. Does this mean that i had an active infection while being pregnant because my CMV IGM levels went up??
    I have become neurotic making sure my daugher “hears me” and that she hasn’t lost her hearing in her left ear. It’s so nerve wrecking not knowing what will be.
    I live in NY and made an appointment with Dr. Lory Rubin- infectious disease in LIJ Schneider’s hospital to speak with him. Do you recommend any good specialists in my area?
    Sorry for the long text, and thanks in advance for your help.

  38. Niki says:

    sorry i had a typo- “Does this mean i had an active infection while pregnant because my CMV IGG levels went up?”

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thank you for your post and for sharing your experiences. I am glad to hear your daughter is doing so well. You are correct that congenital CMV infection is associated with progressive hearing loss and you are wise to have regular hearing tests scheduled every year or whenever there is a concern. You are doing all you can do. It is hard not to worry at every hearing test — I hear this very often from many of my “CMV Moms”. Try to enjoy all the wonderfully positive things your daughter is doing and push back the negative worries and let the positive experiences come to the front.

      Also, you may wish to talk to other CMV moms about your worries and experience. You are not alone! Email my nurse Carol at cmv@bcm.edu for information on our CMV parent-to-parent support network and she can connect you with a family that may be near you whom you can visit, chat with, and even have play dates with. There are also CMV parent groups on Facebook (“CMV Mommies” and others), through the website http://www.stopcmv.org , and through a CMV families CMVLISTSERV based out of Syracuse, NY.

      You also should have her development checked by a developmental pediatrician to make sure she is “on track” with her learning. They can help with special educational accommodations or tutoring to make sure she has the best outcome in school. Also, you should make sure her eyes and retina are OK with regular eye doctor exams.

      You may never know for sure if your daughter was congenitally infected, but it is best to assume it is probable and plan her followup evaluations accordingly, to be on the safe side.

      The CMV IgG antibody levels you described are not significantly different from each other and do not really mean a rise. You stated your CMV IgM levels were both negative and your CMV IgG levels were positive and about the same value. According to these values, your CMV infection was not a recent primary infection at the time the blood tests were drawn. It is possible you experienced a primary infection at or around conception, since CMV IgM usually only lasts 8 to 12 weeks in most women and your first tests were done at 12 weeks gestation. It is also possible your first CMV infection occurred long before your pregnancy. You will likely never know. What is important is that you are now CMV antibody positive now. So go forward with that knowledge.

      Dr Lorry Rubin is a good choice for a pediatric infectious diseases specialist. However, I do not know his experience with managing children, especially long term, with congenital CMV. Just ask him! Also he may be able to help with referral for developmental pediatricians. If he has questions he is welcome to contact me.

      Take care. I hope this is helpful to you.

      Dr Gail Demmler-Harrison
      CMVDOC

  39. Niki says:

    Thanks again for your response! I made a mistake with her hearing loss: it’s severe-profound on right, and NORMAL-borderline mild on left- they still call it unilateral though. From the patients that you have seen; have u seen a unilateral hearing loss eventually become bilateral?? I cry every day for her- because she is so smart and started speaking before 1 (and her vocabulary is so advanced) that it just pains me to G-d forbid see one day that she might not hear again.
    As for her eyes, we have checked them every year and there is no damage thank G-d. Until what age should i have her checked for that?
    She also doesn’t have any feeding problems that i’ve read that many cmv patients have. Is there anything else that she needs to be followed up on?
    She will be going to an intergrated special ed school for nursery because she has some behavioral issues (which i know is mostly because of her hearing- she really acts up in loud noisy places)
    If Dr. Rubin doesn’t specialize in CMV… do you know of a doctor in my area who does?
    Thanks so much again for all your help!

  40. lena says:

    Hello,
    Im 12 weeks pregnant and found out my 2 year old son has CMV. I got tested and was negative for the virus but do not have the antibody what do you recommend i do?
    Lena

  41. Ellen says:

    I was tested for CMV over 5 years ago to see about my status and was negative. I became pregnant and was able to stay negative throughout the pregnancy. I’m wanting to get pregnant again. I have not been tested since that first time. I have no symptoms now, but is there a way I might have CMV now? If for some reason I do, could that be passed down if I conceive while having it? How long does the primary infection last? And, in what stage of pregnancy does it become dangerous?

  42. Anjali says:

    Hi Doctor,

    I am 6 weeks pregnant and had a TORCH test recently. My report says that my CMV IgG is 31 UI/ML and CMV IgM is 12 UI/ML. Is this considered to be risky for my developing baby? I am really concerned since the day I got my result.

    I have had a past infection of Typhoid around 6 years back and chicken pox around 15 years back.

    Thank you.
    Regards
    Anjali

  43. tricey says:

    I’m a mother of a son born with this an he is now 12 an saying a lot of signs are appearing hoping that its not ture an they need to make this more aware to mothers that have giving birth to kids with this cause I,never knew it could be avoided.

  44. Question says:

    Dear Dr. Demmler-Harrisson,

    I am an American living overseas and pregnant. I found out that in-between the time that I was pregnant with my last child (who is now 3 years old) and this pregnancy that I had picked up the CMV virus. I am assuming that I caught it from my child who was at daycare for about a year (from September 2009 through November 2010). My obgyn here ran some tests about 2 months after I conceived and than another a couple of weeks later, regarding my IgG and IgM levels as well as an avidity test. My results came back as 111.1 for IgG (MEIA) and IgM (MEIA) as 5.280. My avidity for CMV IgM (IFI) came out as greater than 40. The results relayed to me by my doctor was that I caught the virus at least 3 months prior (which would have been prior to conception). He therefore is saying that there is no need for me to be concerned. I am getting an amnio in two weeks and asked my doctor if he could test the fetus for the CMV virus, however my doctor said this was not necessary. I trust my doctor, however I still have questions in my head regarding if the chance of passing CMV onto my fetus is a possibility and if I should push him into checking for CMV when I have my amnio. I would greatly appreciate your opinion.
    Additionally, another question, how would one know if you get a recurring infection?
    I have been stressing myself out immensely since I found out that I had caught this virus and if you could answer my queries I would be greatly appreciative. Thank you very much.

  45. Summer says:

    If a pregnant woman is CMV IgG negative and her husband is CMV IgG positive, what are the risks to the baby? Should condoms be worn during pregnancy?
    Thanks!

  46. Anahit says:

    Hello Dear Mrs, I want to ask U a question. a week ago it turned out that my CMV Ig G is 5 , is it very dangerous? I am 29 and my husband is 31, My husband go to the doctor but no CMV is found,. Does he need to take the drugs that the doctor advices me or if only I take them it will disappear???Thanks In Advance.I am not pregnant , if I want will it be dangerous?

  47. sherin says:

    hello dr i wanted to ask u about my case i was tested cmv igG 180 and cmv igMpositive the range was at the border line is that a high percentage of risk of me infecting the fetus please help me the drs here dont help the much with info please tell me what can i do to tell if i infected my baby and how can i test if i had this from before pregnancy please answer back

  48. katrina crookes says:

    thank you for your blog and all the information here. i am living in perth, australia, and have been diagnosed with CMV as has my husband. my gp is still in the process of referring us to a specialist and running CMV avidity tests.
    my husband became ill after a cold with fevers, aches and joint stiffness and blood tests showed he was positive for CMV. i then thought it was best to check my status before we started trying to conceive baby no. 2 (we have an 18 month old son) – i did not expect to have active CMV. also as i had not been ill.
    now we are waiting to find out if we have a primary infection or a reactivation.
    we are desperate to find out how risky a pregnancy may be. how long is it likely to take for our levels to normalise and for us to safely start trying to conceive? are we talking months or years? is it still risky even after the virus becomes inactive?
    any advice greatly appreciated. we are having great trouble finding anyone here who knows much about CMV…

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      The greatest risk for CMV is to catch the virus for the first time during pregnancy – this is called primary CMV infection. Risk to baby unborn is 40 to 50% to catch virus from a maternal infection and if virus is transmitted then 10 to 15% risk of having symptoms and problems after birth. Therefore, most of the time the virus is not transmitted to your baby. Recurrent CMV infections, that happen after the first CMV infection is resolved, also may occur but it is much less frequent and has much less side effects on the unborn baby.

      For women waiting to get pregnant who find out they have evidence of a CMV infection, then waiting until CMV IgM is negative and avidity is high is prudent. CMV IgG levels last a lifetime, so do not worry about this level. In general, it takes 3 to 4 months to resolve the CMV primary infection and have CMV IgM levels go negative, sometimes it takes longer up to 6 to 1 year. After 1 year, risk is nil, even if the CMV IgM level is still slightly high, and will be OK to become pregnant.

      While pregnant, no matter what your CMV status, it is recommended to practice CMV behavioral and hygienic precautions and do not kiss small children and toddlers near mouth and avoid contact with saliva, do not share food or drink with young children, and wash hands carefully after changing diapers. If you have a toddler at home, consider this. See http://www.cdc.gov/cmv for information, as well as our website. Husbands who are experiencing active CMV infection may also transmit CMV to their wives, so same precautions should be used if this is the case.

      If you have specific questions about your situation, please feel free to email me at cmv@texaschildrensblog.org.

      I hope this is helpful.

  49. Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

    In response to an email from Iowa:

    Many children born with congenital CMV surprise us and do much better than doctors predict–I am glad to hear your son is doing well!

    If he has vision problems, he should be a pediatric ophthalmologist and make sure his vision loss is not due to an active CMV infection that needs treatment. If he has an old CMV scar from birth, then that should also be checked every year by an eye doctor.

    Behavioral differences, including ADHD often emerge around this age, and are best evaluated and managed by a pediatric developmental specialist. ADHD may not be directly related to his congenital CMV.

    If your son had congenital CMV, he should also have his hearing tested at least every year since hearing loss is a major problem and may get worse over time. Also, hearing loss may cause behavioral changes.

    Here are some suggestions for you to get access to resources to help your son reach his best potential–

    I recommend you locate CMV specialists in your area, and the University of Iowa Hospital and Clinics have CMV experts there. One expert who has worked with CMV research is Dr Jody Murph 319-356-3986. Also there will be eye doctors and developmentalists there. Your pediatrician may help also with referrals.

    Join our CMV Parent-to-Parent support network and you will be able to contact other parents in your area/state who may be able to give you advice and recommendations. Contact cmv@bcm.edu and request a Parent-to-Parent Support Network application or go to website http://www.bcm.edu/pedi/infect/cmv. Other social network ideas for help include CMV mommies on FB and http://www.stopcmv.org with parents who may live near you and have ideas to help.

    I hope this helps.

    Dr Gail Demmler Harrison

  50. Robert A. Gibson says:

    Oh how I wish my grand daughter’s doctors would consult with you. She is 1 month old and has severe CMV. She has been on the chemo type drug (only one I hear) for three weeks and her CMV counts are three times higher than at the beginning. Her kidneys are not working. The vision doctor says she will not be able to see. She has failed two hearing tests so for. She has a cleft pallet. She is feeding by tube because her food will not stay down. It comes up her esophugus and down her trachea. She is in wonderful care and Hermann Childrens, but wish they had someone with your type expertise.

  51. samantha nason says:

    hi, i have recently visited the doctor about my daughters development and behaviour, she has referred me to a psychologist who has put her on the autism and adhd waiting list for diagnosis. I was told that I had CMV in my pregnancy with her although I was already infected before I was pregnant. She had a blood test as soon as she was born which came back negative and also a brain scan which showed up as being normal. I would like to know if there could be a link between her learning, social and behaviour skills to the CMV and should I mention it to the gp/psychologist? any advice would be grateful, Sam

  52. Tina says:

    Hi!
    My daughter is two months old, after failing
    The hearing test in her right ear twice, the
    Ent specialist suggested to do the cmv test
    It came up positive! I’m verrrrry concerned about
    Her. So far this is the only cmv symptoms she has!
    Please can u tell me if she’s gonna develop
    Any behavior problems? Is there any treatement
    To stop the virulence of this virus so my little
    Won’t develop any other symptom?
    Pleaaaaaaassse help me! I’m very worrryyy
    And cryiiiiiing all the time!

  53. Tamra Logan says:

    I am so glad to have found your blog. Look forward to reading more. I cannot believe how common CMV is. When we found out, I had no idea what it was as I’d never heard of it before. Another reason why we need more info out there to spread the word. Thanks for writing and hope to include you in my site somehow as well.

    Sincerely,
    Tamra Logan

  54. Karen says:

    I have a question for you. My son is now 21 years old now. When he was a month old we found out he had CMV, he had to have a liver biopsy and he lost his hearing in both ears when he was 18 months. My question is would he be able to have any children because of the CMV he had? Brian is in his first year in college and made the Dean’s List twice so yes to the other parents out there your child can have a great life, it is not easy but they will succeed.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi and thanks so much for your post.

      Your post shows that adult survivors of congenital CMV can have a healthy, rewarding, and productive life! Congratulations on your son’s academic achievements!

      Our Houston Congenital CMV Longitudinal Study is now in its 30th year of research on the long term effects of congenital CMV infection into adulthood and we have documented many “successful stories” in addition to many “challenging stories” of living with congenital CMV. If you would like to be added to our mailing list for CMVUpdates, which includes stories and experiences from our CMV research studies, please send me an email.

      Adults who survived congenital CMV infection — whether it was mild or serious life threatening congenital CMV disease can live to adulthood and have a normal adulthood, including having children. Congenital CMV does not appear to affect the reproductive capacity. Also, the risk of transmitting congenital CMV to children of adult survivors of congenital CMV is likely to be nil, since immunity to CMV is also lifelong. Since your son since is CMV seropositive for life, he will harbor the virus for his lifetime, but he also has his own immunity, which keeps the virus “in balance”.

      I hope this information is helpful.

      Take care.

      Dr Gail Demmler Harrison
      CMVDOC
      cmv@texaschildrensblog.org

  55. Agnes Szymanski says:

    Dear Dr. Harrison,
    At the beginning please accept my apologies for my English but I am writting to you from Europe (Poland) so I can make some gramma mistakes. But I hope you will understand my case.
    I am 33 years old woman. It is 35th week of my pregnancy. All USG test and blood tests were without any reservations. Than in 34th week I asked about CMV test. In Poland there is no obligation to make such a test. But I asked to make it. It was my first time ever. My results are: CMV (ICD-9:F19) IgG 1239,2 U/ml; CMV (ICD-9:F23) IgM 0,180 U/ml – both results comes from test made by a company Abbott, CMIA methode on Architect apparatus.
    When I asked doctors what both results seen above mean. They told me that I had in the past CMV but they are not sure if it was during the pregnancy. So just after the labor they will examin my child very closely. I have also Hashimoto disease, I take 5 times a week 25mg of Eutyrox and 2 times a week 50mg of Eutyrox. Somebody told me that high level of IgG can be linked with Hashimoto.
    Colud you be so kind to comment. I’ll be very greateful.
    Best regards from Poland
    Agnes

  56. Pingback: CMV: Every Pregnant Woman Should Know About This Virus | Special Living Today

  57. Elham Ahmed says:

    Dear D.r Gail:

    i hope thay everything with you is fine , im Elham Ahmed from yemen had spontanous abortion in last November and i didn’t do any investigation.

    now im pregnant again!!! im about 7 weeks last Wednesday i did an ultrasound and everything was good(we saw embryonic echogencity and the heart beat), i also did several investigations in which the results showed that CMV IgG is positive 363 AU/ml(normal values is 0.5).

    now im very scared if the baby will get the infection, should i do termination of pregnancy or the results shows that i already got the immunity from the virus.
    my doctor said that i repeat the igg after a week if the titre increased i really have a promblem if it is the same no problem is this true??????

    please answer my E-mail as soon as possible i really trust your opinoin and i cant wait to know what is it.

  58. Jade Simms says:

    Hi Dr. Harrison:
    How does CMV present itself in a toddler? Can it make them very ill? I have a healthy 18month old who was hospitilized for 6 days on I.V. antibiotics for “undetermined bacterial infection”. She had a terrible swollen tonsil, lymphnodes, listlessness, and sore throat. Terrible breath- congestion, clear/white runny nose, and a watery eye that would sometimes get a little yellowish-gunk in the corner. Fever was 105 (!) at the highest and went away within 3 days of I.V. antibiotics. Her CBC went up to 46,000 and sed rate was super high!! Within 48 hours, her WBC was normal and she was running around the hospital, which pointed to bacterial infection that responded to I.V. therapy. Although bacteria seems to be the culprit, could it have been CMV the whole time and not a bacteria? Is there an antibody titer for it? She was tested for mono, epstein barr, adenovirus , strep, UTI, all which came back negative…although strep wasn’t done until after the antiotics started. She was doing great once the fever left and her lymphnodes (biggest one was 1.5cm) are back to normal after a week but talk about scary! And what is worse- I have no answers… Her pediatrician told me that WBC doesn’t go up that high with a virus… But, I can’t help but be curious about CMV since I read it can mimic mono, which they thought she had at first. All I know is my 7 year old has never been this sick! Thanks for any input! I am so thankful she is well, but it is nagging me not knowing!

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thank you for your post on our CMV BLOG.

      It is true a primary infection with CMV can cause a “mononucleosis-like” syndrome, with red throat and swollen neck glands and fatigue. CMV will usually drop the white blood count temporarily, and may also drop the platelet count and also cause a mild hepatitis. CMV mononucleosis syndrome is actually unusual and most CMV infections in all age groups, including toddlers, are asymptomatic or “silent” and not associated with illness.

      It is difficult for me to tell you what caused your child’s illness. However, it was not typical for an acute CMV infection, and the good news is she is recovered and well!

      • Jade Simms says:

        Thank you for helping me possibly rule out a another cause! I think it was strep- interestingly, now my older daughter (7) has same symptoms minus that high fever…3 weeks later and has tested positive for strep- 3rd time in 3 months. I can’t write that off as coincidental that the baby got sick during that time frame. They think big sis might be a carrier. We have inf. disease specialist appt. in a week! Thanks again :)

  59. sara says:

    Hi!
    I wish there was a website like this in Sweden aswell. I had a misscarriage in the 12th week and was diagnosed with primary CMV. Not much facts to find, though. The worst thing is that you don´t really know when the infection rests, so you can get pregnant again. It’s been almost 6 months since I suffered the symtoms(early october), so I just hope I’m ready to go soon:) I think it’s sad that so few people know about CMV, specially when it’s so common. Even in the health-care for women/mothers, people just don’t know. A pregnant friend of mine was told not to see me. It’s terrible, I’m not a walking disease…It’s really good that you have this page, and also that people get answers to their questions-I learned a lot, just reading it:)
    Sorry for my english.
    /S

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thank you for your post. I am glad you found the information helpful.

      I am sorry about your recent pregnancy loss. Usually within 6 months and for sure within 12 months, women who have experienced a primary CMV infection have resolved the CMV primary infection, and should be ready to safely try again for a healthy pregnancy.

      Best wishes to you and your family.

  60. Aditi says:

    Hi Doctor Gail,

    I am 9 weeks pregnant and I got my Torch Test results which shows all IGM as negative (which is good I suppose) and all IGG negative except one which CVM IgG . It is 52 and hence positive.
    I came across your blog accidentally while searching on “what CVM IgG positive means in pregnant ladies”. Can you please suggest what precautions can I take and how bad is the result. This is my first pregnancy and hence I am very worried. Please reply to my concern.

    Thanks ,
    Aditi

  61. Aditi says:

    Hi Doctor Gail,

    I know this post is more than a year long but Please I will be very grateful to you if you can take some little time out and resolve my worry.
    I am 28 years old from Delhi, India. I am 9 weeks pregnant and I got my Torch Test results 4 days back which shows all IGM as negative (which is good I suppose) and all IGG too are negative except one which is CMV IgG . It is 52 and hence positive.
    I came across your blog accidentally while searching on “what CMV IgG positive means in pregnant ladies”. Can you please suggest what precautions can I take and how bad is my result. This is my first pregnancy and hence I am very worried. I have read on onterenet if virus passes on to fetus in first 3 months then baby may have some or one congentinal malformation , now what does this mean and is it true. I am really very very worried.Please reply to my concern.

    Thanks ,
    Aditi

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Aditi,

      Thank you for your post.

      A CMV IgG positive results combined with a CMV IgM negative result means a past CMV infection. It is normal to have a past CMV infection and 50% to 80% of women around the world will have CMV IgG antibody positive and CMV IgM antibody negative blood test results.

      The risk to the fetus or unborn baby is nil when the pregnant woman is CMVIgG antibody positive and CMVIgM antibody negative. It is remotely possible ( <<1% of the time) that CMV will be transmitted to the unborn baby from the mother with an old CMV infection, or from another CMV infection she may catch, but that is very unusual, and almost all of the time the newborn baby does not have any problems form CMV.

      Women who are pregnant should practice hygienic precautions when around young toddlers (children between ages 1 and 5 years of age) to reduce the risk of catching viral infections such as CMV and other viruses form the child's saliva or urine.

      These three simple hygienic precautions are:
      1) avoid contact with saliva by not kissing young children on or near the mouth, but instead kisses on top of the head and big hugs while pregnant
      2) avoid sharing food and drink with young children
      3) wash hands carefully after changing dirty diapers

      I hope this is helpful to you.
      Best wishes and take care.

  62. Kristi says:

    Hello,

    I have read this blog several times. I find myself worried about CMV. I have three children under the age of 5 and I am currently 23 weeks pregnant. Ultrasound has shown that things are on track. My 2 year old niece, whom goes to daycare with my children, recently put her spitty finger in my mouth. I have been so careful throughout my pregnancy and she came up from behind me and wrapped her arms around my neck. Needless to say I am really worried that I have contracted CMV from her. I do not know if she had it, but I assume all children under 3 have it and her spit was in my mouth. I was negative for CMV in the past. I am really looking for advice to calm my fears. I understand the statistics, but since I am already 23 weeks along with no problems what are the changes that my baby would be born with congenital CMV? I have talked to my physician, but he is not worried and says he has only come across it 3 times and I will not be his fourth. He has offered the blood test, but I am not sure what I would do with the results. Please help!

    • Kristi says:

      I came across a few articles one from the Journal of Clinical Virology from 2011 stating that timing of primary infection for gestation age appears to make a difference in the transmission rate and in the effect it has on the baby. This article states that primary infection before 14 weeks gestation appears to have the most damaging effect (severe symptoms) where 14 weeks to 26 weeks a few infants had minor complications and no complications in the third trimester. I was wondering what your thoughts are on this. How the timing on gestation age effects the baby (prognosis).

      Thank you

      • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

        Hi Kristi,

        Thank you for your post.

        Current knowledge is that the risk of transmission of CMV to unborn baby is <1% after a recurrent infection and 40% after a first or primary maternal infection, irregardless of the trimester. Of those that do transmit, then 10% will be symptomatic and 90% will be silently infected, but may have a risk for hearing loss and possibly other effects. If the virus is transmitted in the first half of pregnancy, then it is more likely, but not absolutely, that severe effects on the brain and sensory organs will be evident. The risk of CMV being transmitted to the unborn baby may actually be lowest in the first trimester, but the consequences of the transmission is higher. The risk of transmission appears to be highest in the third trimester, but has the lowest adverse effects on the baby.

        A recent J Clin Virol 2011 52(3): 244-246 article published in 2011 by Enders et al form Germany did indeed study transmission rates during pregnancy and outcomes of the baby.

        They found :

        "The intrauterine transmission rates following primary CMV infection in the pre- and periconceptional period were 16.7% (4/24) and 34.5% (10/29), respectively. For the first, second and third trimester of pregnancy transmission rates were 30.1% (25/83), 38.2% (29/76) and 72.2% (26/36), respectively. The rate of symptomatically infected fetuses or newborns at birth was 22.8% for any symptoms and 10.3% for severe manifestations. No symptoms were observed in infected newborns of mothers with primary infection in the preconceptional period and in the third trimester. The risk of intrauterine transmission following primary maternal infection in the third trimester is high, but the risk of neonatal disease is low. The highest risk of severe symptoms in the fetus and newborn exists around conception and in the first trimester of pregnancy."

        Understanding congenital CMV can be challenging, and our knowledge continues to evolve.

        I hope this helps.

        Take care.

        Dr Gail Demmler Harrison
        CMVDOC

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Kristi,

      Thank you for your post. I am happy to hear that you are aware about CMV and you are aware about the most common ways it is transmitted to pregnant women, and that you are taking precautions to reduce your risk of catching CMV while you are pregnant.

      No one can follow these precautions 100% all the time perfectly. The risk of contracting CMV from a single exposure such as what you indicate is low. It is possible, but not probable.

      A CMV IgG antibody and CMV IgM antibody test may be helpful to determine if a primary infection with CMV has occurred. Your obstetrician or our family doctor should be able to do this simple test on your blood for you. If the result is negative for both tests you may be reassured. It does take up to 12 weeks to serconvert however. If the results of the tests are positive, then your risk of transmitting CMV to your unborn baby is just 40%, most of the time the virus does not even pass the placenta to the baby. If there is a positive result of your tests there also are antibody infusions that may be available to help reduce the risk of the virus betting to your unborn baby.

      It is also perfectly acceptable to not do the CMV antibody blood tests, and just watch your pregnancy carefully as you would have done anyway, and continue trying your best to adhere to CMV precautions.

      I wish you a happy and healthy pregnancy and newborn baby. I hope you do not worry too much.

      Take care.

  63. Jessica says:

    Hi Dr. Gail,
    My name is Jessica. My husband Robert and I had our baby in December 2011, 10 weeks early. A week after he was born after testing his urine and performing a biopsy on my placenta it was determined he was born with congenital CMV. He’s twelve weeks old now and is still in the NICU in Everett, Washington. He was treated with gancyclovir for six weeks through a PICC line. His viral load dropped down in the thousands. Well, recently it spiked back up to 12,000. So, ID suggested giving valgancyclovir. That was given three days ago for two days and he looked very sickly and his white blood cells are now down to 700. ID said to take him off of the valgancyclovir. He looked great yesterday. He’s been given platelets three times in the last week. One of the neonatologists at the hospital we’re at has had a few calls into the CMV specialist only to leave messages. We’re at Providence Hospital in Everett which is a part of Seattle Childrens. Transfering has been brought up but, the thought is that our little guy would have to share a room if we went down to Seattle and with his white cells so low…My question is, “What do we do about this damn CMV’?
    I’ll give a little more background. He was born at 1 lb 14 oz. He’s now 6 lb 5 oz! He’s still on 100% O2 at .2 flow. That’s always been a big question too down here. He was only on a ventilater for one day. He has a small diaphrahmatic eventration but, not having to much affect on his breathing so it’s said. Over the twelve weeks he’s had 5 platelet transfusions, one packed red blood cell transfusion, he did fail his hearing tests, not his eye test, OT says he looks great and is ‘acting’ great. I look forward to your thoughts. Thanks so much, Jessica

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Jessica,

      Thank you for your post on my blog.

      Treatment for the signs and symptoms of congenital CMV with IV ganciclovir and oral valganciclovir are definitely of benefit to some newborns and it appears to have helped your baby.

      One of the side effects of this antiviral treatment is a drop in the white blood cell count, usually the neutorphil count. It occurs in 10 to 30% of these infants who are treated.

      However, CMV may also cause this effect and other concurrent viruses and some other medications also may cause this effect. It is therefore important the doctors evaluate your baby for all causes.

      What is the total WBC, the % neutrophils, and the absolute neutrophil count (ANC)? Those are all different values that are part of the blood count.

      The effect of ganciclovir and valganciclovir on the ANC is reversible. The medication is held for a short while. Often the medication can be restarted again in a few days to a week. In general, a course of oral valganciclovor for 6 months is currently recommended by most experts, to reduce CMV viral load, and to improve both hearing and neurodevelopmental outcomes.

      For newborns with symptomatic congenital CMV disease, a full ABR not just a newborn hearing screen, is recommended, as well as exams of eyes/retinas evaluated on a regular basis, and growth, development and head size followed closely.

      You or your doctors are welcome to call me or send me a private email if you wish to discuss things in more detail. Also, there are CMV experts in your area, and I could perhaps provide some contact information for you.

      Take care.

      Dr Gail Demmler Harrison, CMVDOC
      cmv@texaschildrensblog.org

  64. Kasia says:

    Kasia says:
    March 12, 2012 at 1:16 pm
    Hello
    I’ m from Poland and we dont talk much about this virus in my country. I’m very concern about this problem. I’m 37 years old primary teacher. I work in a small school, mainly with children 10-12 years old and I would like to ask If I can get this terrible ilness through sneezing and coughing. My life is a misery now because I’m tense and nervous all the time through school day. When one of my pupil come towards me Im avoiding contact and I’m stop breathing. Lots of this children are sneezing and coughing. Should I make a leave for the rest of pregnancy? I’m 20 weeks pregnant. I have also over 2 years old daughter at home and 8 years old son. My doughter doesnt attend to day care. How can I prevent catching this from children? Why I didnt get CMV earlier when working with children? Please, can You give me your answer.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thank you for your post. I am also very happy to hear that you are aware about CMV and wish to take steps to prevent CMV transmission to your unborn baby. There is no reason for worry or be alarmed.

      CMV requires close contact to be transmitted between people. CMV is not spread from coughing or sneezing. CMV is not spread by casual contact. It is spread by sharing food or drink between individuals and close contact such as kissing. This sort of contact is common in families and it is not the type of contact that is seen in classroom settings. Young children between the ages of 1 and 5 years of age are the most “high risk” to have CMV and transmit the virus to other adults in their family. The ages of your classroom children is older (they are 10-12 years old), and this age of child is not likely to be a source of CMV to adults. Sneezing and coughing is likely to be caused by another respiratory virus, not CMV.

      It is therefore recommended you avoid contact with secretions of young toddlers, such as your 2 year old daughter, in the home — do not share food or drink with your toddler, and wash your hands carefully after changing diapers or wiping mucous or saliva from their face.

      You may consult my blog or the following website for more information and recommendations http://www.cdc.gov/cmv.

      I hope this information is helpful to you. I wish you a healthy and happy pregnancy and newborn!

      • Kasia says:

        Thank You very much for this information. I’m much calmer now. I only wonder if sore throat can be a CMV virus because I’ve got a cold and I’m worrying constantly.I have heard that CMV virus doesn’t cause any sympotms. Is it true? Im very prone to illnesses as my immune system is weaker during pregnancy. On Polish websites it is written that CMV virus spreads through sneezing and coughing so that’s a reason I’m paranoid about this. I wash my hands constantly and they look miserable.

      • Sun says:

        Dr. Demmler-Harrison I would like to expand on Kasia’s post. I too am an elementary teacher. However I teach the population of students with Significant Disabilities (both cognitive and adaptive behavior). I am currently pregnant ( very early )and just found out I will have a new student who has congenital CMV. I will have to both tube feed and change my student after voiding or having a BM. My student is completely dependent on others for all levels of care. What is my risk in being exposed to bodily fluids 40 hours a week? What is the risk of CMV spreading to my other students? This is not a regular classroom environment. My students do not understand “Universal Precautions” or personal space. In many ways the “germs” in my classroom pass around exactly like they do in a daycare. I am counting on your insight and professional opinion. School starts in 3 days and I am scared!

        Thanks!
        Sun

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          Dear Sun,

          Thank you for your post. You bring up some very important issues regarding transmission of CMV in the workplace. Before I posted my response to your post, I reviewed recent information and also consulted with colleagues in the area of CMV. There are no studies that have been done to address the specific risks to special education teachers. However,, recommendations and comments, based on other studies may be used as a framework to address your concerns.

          I agree that being a teacher of children with special needs and significant disabilities poses a different level of risk than a teacher in a regular classroom. Contact with potentially infectious bodily secretions is likely to be higher in a special needs classroom than in a regular classroom. It may be more difficult for a teacher, in a classroom with special needs students, to avoid contact with potentially infected secretions.

          Children in a special needs classroom may be excreting CMV in their saliva and urine. Based on our long term studies of CMV excretion in children and adults born with congenital CMV, they are probably more likely to be excreting CMV if they are younger than 5 years of age. Students older than 8 years of age are unlikely to be excreting CMV.

          In addition to the one child you know as being identified as having congenital CMV, you also may have several other children with CMV, congenital or acquired, that you did not know about. Therefore, precautions should be taken with ALL children in ALL classrooms, and not just with the one student you know has the diagnosis of CMV.

          Your student with congenital CMV has a right to an education and special accommodations, so removal of the child from the classroom based on the diagnosis of congenital CMV is not recommended.

          CMV is likely to spread readily in the special needs classroom, although there are no specific studies that have addressed this particular issue. Learning from family and day care and hospital settings, the risk to the teacher/care taker in a special needs classroom may be estimated between 2 and 8% per year (or estimated to be around 6% per 9 month pregnancy term) if precautions are not taken to reduce transmission. If recommended CMV precautions are taken, that risk is likely to be reduced by at least half maybe more, according to recent studies in France and earlier studies in the US.

          Because of this risk you should practice precautions with all of the children in your classroom while you are pregnant. If you think it may be difficult for you to reliably practice precautions recommended to reduce CMV transmission, and because you are very anxious about your work environment during your pregnancy, you may wish to ask your employer for alternative duties during your pregnancy.

          Also, remember that the risk of CMV transmission to the pregnant woman is also within her own family and home setting. Toddlers are especially efficient and silent transmitters of CMV, so precautions should be taken with ALL young children – at home and at work and other settings- while you are pregnant.

          I hope this information is helpful to you.

  65. Daisy Butler says:

    Hi,
    My husband has been diagnosed with CMV (we think he has had it for about 4 weeks). My Sister in law is pregnant and we see them very regularly. Should i tell he to go to the doctors for a blood test? will it tell her if she has the virus/has ever had the virus?

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Daisy,

      Thank you for your post on my blog.

      It is usually recommended that every pregnant woman know her CMV serostatus. A CMV antibody test will determine if an individual has been infected with CMV.

      A positive IgG antibody and a positive IgM antibody usually means a recent infection — within 3 months or so.

      A CMV avidity index can often, but not always, narrow down the timing of the infection if that information is needed.

      A positive CMV IgG antibody and a negative CMV IgM antibody usually means a past infection, months or years ago.

      A negative IgG Antibody and a negative CMV IgM antibody means the individual has not been infected with CMV.

      A pregnant woman who is CMV antibody negative — or any pregnant woman who wishes to reduce her risk of CMV to her unborn baby — should take three simple special precautions around young infants and other individuals known to have active CMV infections — do not kiss on or near the mouth, do not share food or drink and wash hands after changing diapers or wiping nose or mouth secretions. CMV is spread from person-to-person only by close and intimate contact with secretions. Casual contact by being in the same room or even just hugging, does not transmit or spread CMV. So it is probably not likely your husband has spread CMV to your sister-in-law. Young toddlers however can easily spread CMV in the family unit through contact with saliva and urine. She should be aware about CMV precautions to take.

      You may also refer to this website http://www.cdc.gov/cmv for more information about CMV in pregnancy.

      I hope this information is helpful.

      Dr Gail Demmler-Harrison
      CMVDOC
      cmv@texaschildrensblog.org

  66. Grace says:

    I wonder if you could give me some advice please. This is a very helpful blog! I am doctor over in the UK and as part of my training will work in paediatrics. I am concerned about CMV as my husband and I are planning a baby. I am concerned about previous exposure and also new exposure. Would you advise being tested pre-conception and also if I have had CMV in the past does that still pose a risk of re-activation and transmission to baby? Also is working on a childrens ward putting yourself at higher risk to serious viral illness when pregnant or is the risk negligible? Many Thanks

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Grace,
      Thank you for your questions. Knowing your CMV IgG antibody status prior to pregnancy is an excellent idea. If you are CMV IgG negative, then you should take the extra precautions I outlined in my BLOG to reduce your risk of catching CMV while pregnant. In the hospital settings, the universal and other precautions practiced are adequate to prevent CMV in the hospital. The precautions outlined in my blog post will be also needed in your home while pregnant. If you are CMV IgG positive prior to pregnancy, you may rarely reactivate your CMV infection and transmit the CMV virus to your unborn baby. This occurs < 1% of the time in CMv seropositive mothers. It is also possible, but unusual, for a new strain of CMV to infect you during pregnancy. So you are wise to practice CMV precautions when pregnant., no matter what your CMV serostatus.

      Working with children in the health care setting , if good and recommended universal precautions are practiced, does not pose a risk to the pregnant woman. It is the mother's own toddlers and other infants close to her that pose the greater risk for CMV transmission.

      I hope this information is helpful to you. I wish you a healthy pregnancy in the near future!

  67. Krystal says:

    I just found out that I have CMV, I was giving a Lab result page and a CDC print out, the midwife told me she didn’t know anything about it, only it can effect our unborn baby, and sent me on my way. The IgG was 8.4 and the IgM was<0.9. I have no idea what this means. She also told me they couldn't tell if I got the virus during pregnancy or before. I have a 4 year old son also, I'm not sure if I should have him tested. She said I have built up an immunity , but I do not know what that means either, will that prevent me from passing it to the baby?

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thank you for your post. The CMV antibody tests you post indicate a past or old CMV infection because your CMV IgG antibody is positive and your CMV IgM antibody is negative. It is not abnormal to have CMV IgG antibody; in fact 50% to 80% of women of childbearing age will have CMV IgG antibody. The risk of transmitting this infection to your unborn baby when you are pregnant and have CMV IgG antibody is really low, less than 1%, and is termed a recurrent CMV infection. It is of little risk to your unborn baby. The higher risk is catching CMV for the first time when you are pregnant, which is not the case for you at this time.

      I hope this is helpful to you. Best of luck with your pregnancy.

  68. SM says:

    Considering the fact that CMV is endemic in most areas, would it be wise to attempt to contract the virus prior to childbearing, since the risk is so much less for transmission if it is not a primary infection? I know CMV sero-status affects transplantation if one were to need it in the future, but usually the problem is being seronegative when the donor is serpositive.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thank you for your post. Yes, a woman of childbearing age who is already CMV seropositive is at very little risk for having a baby with congenital CMV infection or CMV disease. The greater risk is catching CMV for the first time while you are pregnant. However, even though CMV is readily transmitted within family units and other close contacts, it is difficult to know who is excreting CMV in their saliva, for example, without viral testing. It is therefore difficult to formally recommend an individual catch CMV on purpose before pregnancy. It is recommended however that women of childbearing age practice hygienic precautions, especially if they are known to be CMV seronegative, but also can be recommended for all women who are pregnant, to reduce their risk of catching CMV during their most vulnerable period. A CMV vaccine that is safe and effective would be the long term answer and allow women to be vaccinated and enter their childbearing years already CMV positive before pregnancy.

  69. AbieS says:

    Hi dr
    My wife just seas diagnosed with CMV IGM positive. Her fluid was low if the 20 week ultra sound which made them take to blood tests.
    Now we went back a week later and the ultra sound looked perfect. The doctor said if not for the blood work he would tell us have a good day.
    But we are still worried. Her IGM was 1.12 and IGG was 0.2.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear AbieS,

      The CMV IgM positive results and CMV IgG engative results may mean one of two things — a false positive CMV IgM result or a very early primary CMV infection.

      Most of the time both CMV IgM and CMV IgG antibody levels rise near the same time, and may increase over a period of several weeks. CMVIgM antibody lasts usually around 16 weeks and CMV IgG antibody lasts for a lifetime.

      It would be advisable to repeat the CMV IgG and CMV IgM antibody levels in 2 to 4 weeks to determine if the levels have risen. If the CMV IgG antibody remains negative, then the CMV IgM level is a false result. Your wife should take precautions to reduce her risk of catching CMV during her pregnancy if she is CMV IgG negative.

      If the CMV IgG antibody turns positive and the CMV IgM level rises, then a primary (first) CMV infection has occurred. If that happens, then CMV may be transmitted to the unborn baby about 40% of the time. Of those babies who do get infected in utero, about 10% will have symptoms at birth. Special procedures and treatments may be indicated, and should be based on the advice of your doctors.

      I hope this information is helpful to you and your doctors. Please consult your doctors for more specific advice, since they know your situation in much more detail.

      Best wishes for a healthy pregnancy.

  70. Helen Morgan says:

    Dear Dr, my husband is CVM IGG detected and CVM IGM undetected. I am CVM IGG negative and CVM IGM negative. First of all does that mean I have never caught the virus off my husband, we have had unprotected sex for 20 years now? Second of all Dr, we are having a straight surrogate. Does that mean she will catch the virus through my husband’s semen although the CMV is not active and a past infection? I am so worried and do not know what it means. Thank you.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Helen,

      Thank you for your post. If your husband is CMV IgG positive, then he acquired or caught CMV previously. He may or may not ever reactivate his CMV infection in his semen or other bodily fluids, and since your have not acquired CMV it is unlikely that he has reactivated his CMV and it is not likely he will reactive in the near future. It is not likely he will transmit CMV to your surrogate, but it is difficult to tell you with 100% certainty. Is your surrogate CMV IgG positive or negative?

      I also recommend you consult with your own fertility and invitro specialists about their recommendations regarding your surrogate pregnancy and CMV risks and what tests they recommend for you as a couple and surrogate.

      I hope this helps. I wish you a healthy pregnancy. Take care.

  71. Deepak says:

    Dear Dr. I recently came across CMV through my wife’s blood report. And I am really concerned for her. We want to have baby and were planning for it.

    My wife had a miscarriage in Aug 2011. Hence, we wanted to make sure everything is fine before we go for her next pregnancy. Doctor suggested TORCH test in which CMV IgG was found positive. Following are the results
    TEST- Toxoplasma-IgM-Negative(0.29)=<0.55 Iu/ml
    IgG- Neg(1)=<4.0

    RUBELLA IgM-Neg 0.14=
    IgG -Neg 0.1

    CMV- CYTOMEGALOVIRUS- IgM-Neg 0.07=6.0 aU/ml

    Herpes(HSV)IgM- neg
    IgG- Neg

    PLEASE SUGGEST WHEN CAN MY WIFE CONCEIVE. Will the CMV impact the growth of baby. More importantly, will CMV IgG positive, impact my wife’s health. I really love my wife and she has been going through a difficult stage of her life.
    Your suggestion or inputs will really help us. Thank you once again Doctor.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Deepak-

      Thank you for your post.

      A CMV IgG positive test result with a negative CMV IgM test result is fine. About 50 to 80% of healthy women have CMV IgG antibody. So it is not abnormal to have antibody to CMV. Most people will catch CMV at some time in their life and most have no problems or consequences to their CMV infection. If CMV is caught during pregnancy, then there may be problems with the baby in some cases. But becoming pregnant after a CMV infection has past is rarely associated with CMV problems in the baby or the mother.

      If your wife already has CMV IgG antibody, then consider her “immune” to CMV and CMV will not impact her health. Furthermore, from a CMV standpoint, it appears perfectly fine to try and conceive and have a baby at this time, provided your doctor does not find any other contraindications with a pregnancy at this time.

      I hope this is helpful to you.
      Best wishes for a healthy pregnancy.

  72. Rose says:

    Dear Dr., I’am from Portugal and I have been diagnostic from CMV last October 2011, when I then lost my baby. Now, almost 8 month later I have being doing the exams again and the results where:
    IGG – Positive
    IGM- index 1.09 (last exams in March had index 13.79 and in May index 1.79)
    What that means? That it has now became to levels “equivocal” and it’s no more positive?
    Can I presume that has pass the primary infecction? I also had the Avi test with the results of (75%), inicially, in October I had 0,08%.
    Can I presume that it’s “safe” to try to have a baby? Thank you very much

  73. Catrina Byrge says:

    Hi Dr. Gail,

    My name is Catrina Byrge and I am the founder and CEO of PMG Awareness Organization. As I know you are aware, CMV is one of the known causes of polymicrogyria and as such is a hot topic for our organization.

    I just wanted to say thank you for what you are doing here! We thank you for championing this cause for our children and those yet born!

    I was just speaking with Janelle Greenlee and she says you are doing amazing work. I will surely be following the blog and posting updates to our families and supporters.

    Thanks so much!

    Catrina Byrge, R.N., C.E.O
    PMG Awareness Organization, Inc.
    http://www.pmgawareness.org
    Catrina@pmgawareness.org

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi Catrina!

      Thanks so much for your kind words. Stay tuned — I hope to keep expanding our BLOG to provide and promote factual information about all aspects of congenital CMV. This is just our first steps!

      I will check out your site, too!

      Please keep in touch!

  74. Catrina Byrge says:

    Dr. Gail,

    Could you also comment on how long the CMV infection can continue to cause problems after birth?

    Thanks again!

    Catrina Byrge, R.N., C.E.O
    PMG Awareness Organization, Inc.
    http://www.pmgawareness.org
    Catrina@pmgawareness.org

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi Catrina,

      Children born with congenital CMV may continue to have ongoing problems into adulthood. In our longitudinal study that has been ongoing for 30 years, we have had our patients and study subjects have progression of their hearing loss into their late teens and into their mid twenties.

      Eye disease progression occurs in some patients also in late childhood. If the child born with congenital CMV has neurological involvement, then the effects can be a lifetime of challenges.

      The liver and low platelets and other problems of their body usually resolve in the first few months to year of life, but the neurological and sensory problems are usually lifelong.

      Antiviral treatment in the first months of life helps to reduce the hearing loss progression an d improve developmental milestones, etc.

      I hope this helps answer your question.

  75. Jordan Hoech says:

    Hi Dr. Demmler,

    I was a part of your study for almost 18 years and I am loving your blog! I am now having more and more friends who are becoming pregnant and I am all for spreading your blog to inform the general public of this virus. Thanks for all that you do!

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hey Jordan!
      Thanks so much for stopping in and for posting your kind comments on my blog post. Also thanks so much for being part of my study.

      Everyone – stay tuned to http://www.texaschildrensblog.org for more on this very important study!

  76. Kristin Pomeroy says:

    Hello! My 4 1/2 month old son was recently diagnosed with cCMV. He had a small head at birth, although not small enough to be diagnosed as microcephaly. His doctor decided to investigate the small head size just before his 2 month check-up. The first thing she sent him for was a TORCH test. His IGg for CMV came back at 1.48–the IgM is not in his records. His Dr. and an infections specialist were not sure if the test was showing my antibodies or his. Therefore, we did a urinalysis. It came back almost 21 days later positive for CMV–the lab values are not in his records. We love his doctor and truly believe that she has and is doing everything that she can for him; however, it just doesn’t seem like she has a lot of experience with cCMV. His hearing and vision are fine right now. His head size has been diagnosed as microcephaly–it’s right at 3 standard deviations below the mean and appears to be growing there. Developmentally he is on target. His doctor told us that it’s too late for anti-virals. The game plan is for hearing screenings every 3 months and to watch his developmental milestones. Does this sound like a typical action plan for cCMV? Should we go to other doctors? Get second opinions? Is it really too late for anti-virals?

    Thanks for any input that you are able to give!!

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hello Kristin,

      Thank you for your post.

      It is difficult to know with certainty if your son has congenital CMV or perinatal acquired CMV. CMV can be congenital – that is baby is born CMV infected-and congenital CMV is best documented by isolation or detection of CMV in the urine or saliva collected in the first three weeks of life. Since your baby’s urine test was done past that time period, he could have acquired CMV from around the time of birth-from mother’s vaginal secretions, which often carry CMV, or from breast milk, which also commonly carries CMV. Both are normal natural ways to acquire CMV at the same time mother has given antibodies to protect the baby, and generally do not cause problems in otherwise healthy infants. Infants with perinatal CMV often also start having positive urine tests for CMV around 3 to 6 months of age, and their CMV IgG antibody lasts lifetime.

      Because the diagnosis of congenital infection is not certain, may be part of the reason why your doctor is reluctant to treat your baby.

      If we had routine newborn screening for congenital CMV at birth, then such issues would be solved.

      A small head-microcephaly-can be caused by CMV, but it also can be caused by many other things, and may or may not mean he has brain involvement from the virus. Is there calcification in his brain or enlarged ventricles or anything else? Sometimes small head size may run in the family. If it is growing along a curve, and he is developing normally for age, then it is likely he will continue to do well. If he has an abnormal brain imaging test, such as CT scan, and Calcifications are found, then that is more suggestive of CMV.

      Does he have vision loss, eye muscle imbalance, or chorioretinitis ? Any other problems that may be due to CMV?

      Your doctor may only be familiar with the IV form of antiviral treatment- ganciclovir- given IV for 6 weeks.

      Now there is antiviral treatment available that is orally administered- called valganciclovir, which is much easier to give. It is given to infants with proven congenital CMV who have evidence of neurological involvement or other CMV associated illness, up to 6 months of age. If your doctor is convinced your son has congenital CMV and that his microcephaly is caused by CMV, then antiviral therapy may be given for a couple of months. However, there are no clinical trials to really support this action of treatment, since it would be started past the newborn period. And if your son is doing well at this point, treatment may not be indicated, or it may help a little. It is difficult to tell at this point, unfortunately.

      I hope this information is helpful.

      • Kristin Pomeroy says:

        Thank you so much for your time. The information was very helpful for me. Additionally, it gave further information to his pediatrician and helped expedite an appt with an infections specialist.

        • Niki says:

          Hi, sorry to intrude. But i would also recommend testing his Guthrie card (heal stick blood spot) from when he was born. Try to get it from the hospital, and have your pediatrician or infectious disease doctor test it for cmv. This is how we diagnosed my daughter at 3 1/2 yrs old!! By that time, she had lost all hearing in her right ear and she was born with normal hearing. If he is positive for CMV at birth , then i would strongly recommend you giving him the antivirals , as it would help with progressive hearing loss which is the most cause of CMV.

          • Kristin Pomeroy says:

            Thanks Niki! We have an appointment with an infections specialist on Monday so I’ll bring the heel stick card. We just did an MRI yesterday too.

  77. Niki says:

    no problem- good luck!! (and keep me updated- i really hope its not cmv)

  78. Kristin Pomeroy says:

    We had an MRI and it showed brain involvement from CMV. There’s a relative absence of the anterior corpus callosum and thinning of the callosum posteriorly. Additionally, the gyral patterns in the anterior frontal lobes are asymmetrical probably from migration. We are starting valganciclovir tomorrow.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Yes Niki is correct, the retrospective diagnosis of congenital CMV infection may be established in research laboratories by analyzing the dried blood spot on the Guthrie Newborn screening card for evidence of CMV DNA. It is helpful it if it positive, but if it is negative, it does not completely rule out congenital CMV. It is a specific test but not as sensitive as other measures for diagnosis of congenital CMV, because not all newborns with congenital CMV have large amounts of CMV DNA in their dried blood spot samples. Studies have looked at the possibility of using dried blood spots as a screening tool for congenital CMV infection.

  79. Sarah says:

    Please help us better understand congenital CMV and its affect on bones and connective tissue. Our daughter had elevated liver enzymes at 10 weeks old and the hospital didn’t check for CMV. Not until she was 4 months old, more bloodwork was done and the GI dr was able to diagnose congenital CMV. She was jaundice at birth and has developmental delays seeing PT Once a week. She is now 8 months old and is doing better. Do you have knowledge of congenital CMV affecting bone health? The dr’s are not recommending treatment and very vague with information. Our daughter has also been dealing with a cough and runny nose for weeks, no fever. Is this related? Is there an expert in FL that you recommend?
    Thank you so for your help.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      HI Sarah, Thank you for your post on my TCH CMV blog.

      Involvement of CMV in the bone is pretty unusual. However, infants born with congenital CMV disease may rarely show abnormalities in their long bones that can be seen on X-ray. These abnormalities may be metaphyseal transverse bands or scerosis and usually the newborn or infant has severe disease due to congenital CMV. The meaning of abnormal bone X-rays regarding the eventual bone health of the child are not really known and have not been systematically studied.

      Infants and toddlers with congenital CMV disease may also experience malnutrition from feeding disorders and malabsorption disorders of vitamin D, and they may have rickets, which may result in abnormal bone growth and development.

      CMV may also invade the bone marrow and cause a persistent infection resulting in abnormal blood counts.

      Regarding doctors in Florida, There are pediatric infectious disease experts at University of Florida, University of South Florida and University of Miami that may be helpful. In addition, a colleague who trained with me in pediatric infectious diseases and CMV, and who may be particularly knowledgeable about congenital CMV, is Dr Dawn Sokol who is currently at Nemours Children’s Clinic in Florida near Orlando. She also may be able to help you.

      I hope this information is helpful to you.

  80. jas says:

    hi i am 17 week pregenent ..my cmv igg 8 nd cmv igm negetive….can effect on baby…..it is minor or big problem…

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Jas, thank you for your post. In order to best answer your question, we want to make sure we fully understand what you’re asking. Can you send a more detailed e-mail to cmv@texaschildrensblog.org so that we can ensure we can help?

  81. sadaf says:

    Goodday!!
    >
    > i am sadaf from pakistan, my sister came to knw that she is CMV+ i went through diffrent sites on intrnet i got to knw that it has no cure n even one cannot get pregnant but here in pakistan i visited dr they said that its cureable and there is atratment for 6 mnths she had advised metrozine, ciproxin,meliane,paramet,glucophage…to her she assured that that it would become negative she further added that no one get this virus from her though on net i read that this that this can be transmitted even from saliva or even if we shared a drink or water in the same glass we are very confused as we have little children in our home pls do clarify if this can be easily transmitted and the precautions we should take plus also kindly advise if the below mentioned medicne will be able to finish this virus and will she be prgnant and end up with a safe pregnany
    > awaiting to have your positive feed back sir…!!
    >
    >
    >
    > Thanks & Regds
    > Sadaf Siddiqui

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      CMV infection will resolve on its own in all healthy women. It is a common and usually harmless virus to the healthy person.

      It takes between 3 and 6 months for most women to make the CMV virus “latent”. The medicines you mentioned will not have an effect on CMV.

      I recommend you wait 3 to 6 months and try a pregnancy again.

      You also may ask your doctors to do a CMV IgG antibody and CMV IgM antibody test and CMV avidity testing.

      The CMV IgG antibody will be positive for life, so do not worry about this one.
      The CMV IgM antibody will go down and when it is negative or near negative, it is safe to become pregnant.
      The CMV avidity index is a special test, and when it is high it is OK to become pregnant.

      CMV is transmitted through close contact with saliva and other body secretions. It is a common infection. It however can be harmful to the unborn baby if caught for the FIRST TIME during pregnancy. Old and resolved CMV infections that happened in the past are usually not a significant risk to the fetus.

      I hope this helps.

  82. Faton says:

    Hi everyone first I would like to apologize for my bad gram of English, this is the history. We have one beautiful daughter and she 4.5 year old we had a regular break after first child for a two years after 2 years we try to get pregnant but at happened after first child first dead embryo, and than the mistakes has happened after 6 months and she got pregnant again we lost a other baby with no any analysis and the doctors only sad is we need to have break of 1 year of not being pregnant which we follow that of course. Couple weeks ago we went to the doctors and we did urinalysis and blood. In urine they found some bacteria which we have fix this problem but the in blood we have found CMV positive and they haven’t told us about CMV treatment at all all they told us is very dangers this virus but I have couple question on this because I read this site and it says it is not good mother to kiss her daughter,to not eat from a same spoon . . . Etc. Please can you say more what to do and what to not do.
    For example :
    1) Since there is no cure, what steps should we take to reduce CMV ( any possibility’s for this (YES or NO), if yes what exactly to do .
    2) Is any possibility’s CMV transmitted from animals to man.
    I am sorry if is not something clear but I am not so good in English and I am from Kosovo ex Yugoslavia. Thanks a lot for this help.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thank you for your post.

      Is your CMV test an antibody test? If it is CMV IgG antibody, then that is a normal results to be positive and may not mean any risk to your next pregnancy. If the CMV IgM antibody is also positive, then you should wait to get pregnant until the IgM antibody is negative.

      CMV is NOT transmitted from animals to humans. Some animals have their own strain of CMV, but human CMV is transmitted by close contact between humans.

      It would be best to avoid contact with saliva, runny nose and urine from any young child while pregnant and to wash hands carefully. Also do not share food or drink with young children while pregnant. In addition to my website, the website http://www.cdc.gov/cmv has additional information on CMV you may wish to review.

      Best wishes for a healthy pregnancy next time around. Take care.

  83. saragg says:

    Hi doctor I wanted to know what you think of what I decided when I was 12 Weeks pregnant the doctor told me I was cmv positive but he couldn’t tell till I was 21 Weeks if the baby had it to o so I waited took a amino test and they told me that unfortunatly the baby was also poaitive so they wanted to.see how high and it was way over a million cells so they told me that the baby waa very affected and will be not healthy so they told me to abort and thats what I did but I just am so confused because they told me the. Baby looked great so I just domt know if I made the right desition the doctor told me he would of told his.wife to abort I just hate how I have never heard.about this im my entire life I just always thought these kind of sickness would be related to down syndrowm but I know now its not.Please let me know what you think im atill so confused and this happend to me 2 Weeks ago it just went so fast when I first found out about it I read online its very rare for what happend to me and everyone told me its nothing I just cant believe it thanks

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      This is a very stressful and heartbreaking time for you. You made the best decision you could, at the time you made the decision, and it was based on the best information you had at the time. It is difficult to know what the outcome of your pregnancy and baby would have been. It is possible your newborn would have been born with many problems and live a life of disabilities. It is possible you saved your baby the suffering and sorrow. No one will know for sure, but you did the best you could for your baby at the time.

      It is painful and sorrowful to experience the loss of your baby.

      Move forward, knowing you did the best you could.

      Best wishes.

  84. Cynthia says:

    My daughter just found ot she is preg. she was diag. with CMV this past March of which she was hospilized for a week.. she has been doing great . She is resting but is now looking for a OB snce she just found out 9/18/2012.. Are there any additional a suggestions.. the only thing I have concern about is her feet or ankles swelling a little.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Cynthia,

      Thank you for your comments.

      If your daughter recovered from her CMV infection before she became pregnant, with lab tests that show a positive CMV IgG antibody level, a negative CMV IgM antibody level, and a high CMV avidity index, then there is minimal to nil risk to her fetus. Her body will develop immunity to CMV and protect her unborn baby.

      CMV does not cause ankle swelling so I recommend she consult her OB about that issue.

      Best wishes for a healthy pregnancy.

  85. Kim says:

    Thank you for educating the public about CMV. I had never heard of CMV until Setember 9th, when I was told my baby who was born via emergency csection at 32 weeks gestation had CMV. I was told CMV had destroyed his lungs, liver and most of his brain. I was told he would never advance in life and would pretty much live as baby his entire life needed 24 hour medical care. My husband and I decided that wasn’t a life anyone should have to live so we removed his ventilator and got to hold him for 3 special hours as he passed. We also have a 17 month old goes to daycare so we are assuming I was exposed via my 17 month old for the first time while pregnant. My husband also had mono a few weeks before our son was born so I am thinking he must have had CMV too.

    I am now searching and looking for answers. I am scheduled to meet with a perionatologist in the University of Washington and hopefully they can answer some questions about my future; if I will be able to get pregnant again and what the chances are of having another baby with CMV.

    A big question I have is why I wasn’t educated about this virus. Especially as a mother with a toddler in daycare. Why is such a devestating virus that has long term effects on ones quality of life not more well known? My family will never be the same after experiencing such a terrible loss. We will forever miss our sweet son. I know I will do what I can to educate others.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Kim,

      Thank you for your comments and for sharing your heart wrenching experience and the loss of your son from the effects of congenital CMV. My condolences to you and your family.

      The doctors at University of Washington should be able to guide you through your next pregnancy.

      Once you have recovered from the loss of your son, and your lab tests show your CMV infection is resolved – CMV IgG antibody is positive, your CMV IgM antibody is negative, and your CMV avidity index is high – you may become pregnant again with minimal or nil risk for CMV infection and CMV disease in your next baby.

      Your next pregnancy should be at minimal risk for the effects of CMV. The first or primary infection with CMV that occurs during pregnancy is the infection that carries the greatest risk. After the first infection is over, your body makes antibodies and other immune responses, that protect subsequent pregnancies.

      You are welcome to share my blog to any of your friends who are pregnant or or child bearing age, to help spread CMV Awareness.

      Take care.

  86. Dana Comer says:

    My daughter is 6-1/2 months pregnant and works in an emergency room as an RN. Recently, she has informed me that there have been several cmv patients at the hospital, one just sitting in the hallway and I’m assuming the others were in isolation. My daughter has not taken care of any of those cmv patients. However, I am worried that she might have been exposed to cmv by either working on the same equipment as the other nurses who cared for those patients or just the fact that those nurses did not change their gowns after they cared for their patients. Obviously, I’m worried about the one that wasn’t put into isolation until later on in the day. My daughter is very good at always washing her hands and trying to stay clean. How would we know if she was exposed to the virus? Should she quit working at that hospital? It doesn’t seem like the nurses she works around follows the appropriate rules for cleanliness. Is she late enough into her pregnancy that it won’t affect the fetus? She started working at the hospital this past July. Thank you in advance for your response.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Dana,

      Thank you for your comments and post. Your questions bring up common concerns about how CMV is commonly transmitted to pregnant women. I am happy to hear you and your daughter are CMV Aware and wish to practice the proper precautions to keep her from catching CMV and transmitting CMV to her unborn baby.

      If your daughter is CMV antibody negative, then she is at risk for catching CMV for the first time during pregnancy, and she should practice hygienic precautions when in close perosnal contact with young children, who are the ones likely to be shedding CMV.

      If she is CMV antibody positive at beginning of pregnancy, then she is much less likely to transmit CMV to her unbaby, because her CMV antibodies are protective.

      Although exposure to patients who are shedding or excreting CMV is likely to be common in the hospital setting, transmission of CMV in the hospital setting is not common. In fact, transmission of CMV from a patient to a health care worker has not been convincingly documented to occur.

      Standard universal precautions are sufficient to prevent CMV transmission and are recommended. In the hospital, patients with CMV infection should not be isolated in any special manner.

      The real risk of exposure of from CMV to the pregnant woman is contact close contact with young children in her own family or extended family, and with close family members. CMV is transmitted through close contact with saliva or body secretions or by sharing food or drink. It is not air borne and it does not survive on surfaces very long.

      When caring for children, hand hygiene, particularly after changing diapers and wiping drool and secretions from faces, is advised to decrease transmission of CMV. Because excretion of CMV is common in people of all ages, a child with congenital CMV or any patient with CMV infection should not be isolated and should not be treated differently from other children or patients in the hospital. They also are not a risk to a pregnant woman if universal precautions and good hand hygiene are practiced.

      If your daughter has a safety concern however, she should contact her nursing supervisor immediately and discuss the issue with her supervisor to see if a temporary transfer of duty responsibilities is in order, for peace of mind.

      I hope this information is helpful to you. I hope she enjoys a healthy pregnancy.

  87. Martha Gaz says:

    I was diagnosed with CMV during the 27th week of my pregnancy. My daughter died, however she was tested for cmv before and the result was negative. Besides that, she had down syndrome, large spleen and liver, and more white cells than need in her boold, probably congenital leukemia. I want to get pregnant, but I am afraid this happens again. I had a TORCH screen a couple of months ago, and the IgG results were high, especially CMV with 216.34. The IGM results were all negative. What are the odds of having this problem again? Would hypperimmune globuline be a good plan? Can you recommend a specialist in El Paso, TX?

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Martha,

      Thank you for your post on my CMV blog and for sharing your experience. Please accept my condolences on the loss of your baby. This heartbreaking experience should not happen again.

      Regarding congenital CMV – CMV effects are almost always the result of a first or primary infection with CMV in the mother. If your CMV IgG antibody is positive – no matter how high – and your CMV IgM antibody is negative, then you are past your primary infection phase and you will pass CMV antibodies and “immunity” to your next baby. CMV IgG antibody will last your lifetime, so if it is positive, that is OK.

      Infusions of CMV hyperimmune globulin would not be of benefit for your next pregnancy. You already now have high levels of IgG antibody.

      Regarding risk of Down’s syndrome and congenital leukemia, for your next pregnancy, I suspect the risk are very low to nil, but that question would be best answered by a maternal fetal medicine specialist.

      I will try and find you the name of a maternal fetal medicine specialist in your area. Your OB and local obstetrical hospital also may be able to help.

      I hope this is helpful to you.

      Best wishes for a healthy pregnancy when you decide it is time to try again.

  88. Helena says:

    Dear dr Gail, my husband is igg detected and igm negative I am negative in both so I have never acquired the infection. My son was stillborn, he had absence if the corpus collasum. My ques us if my husband is positive and I am igg and igm negative, could my husband have passed this to my son without passing it to me first? He was never tested for this infection but I have read through this and have read it van effect the development if the brain and so am just wondering if it can pass from husband to baby through pregnancy without me being affected. Thank u doctor.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Helena,

      Thank you for your post and comment on my CMV BLOG. I am so sorry for the loss of your son.

      For your son to have a symptomatic congenital CMV infection with brain involvement, you must first have a CMV infection. It is not likely your son had congenital CMV as the cause for his brain condition if you remained CMV IgG and IgM negative.

      It is also not likely your husband gave CMV to your unborn son without first having given the infection to you. CMV can be seen in the sperm and seminal fluid of men, but in all instances of congenital CMV infection, the mother was also infected with CMV.

      Since you are CMV IGG negative, you remain at risk for catching CMV for the first time. If you try to become pregnant again, please remember to practice CMV precautions when around young children or persons with an active CMV infection.

      I hope this information is helpful. Best wishes for a healthy next pregnancy when you feel the time is right.

  89. Rochelle Leivers says:

    Hi. I’ve been so frustrated by doctors general lack of knowledge about CMV
    I have always tested as being CMV IgG negative for my previous two pregnancies and today I discovered that I am 6 weeks pregnant and all of a sudden I have shown to be CMV IgG positive with a level of 195.
    My Dr said its fine that I’ve had past infection but how does she know that it isn’t a recent infection as I was negative 18 months ago when my daughter was born.
    Should I be pushing for an IgM test? My husband and two toddlers have just come through a revolting winter of coughs and colds and I’m terrified that my exposure to CMV is recent enough to possible affect this new baby.
    Can someone please help me with some advice???
    Thank you

  90. Rochelle Leivers says:

    Sadly I have just found out that I have also had CMV IgM antibodies detected in my blood too (After I begged my dr to test). I’m devastated and wonder where my journey with this tiny embryo will go :(

  91. Rochelle Leivers says:

    Sadly I have just found out that I have also had CMV IgM antibodies detected in my blood too (After I begged my dr to do the test). I’m devastated and wonder where my journey with this tiny embryo will go :(

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi Rochelle-

      Only estimated 40% of pregnant women with CMV IgM antibody and a primary CMV infection will transmit CMV to the fetus. Most of the time, the placenta is able to block the infection.

      I hope you have consulted an experienced (with CMV) maternal fetal medicine specialist.

      Also, there is a clinical trial ongoing right on now on the use of CMV hyperimmune globulin to block transmission of CMV in women who have CMV IgM antibody or are experiencing a recent or primary CMV infection. It is listed on http://www.clinicaltrials.gov. It is headed by Dr Brenna Anderson and is a 14 center NICHD maternal fetal medicine units network randomized clinical trial.

      I hope this is helpful to you.

  92. saragg says:

    Hi dr.Gail thanks so mhuch for answering me I had a nother question that keeps driving me crazy and wanted to know if you can please answer it for me I wanted to know when I did the amnio test how did the doctor know that I have a primary infection he told me the baby had a big number of cmv n his system and said he was in the percantage of being ssfomewhat like.a
    Vegetable so is it bec he had a high number it.means hes in the worst stage bec when I read about cmv I get confused could it be my baby wasnt even sick at all e ven if he had it in the water

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hello SARAGG-

      Thank you for your post.

      CMV infection in the womb in utero in the fetus is determined by CMV DNA and culture testing on the amniotic fluid waters. A very high titer or high amount of CMV can suggest the fetus is severely affected, but not by itself. By itself, it also cannot determine if you had a primary or first CMV infection.

      CMV disease in the womb in utero in the fetus is determined by fetal ultrasound or fetal MRI testing to assess the fetal internal organs, size of fetus and condition of the placenta and cord.

      Combined both fluid and ultrasound results- then you can determine CMV disease in the fetus.

      To determine if your CMV infection was primary, blood tests are needed- CMV IgG CMVIgM and CMV avidity.

      Practically speaking, almost all fetal congenital CMV disease is associated with a mother’s first or primary CMV infection.

      I hope this information is helpful to you.

  93. Rochelle Leivers says:

    Thank you so much for your email reply. I have been referred on to an ID consultant but sadly I still have a couple of weeks before my appointment date. I ended up having two avidity tests taken as my original GP decided to send my bloods away for it after she did some reading and reconcidered it’s importance and my new GP sent away for one too. Both tests were processed in different labs and surprisingly the results have come back considerably different. One test taken at 6 weeks pregnant came back with an avidity index of 43% (which I understand as bring equivocal) and my second lab test taken at 7 weeks came back with an avidity index of 71% which I understand is high. Have you seen such a variation in results in labs taken only a week apart before. I’m hoping this puts me in a lower risk category although I wish I hadn’t had the equivocal result to cloud my positive thinking. Thank you also for the information on the clinical trial. I am in Australia- I hope I will still be eligible if my specialist agrees to it.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      CMV avidity results evolve over time, so it is not unusual for it to evolve from equivocal to high. It is actually somewhat encouraging to hear your results are equivocal to high. It is also not unusual for different labs to disagree on the results. Published studies have documented that.

      One way to make sure they are accurate is to run the two blood samples on the same test run in the same lab.

      A third sample may also be drawn as a “tie breaker”.

      There are CMV specialists in Australia. What part are you? Near what city? Dr. William Rawlinson is sponsoring the next International Congenital CMV Conference in Brisbane in April 2015. He is a good resource for Australia.

  94. Sandra S. says:

    Dr Demmler-Harrison, I look forward to meeting you on December 7th. My daughter is 10 months old with Microcephaly, Right Side Polymicrogyria, Gross Motor Delay, and Hearing loss in left ear. She tested highly positive for a prior CMV infection which we believe was in utero. Thank you so much for your work and for advocating for CMV families.

  95. Mary says:

    Hi dr:
    I am currently 12 weeks pregnant living in Canada. My ob/gyn provided a photocopy of my CMV screening results from bloodwork done three weeks ago. After reading the results myself i found i am positive for IgG and IgM. My OB initaled the bottom of the page but did not speak with me about what this result could mean or send me for a second round of blood work. Should i bring this to her attention, as this may have been an oversight on her part???? What are the chances these results are due to a pre-natal infection?

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Mary,

      Thank you for your post.

      I recommend you contact your doctor as soon as possible and discuss the results of your CMV testing.

      A positive CMV IgG and IgM antibody indicates a possible primary CMV infection, which may be transmitted to the fetus during pregnancy.

      A CMV avidity index may be helpful in determining the timing of your CMV infection.

      If you are experiencing a primary CMV infection, then your obstetrician may recommend other evaluations or interventions.

      I hope this is helpful to you. Best wishes for a healthy pregnancy.

  96. Rosemary says:

    Hello Doctor, thank you very much for this blog and the answers you’ve already provided.
    I am 6 weeks pregnant, CMV positif, very recent infection (less than 3 months). Your citation of the study on the transmission rates according to time of transmission is very interesting. I would just like to know what is considered “pre-conception” and when is it “around conception”, because in my case I am almost sure of when I got sick with the virus (mononucleosis symptoms that lasted a month), a month before conception. I still have positive IgM rates of course.
    I am very worried about this virus, even if transmission rates are low so early on. Do you think the hyperimmune globulin treatment is available in France? What about the after-birth treatments? I am in the Paris area; do you reccommend a particular doctor or hospital here?
    Thank you very much!

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Rosemary,

      Thank you for your post.

      Dr Yves Ville (France), with the University of Paris Sorbonne, yves.ville@gmail.com, is a world-renowned expert in prenatal infections, including prenatal CMV infections. I recommend you contact him for CMV related questions about your pregnancy and indications for prenatal treatment. If you have any trouble contacting him or his colleagues at University of Paris, please let me know. There are also CMV parent associations in France on the web and Facebook and these parents may also help you contact the right health care professional.

      Pre conception means proven CMV IgG antibody positive results before pregnancy/conception. However, since most women do not have accurate timing of their CMV exposures and infections and their conception dates, we often characterize the timing of the CMV infection in more loose and less accurate terms to include just before, as well as closely after conception as “peri conception” if at the time of pregnancy diagnosis there is both CMV IgG and IgM antibodies present. Since CMV IgM antibody lasts 3 to 4 months at least in most women, it is likely you experienced a primary CMV infection around time of conception. It is possible administration of CMV hyperimmune globulin may reduce the approximately 40% transmission rate to your fetus. Also, there are neonatal treatments available with IV ganciclovir and oral valgancilovir that are of benefit to the newborn infant. Both treatments should be available in France. They are readily available in Italy and other European countries as well.

      I hope this information is helpful to you. Please let me know via private email listed on the blog if you have any other questions or concerns or need information.

  97. Raylene says:

    I have a 10 year old daughter that was born with extreme congenital cmv. She is completely dependent, has microcephaly, lissencephaly, heart/lung/liver/stomach/intestine/eyes/ears etc problems. Seizures, cp, and so forth. Questions- what kind of medical services do you offer because I live in Texas and could bring kayla to an appt if you could be of a help at all since usually none of her doctors are familiar with actual cmv cases. Also my sister is pregnant and says she took a test at a lab test place that shows she hasn’t contracted cmv so what precautions should she take against Kayla and my other children? She is very nervous and usually I just tell anyone pregnant to not be in the same room as my daughter because she coughs and vomits a lot. Thanks for your time and all you’re doing to aid in the disappearance of this virus as a major problem.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hello Raylene,

      Thank you for your post.

      Here at Texas Children’s Hospital we have a CMV multidisciplinary team of specialists in audiology, otolaryngology, ophthalmology, neurology and neurodevelopment that see our CMV patients on a regular basis. We also have a full team of other specialists, such as in GI, epilepsy, etc. with whom we consult, when their expertise is needed.

      If you wish to schedule a consultation, please contact my office at 832-824-4330 or correspond with me via the email provided in the blog.

      Regarding your sister and her pregnancy. She should practice CMV precautions when she is around any young children close to her and not just Kayla. Many toddlers and young children silently shed CMV in their saliva and urine. Experts recommend CMV precautions be practiced for women who are pregnant and if they wish to reduce their risk of catching CMV during pregnancy they should avoid contact with saliva, wash hands when changing diapers and wiping drool and runny noses, and also avoid sharing food and drink. Give big hugs and kisses on top of the head instead of kisses hear the mouth or face.

      My blog post outlines these recommended precautions, as well as http://www.cdc.gov/cmv and other websites run by nonprofit foundations dedicated to CMV awareness also have recommendations you can give your sister to review. I hope you find this information helpful.

  98. Scout says:

    Hi

    My wife and I are/were TTC our first child. We are using IVF and she tested positive for IgG and IgM antibodies. Her first test was in August and they were both around a level 4. She tested again in September with not much of a change in levels. In October we tested again and her IgG levels went to 9 and her IgM levels stayed around a 4. She just recently tested again and her IgG levels remained the same and her IgM levels went down to a 3. Our doctors cannot tell us what these levels mean or imply for how long we will be waiting for her IgM levels to be negative. We’ve seen online some people saying their doctors just suggested waiting 6 months after testing positive, because the antibodies will be built up long enough where it is safe to conceive. Can you tell us anything about what these levels mean or how long it usually takes for IgM levels to go down? Do the levels slowly move down or drastically? Does the jump in IgG levels mean anything?

    Thanks!
    Scout

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Scout,

      Thank you for your post.

      The presence of CMV IgM antibody rises quickly after a first or primary CMV infection and then slowly declines over a period of 3 to 12 months. It depends on the individual as to how long it lasts. Most women will have CMv IgM antibody last for 3 to 4 months, but a few will have ti last for 6 to 12 months.

      A test called CMV avidity index may be done to assist in determine if the CMV antibody is now “mature” and capable of providing immunity to CMV and protecting the fetus for a future pregnancy.

      If an avidity index is not available to you, then I usually recommend 6 to 12 months waiting period after a CMV primary infection before pregnancy.

      The gradual rise in the CMV IgG antibody is normal and expected. I would not worry about this. It is what should happen.

      The numbers per se do not mean anything specific because the numeric readings vary with each type of text method.

      I hope this is helpful to you.

  99. Rachel Morgan says:

    Hi Dr.

    I have a 7yr old daughter who I passed the cmv onto while pregnant, she has profound hearing loss , lower tone cerebral palsy , eye problems , but most worryingly is her behaviour / social skills, she’s cannot talk but uses British sign language to help communicate, I am worried about her behaviour , I can’t put my finger on whether she’s maybe autistic , OCD , aspergers etc, she isn’t like a normal little girl never has been she seems in her own world a lot of the time, she can do a lot of things , go to bathroom , fend for her self but she doesn’t seem to have any social awareness of her self , the doctors , teachers etc don’t see the way he behaves at home so they just put it down to her being deaf , it’s soul destroying knowing I did this to my little girl , have you got any experience with children with different behaviours / odd behaviour , thanks x

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Rachel,

      Thank you for your post.

      I suggest you consult a Developmental Pediatrician to see and evaluate your daughter for a behavioral disorder and recommend therapy for her to improve her socialization skills. It is possible her hearing loss is contributing to her social differences, but it is also possible she may have a social disorder. Therapy can help her. Are you able to access a specialist in Developmental Pediatrics?

      Here’s a link to our hospital’s Developmental Pediatrics web page – http://www.texaschildrens.org/Locate/Departments-and-Services/Developmental-Pediatrics/

  100. Lauren says:

    Hi,
    A few months ago I had a early miscarriage, blood tests showed I had contracted CMV which could’ve resulted in the loss. Blood tests showed I am now inactive. I was told to wait 2-4 years before trying to concieve again. I have done alot of reading on cmv and cannot find anywhere else which supports this time frame. My dr gave me the link she used and that is the only place which says 2-4 years.
    I was just wondering on your thoughts.
    Thanks so much.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Lauren,

      Thank you for your post.
      In most healthy women of childbearing age, a primary or first infection with CMV will resolve in 3 to 12 months. There is individual variation, therefore there is a range.

      The lab indicators that the primary CMV infection is resolved and it is “safe” to become pregnant again from the CMV perspective, is presence of CMV IgG antibody (any level high low medium) and negative or absent CMV IgM antibody, and if available, a high CMV avidity index showing mature CMV antibody response. If these results are all present, then the risk to the next pregnancy and fetus for having congenital CMV and symptoms from CMV are very very low to nil.

      I usually recommend a waiting period of 6 months to a year, or until the CMV IgM is negative and the avidity index is high. Waiting 2 to 4 years is also OK, but may not be necessary for most women, especially if their antibody tests show resolution of the primary CMV infection.

      I hope this information is helpful to you.
      Best wishes for a healthy pregnancy.

  101. kevin says:

    Hi Gail,

    My wife is an occupational therapist at Children’s Hospital in Philadelphia, she treated a kid with congential cmv, on December 4 and December 20. She was 12 weeks pregnant on Dec 4 and then 14 weeks the second. She then had blood work on December 27 and her igg was .24 and her igm was 1.3. Then her blood test on January 14 was igg .12 and then igm 1.2. We are now setting up meetings with doctors in Philadelphia to recieve the cyctogam. Her 20 weeks ultrasound isnext Thursday. I was just wondering your thoughts on this and your thoughts on cyctogam.

    Thank you,

    Kevin

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Kevin,

      Thank you for your post on my CMV blog.

      First, acquisition of CMV via an occupational exposure in the hospital where universal precautions are used- good hand washing and avoidance of contact with body secretions and saliva and urine-has never been convincingly documented. So the risk of acquiring CMV from a known hospital exposure is very very low to nil. The risk however of acquiring CMV from a household close exposure to someone in your family, esp a toddler or young child, is much much higher and more probable. Has your wife had any other close contact with someone likely to be actively CMV infected?

      The CMV serologies you describe are of concern, but are not diagnostic at this time of a primary CMV infection at this time. The CMV IgG antibody level appears to be negative – is this correct? What is the interpretation of the values you provided? Each cut off for each test type is different. The CMV IgM level appears to be a low of equivocal value – is this correct? Is it possible this is a false positive result? How was the result level interpreted?

      Have other CMV tests been done – such as CMV DNA levels? Were CMV levels in your wife’s urine saliva or blood?

      Is an amniocentesis planned to determine if the baby is infected with CMV at this time?

      CMV hyperimmune globulin (“Cytogam”) may be used in women who are pregnant and experiencing a CMV primary infection to reduce risk of transmission to the fetus. Some studies suggest it is indeed beneficial with minimal risk to nil risk to the mom and baby. There is also a clinical trial ongoing (go to clinicaltrials.gov) around the country with the principal investigator is located at Brown University. You may wish to investigate participation in the clinical trial.

      Consultation with an experienced maternal fetal medicine specialist is also recommended.

      I hope this information is helpful to you. Best wishes for a healthy pregnancy and healthy baby.

  102. nayena says:

    Dr gail.. Thank you for starting of this post..I had never ever heard of CMv.. uptil recently that i had to terminate my featus of 20 weeks. due to Isolated Ventriculormegaly.. Post this my Gynac..\advised me to get a torch titer for IGG and IGM ..My CMV IGG is reactive iao 554..
    Cmv IGm is non reactive.. After seeing this my gynac has advised me not to plan for future preganacy…I have been taking Rovamycin..in hope of reducing..Is this proper..would it help in bringing down the CMV…Kindly advise..I would like to plan for future pregnancy

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Nayena,

      Thank you for your post.

      First, please accept my condolences on the loss of your unbaby. Did your fetus have any testing on amniotic fluid for CMV to prove CMV was the cause of your fetal ventriculomegaly? There are many causes, and congenital CMV is just one of them.

      Regarding the results of your CMV serology, a positive CMV IgG and a negative IgM is reassuring and means you have resolved your CMV primary infection. CMV IgG antibody is also very common and not necessarily an abnormal test result, since over 1/2 to 2/3 of women around the world will have CMV IgG antibody positive results and will have no ill effects from the infection. A positive CMV IgG antibody and a negative CMV IgM antibody result suggests CMV was a possible cause for your fetal loss, but does not prove it. Only a fetal test for CMV will confirm this.

      We generally recommend it is OK to plan another pregnancy 6 to 12 months after the last pregnancy loss and when the CMV IgM levels are negative. So, you may be able to play another pregnancy, from the CMV consideration perspective, later this year.

      I am not familiar with the medication name Rovamycin, so I am not able to provide any comments on the use of that medication. If there is another name please send it to me.

      I hope this information is helpful. I wish you a healthy future pregnancy.

  103. Lynn says:

    Hello Dr. Gail,
    Thank you for providing such an imformative website. The information that is available to people regarding CMV tends to be very ‘generic’ in nature, and typically comes to our attention when its too late! I recently ended a pregnancy due to CMV. We performed an amnio to determine if the markers we were seeing were due to infection passing to the baby or other reasons, and it was determined that the infection had in fact passed. I think I already know the answer to this question due to reading every single one of the above blog questions, but want to ask myself. If I still am testing positive for IgM, should we not try to get pregnant until that number reads negative? My PCP feels that since I have positive IgG (antibodies) levels that have risen since my initial testing, we would be fine to attempt to get pregnant. I do not want to be foolish and risk the health of any future child, but wish we had some CLEAR answers. Should we wait for my IgM to be negative, (it has dropped, but is NOT negative) and for what period of time) before we attempt another pregnancy? I sought the advice of another Dr/friend at Baylor (and have a suspicion she asked your advice before answering my question :) but I am hoping to hear right from you. Thank you again for your time, and for all the amazing work you do trying to spread awareness for CMV and the many people it affects. Lynn Maloney

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Lynn,

      Thank you for your post on my Texas Children’s CMV blog. Condolences on the loss of your baby during your last pregnancy.

      Regarding your question about when is a good time to start planning for another pregnancy from the CMV perspective, most experts recommend waiting until the CMV IgM antibody is negative and the CMV avidity index is high (usually over 60% is high for most CMV avidity index testing available) before attempting another pregnancy. The CMV IgG antibody rises quickly and remains positive for a lifetime, but its “maturity” and “strength” and ability to possibly prevent in utero transmission of CMV may take several months to evolve. Most otherwise healthy women will resolve their primary infection and their CMV IgM serology will return to negative within 3 to 4 months, on average. Some women will take a little longer, since each individual has a unique response to the infection. If you do not have CMV serology reports to guide you, then most experts recommend a waiting period of at least 6 months, possibly up to 12 months.

      I hope this information is helpful to you. Best wishes for a healthy next pregnancy.

      If you are in Houston and wish to discuss your individual circumstances further, you are welcome to contact me directly.

      • Lynn says:

        Thank you so much for your fast response. I am NOT in Houston, but we lost our first child to a genetic disorder called MECP2 duplication syndrome. Dr Melissa Ramocki from Baylor University is very much involved on research on the little known disorder and we worked closely with her while our son was alive. When we learned of the CMV we reached out to her in hopes that she could help us get some specific answers. Shes been so wonderful and supportive to us though weve only spoken through email. I truly appreciate your responding to me. It seems as though I am one of those people whos infection takes some time to respolve as we discovered I had CMV at the end of November and am still testing positive for IgM. We suspect that I came in contact with it possibly in September, but that is only attempting a guess based on symptoms (which sort of mimic the fatigue of early pregnancy anyway!). Very frustrating. You’ve already spent a great deal of time answering my question, but I have one more…WHY do you think this is not spoken about to more women? Why when they do an initial blood test for pregnancy do they not check to see if the woman has any IgG? It seems so simple to me to do! My Dr. told me that it is because ‘most’ women have been exposed by child bearing age, but one look at this blog shows that just isnt true.
        Thank you again!
        Lynn

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          Dear Lynn,

          You are correct. We need to do more outreach to spread CMV Awareness not only to the public but also to our own doctors and other health care professionals who care for pregnant women.

          It is recommended that pregnant women be made aware of CMV and be provided counseling on how to properly avoid contact with secretions that are likely to be CMV infected so they can reduce their risk of catching CMV while pregnant.

          Between 50% to 80% of women of child bearing age will have been infected with CMV before they reach child bearing age, but many, as you have seen, enter child bearing age not having had CMV and not having been made aware of CMV. We still have a long way to go.

          You may wish to consult our websites and blog and websites such as http://www.cdc.gov/cmv for ideas on how you can also help spread CMV Awareness.

  104. danyale says:

    I am 19 weeks pregnant and have been diagnosed with cmv .My unborn son also had the virus my doctors are telling me there is no hope and I need to terminate the pregnancy. But I can’t do that without knowing that there is absolutely nothing I can do to possibly help or save him. I am being told that there is no chance he will be born without a disability if he is born at all. He is 2 weeks behind now growth wise and has intestinal blockage but other then that he is normal . Is there no way for me to help keep him or any treatment center I can go to? I also live in Dallas texas so any form of help would be appreciated.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Danyale,
      Thank you for your post on our CMV Texas Children’s blog.

      You are welcome to contact us for an evaluation here at our Fetal Center at the Texas Children’s Pavilion for Women. Please e-mail me at directly as soon as possible at cmv@texaschildrensblog.org so we can discuss your case individually and privately and possibly arrange a consultation with our Fetal Center Specialists, if that is what you wish to do.

      It is difficult for me to tell you more details about your baby without more information. However, there is hope!

      Transmission of CMV to the fetus after a maternal primary infection occurs about 40% of the time.

      If transmission to the fetus occurs, then about 10 to 15% of infants will have CMV disease from the infection. If your baby is not growing well and has an abnormality of his intestines, but his brain is growing well and his head size is growing, then there is hope he will not have a developmental disability.

      There is a broad range of the disease and not all infants are severely affected and not all infants have evidence of brain involvement. Some do have brain involvement and some do not. Even infants with brain involvement have a wide range of outcomes, from normal intelligence ( if brain involvement is mild) to severely affected (if brain involvement is extensive and destructive).

      There are interventions that may help reduce the transmission and the disease caused by CMV to the fetus. It is hyperimmune CMV globulin infusions. It is possible you may benefit from this treatment.

  105. Jaclyn says:

    Dr. Demmler-Harrison,

    My son was born in June with very severe symptomatic CMV. He is doing ok (not meeting milestones, but is gaining weight and interactive) but I would like to get pregnant again soon. I had my blood drawn in October and my CMV Igm was negative (I was not given a #). I just had my labs drawn again 2 weeks ago and my CMV Igm is 1.92 where 1.1 or less is negative. Do I have a recurring infection? Should I continue to wait to conceive? Should I rerun the blood tests each week?

    I appreciate any comments and help you can give me. I can’t relive the last 8 months again. I want a healthy baby.

    Jaclyn

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Jaclyn,
      Thank you for your post on my CMV blog.

      Possible explanations for the “bump” back into the positive range for your CMV IgM level include:
      – False positive reaction from an undetermined interference
      – Laboratory range error
      – Different types of CMV IgM tests were done on each sample so their ability to measure CMV IgM may vary
      – Recurrent CMV infection
      – You may still resolving your primary CMV infection – some women may take 6 to 12 months- and your levels of CMV IgM are fluctuating between the low positive/high negative ranges

      It may be prudent to repeat your CMV IgG and IgM and also perform a CMV avidity index in 1 month, when you are feeling healthy and well, and see what the results show.

      Request copies of the report that includes values. If CMV IgM is negative, CMV IgG is positive, and CMV avidity index is high (usually > 60% is a good high level for most tests) then repeat them one more time in 2 to 4 weeks again. If you get the same reassuring results, then it is OK to start planning your next pregnancy.

      Every woman’s response to CMV infection is different. I hope this information is helpful to you. Best wishes for a healthy pregnancy !

      I hope your son is doing well and is provided all the services he needs through your doctors and agencies available in your area.

  106. Sandra S. says:

    Thank you for all you do for my daughter Lillian <3 We are so thankful for you and Holly and the wonderful team at TCH.

  107. Jaclyn says:

    Thanks so much Dr. Demmler. I also sent some of my information to Holly today. I am hoping we can have a conversation next week to help guide me a little better (with a new pregnancy and help for my son).
    What is an avidity test? My ob said she won’t retest me for another 3 months. How do I convince her to test me again sooner? I am still waiting for the urine test. They are telling me it takes 25 days to get back. Does that seem accurate? The obs are saying if the urine test comes back negative then it was probably just a recurring infection from my son and I have antibodies for that infection already (and I can start trying next month). Thank you again for your help. I feel at a loss because no one around here seems to understand CMV.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi Jaclyn,

      A CMV avidity test is a special CMV antibody test that can be drawn on your blood and ordered by your doctor to be sent to a reference laboratory. A high avidity index over 60% indicates a resolved CMV infection and is usually a safe time to become pregnant again, if everything else is also OK.

      A CMV urine test by culture indeed may take 21 to 28 days to finalize. CMV may grow in culture in a few days or a couple of weeks, but labs must keep the cultures for 3 to 4 weeks. CMV may be shed in your urine and other body secretions intermittently in a recent and past infection. It usually does not mean much if it is positive or negative, when considering when to have another baby.

      I hope this information is helpful to you.

      • Jaclyn says:

        Thank you again. So to summarize, the urine test does not really matter and I can pass on doing this one again regardless of the results. I need my igm to be negative 2 more times in the next month or so and the avidity test to be at least 60% and then it should be safe to conceive. (My igg is already very high) Correct?

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          Dear Jaclyn – Yes, that sounds correct. Best wishes for a healthy pregnancy.

          • Jaclyn says:

            Hi Dr. Demmler,

            My avidity test is 94%. Do you still recommend a repeat IgM? (It was positive last time).

            Also, my son’s CMV viral load is now undetectable (he’s 8 months). Can he still have progressive hearing loss?

            Thanks again,
            Jaclyn

          • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

            Hello Jaclyn,

            To be on the safe side, you should obtain another CMV IgM level also to make sure the CMV IgM value is in negative range before trying to become pregnant again. The high avidity test is reassuring but you should also continue to follow your CMV IgM test until it is negative. A repeat urine CMV test on you probably is not necessary and is not useful in timing the next pregnancy.

            Yes your son may still develop hearing loss; his hearing should be followed throughout his life. Antiviral treatment reduces the risk of hearing loss and progression of hearing loss but it is not 100% effective, just provides some benefit.

            I hope this information is helpful to you.

  108. Veronica says:

    Hi,
    Really need some advice. My perinatal doctor indicated that my sonogram show my baby measuring at 17 weeks but I am 19 week based on my last menstral period. She said could be one of 3 things, genetics, chromosal, or infection of why the baby is small. Recently I had a blood test it was positive for B19 3.0 and CMV IGG 14 and CMV IGM Negative. At this point do you think termination should be an option? P.S. The songram showed a normal baby and nothing wrong with the placenta or umbilical cord or organs. Really Confused and WORRRIED!

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi Veronica,
      Thank you for your post on my CMV blog entry.

      If your baby appears normal on US except for being a little small, then it is important to investigate the cause with further testing, as recommended by your perinatal medicine doctor.

      I do not recommend a pregnancy termination based on the information you provided.

      Please discuss this important issue with your doctors and your family.

      There should be more tests performed on your blood and amniotic fluid. Many babies can be born small and be otherwise OK. Sometimes however there is a fetal condition that needs treatment.

      Regarding the parvo virus serology- was it IgG or IgM? IgG is relatively common to parvo virus, but an acute parvovirus infection can be dangerous, and the IgM antibody will also be positive.

      Regarding your CMV IgG and IgM, the results indicate most likely a past infection with CMV.

      I hope this helps you. Best wishes for a healthy pregnancy and healthy baby.

  109. Julie says:

    In 2004 I was told that I had caught the CMV virsus and would be delivering a unhealthy baby girl. During my pregnancy my husband was away for his job and my mom had to attend appointments with me. I was told at 24 weeks that my daughter stopped growing and I should think about having an abortion! The dr gave me names of OB’s in different states then I live in that would help me out. I WAS IN SHOCK, IVE BEEN FEELING MY DAUGHTER KICK AND MOVE…THERE WAS NO WAY I WAS GOING TO DO THAT!! I never saw that dr again after that visit. At 32 weeks I ended up having my daughter at 2lbs, I ended up having preclampsia and my placenta abruptured. My daughter is almost 9 years old and is a very healthy little girl. She is underweight and alittle bit shorter than her friends but she doenst mind at all. I have had 2 other kids since 2004 and I didnt have any health problems with them at all. I was in shock when I started reading about CMV. I wish dr offices would stress more to pregnant women about this.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Julie-

      Thank you very much for your post on my CMV blog post.

      I am very glad to hear your daughter is doing so very well. Your post tells a very important story.

      It is true that congenital CMV may cause severe problems in the unborn baby and the newborn, and leave many of these infants with severe difficulties. Unfortunately, many doctors and health care workers only are knowledgeable about the severe effects of CMV and are not knowledgeable about the silent and mild symptoms associated with congenital CMV.

      Not all women who catch CMV during pregnancy will even transmit CMV to their unborn baby. Only 40% of the time will the CMV virus even be transmitted across the placenta. Therefore, most women who catch CMV during pregnancy often deliver babies who are healthy and not CMV infected.

      Of those 40% pregnant women who do transmit CMV to their fetus after catching CMV while pregnant, most (85 to 90%) of the babies actually will appear normal or near normal even though they are CMV infected. Even a small fetus, otherwise who is well appearing, may turn out to be a healthy and happy baby. A fetus or unborn baby who is just small from congenital CMV, but otherwise appears healthy, may do just fine and grow up to be a happy healthy child. Some may have minor problems with hearing loss or other problems, but in general, they appear happy and healthy. At birth is the only true time we can see how severe the problems with congenital CMV may be.

      We are spreading CMV Awareness through many different channels and avenues of communication with the medical and public community.

      This CMV blog is just one of them. You can also do your part to spread CMV Awareness. Your blog post has been very helpful!

      Thanks you and take care.

  110. Emma says:

    Hello
    I’m British and live in England. I’m 16 weeks pregnant with twins (non identical, so two placentas) and I’m currently studying at university to retrain as a primary school (elementary) teacher.

    I am a worrier by nature and am really concerned about CMV. I have no contact with young children (other than those I will be teaching, above the age of 4) and am in a monogomous relationship (so no new sexual partners).

    There is a lot of information on the Internet, and I know not all of it is accurate. However, I have read on the British National Health Service website that although close and prolonged contact is needed to catch CMV, it can be caught from coughing and sneezing. This really worries me as a lot of my classmates cough and sneeze a lot, and I never see them going to wash their hands etc.

    I don’t understand why some sources say it is not airborne, but others say it is caught by droplets of saliva from coughing and sneezing. Could you clarify this?

    I tested negative for any antibodies last week, and will ask to be tested every 4-6 weeks until birth (but I worry that my ob gyn will not agree to this on public health care so I am trying to find a private clinic who will do this for me).

    Thank you for this fantastic blog, and I’m sending my prayers and thoughts to all those women who are going through the many worries and fears that come with this horrible virus.

    Emma

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Emma,
      Thank you for your post on my CMV blog.

      I am glad to hear you are CMV aware and wish to take precautions to reduce your risk of catching CMV while you are pregnant.

      Regarding your specific questions about transmission of CMV – CMV requires close contact with body secretions that contain CMV in them from a person actively infected with CMV to be transmitted to another person.- including urine, saliva or nasal secretions, or sexual contact through cervix secretions or semen. Since most CMV infections are “silent”, the person does not know they are shedding or excreting CMV in their body fluids most of the time.

      CMV in these infected body fluids rarely lasts very long outside the body. In fact, once secretions dry thoroughly, or if they land on porous materials – such as fuzzy toys or carpets- the virus “dies” and cannot transmit itself to another person. Body fluids that are still moist, especially if they are on smooth surfaces, or transmitted directly to the person, such as through saliva contact during kissing or sexual contact – may transmit CMV. Also sharing a food utensil or drinking cup or glasses that is still moist from the other person’s saliva, may also transmit CMV to the next person.

      Regarding sneezing and coughing, it if the nasal or salivary secretion lands directly on your mucosa (inside) of your eyes or your mouth, or is still wet on your hand and you immediately touch your eye, nose or mouth, then it is possible you may catch CMV from that person’s cough or sneeze, if they are actively infected at the time of the sneeze or cough. However CMV is not, in the traditional definition, a highly contagious “airborne” virus, such as measles or chickenpox viruses, which are classified as “airborne” transmissible. That is, CMV cannot survive in the air, CMV cannot survive long on most surfaces, and CMV cannot be transmitted through air ducts or on clothing or other surfaces. I would encourage your students to practice the “safe cough and sneeze” procedure: use the crook or elbow area bend of their arm to block the secretions, or use a tissue/handkerchief, and then wash their hands.

      Please also make sure you practice the recommended CMV hygienic precautions when in contact with all children, at home or school or work, or family.

      Testing your CMV antibodies ever 4 weeks is probably not necessary, but testing them ever 8 to 12 weeks may be of benefit in detecting a primary CMV infection during pregnancy. It takes a little bit of time – sometimes up to 12 weeks- from any potential CMV exposure to develop antibodies. However, if monthly testing provides you peace of mind, which is important, and it not too much blood or discomfort for you, then it may be worth the frequent testing in your individual circumstance.

      If you do catch or acquire CMV during your pregnancy, please consult a specialist in maternal fetal medicine and request evaluation of your fetus and explore the possible need for prenatal treatment with hyperimmune globulin in your individual case, to reduce the possible risk of CMV transmission to your fetus. Some clinical studies have shown a benefit, and randomized clinical trials are underway currently. This potentially beneficial treatment will be the focus of my next Texas children’s CMV blog, so please stay tuned.

      Dr Paul Griffiths is an expert in CMV in England and is a potential resource for you, especially should you acquire CMV during your pregnancy.
      His contact information is below:
      Professor P D Griffiths MD DSc FRCPath
      Centre for Virology
      University College London Medical School Rowland Hill Street London NW3 2PF UK
      Telephone: 0207 830 2997
      Fax: 0207 830 2854

      I hope this information is helpful to you. Best wishes for a healthy pregnancy.

      Thank you for your thoughts and prayers on behalf of our CMV patients and their families around the world.

  111. Jincy Thomas says:

    Hello Doctor,
    This is JIncy,
    I have diabetic of type 1 for the past 2 years, with continunous variations in the values, now im pregnant (9 weeks.) I have CMV of value 180. Im already agitated with all the risks of delivery that the doctors had informed , as i have diabetics, Will CMV be another factor of risk? Is there any remedy?
    Thank You Doctor.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Jincy,

      Thank you for your post on my CMV blog.

      Based on your post, I am not able to determine if your CMV results are IgG or IgM antibody. If the value is representing CMV IgG antibody, then most women of child bearing age are CMV IgG positive.

      It is important to know your CMV IgM and CMV avidity index, to determine if you have had a recent CMV infection and possibly any risk to the fetus.

      CMV is common and most often silent without any probklems. Only some of the time does it cause a problem with the mother or the baby.

      I hope this helps. Best wishes for a healthy pregnancy.

  112. Rachel says:

    Dear Dr. Demmer-Harrison,

    My husband had CMV last summer, and since I had never had it (totally negative), I was put on birth control.

    SInce then, although I still tested negative in September, by November, I had caught it.

    My latest blood test (Feb. 5) shows 98.9 IgG, positive IgM (including Method 2), and high avidity. I’m in Israel, and my lab considers avidity to be high at over 30%, and didn’t specify what number I’m at. I noticed you wrote that avidity is usually considered high at 60%.

    If I take another blood test in the future and get a negative IgM (WITHOUT testing with Method 2, since I’d need to go to back to a specialist), and “high avidity”, i.e. some unknown number, but over 30), would you say I could become pregnant?

    Also, I saw you answered a poster that she should have IgM tested 2 times in one month, to be sure she’s reallyy negative. Do you think I should do that too when I finally come out negative?

    Thank you so much for your time and this service,
    Rachel

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Rachel,

      Thank you for your post on my Texas Children’s Hospital CMV blog.

      I am glad to hear you are taking steps to reduce the chance of transmitting CMV to your future pregnancy, by waiting until you have resolved your primary CMV infection before trying to become pregnant. It is difficult to wait, but important to do so.

      CMV avidity tests vary by manufacturer and by country. There are probably at least six or more different types of CMV avidity tests, and they do not always agree with each other also. It is possible some tests may have 30% as a high index, others 45% and most show 60%. Please consult your lab for the proper interpretation.

      If the CMV IgM is negative, the CMV IgG is positive, and the CMV avidity index is high, then the primary infection has resolved and it is safe to try pregnancy. This usually takes at least 4 months, and sometimes 6 to 12 months.

      Since you acquired CMV in November 2012 and it is now February 2013- that is 4 months elapsed so far. Since our CMV IgM antibody is still positive/high, you may wish to retest your blood for presence of CMV IgM antibody in 1 to 2 months to determine when it becomes negative.

      There was one post where the individual had CMV IgM antibody tests that were fluctuating between positive and negative. In that case, I recommended “just to be sure” to perform two CMV IgM tests and make sure they were both negative two times in a row before proceeding with a pregnancy try. If there is any doubt, you also may wish to do the same.

      I hope this information is helpful to you. Best wishes for a healthy pregnancy.

  113. Sandra S. says:

    Hi Dr. Demmler – I am a patient but have a question that might pertain to more than just myself. I wanted to know if my daughter could continue to have progressive hearing loss despite the fact that she is no longer shedding the CMV virus? If this is true can you explain why? Thanks :)

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Sandra,

      Thank you for your post on my Texas Children’s CMV blog. You ask a very good question.

      Infants and children born with congenital CMV infection may shed CMV from their urine and saliva for many years. The range is between 1 and 8 years of probable continuous shedding, based on research at our Houston center and other centers. Shedding of CMV may also be intermittent or “off and on” for the lifetime of the person.

      Hearing loss associated with congenital CMV can be present at birth or occur later in life. It is almost always a progressive form of hearing loss. The progression or worsening of the hearing loss may evolve rapidly over a few months or slowly over a few years. In our long term study, we have seen hearing loss progressions occur through childhood, adolescence, and even into early adulthood in the early to mid 20s.

      There does not appear to be a relationship between the duration of urine and saliva shedding of CMV and the hearing loss progression. That is, in children with congenital CMV, hearing loss will continue worsen long after the urine CMV shedding has stopped.

      While we do know it occurs, we do not know why or how the hearing loss progresses or worsens over time. There are many different “theories” as to why it occurs, including continued virus replication that damages the cochlea and nerve, disruption of the ion transport system that carries the hearing impulses (similar to a battery wearing out), or inflammation from the person’s own body that produces damage to the cochlea and inner ear, and many others.

      It is important for children born with congenital CMV to heave their hearing tested on a regular basis throughout their childhood and adolescence,and even into adulthood.

      I hope this information is helpful.

  114. Christina says:

    Hello Dr. Gail. I found out today that I had a chemical pregnancy. Here is some background info…..I got sick with CMV in December of 2011 which was 2 years ago. I have a 2 1/2 year old daughter. I am wondering if the cmv virus is always in you after u get it….I hope it does not effect any future pregnancies I may have. I would appreciate any helpful information. Thank you.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Christina,

      Thank you for your post on my Texas Children’s Hospital CMV blog.

      CMV is a virus that is a life long infection after it is acquired, but most of the time it does not cause symptoms or problems, because it goes dormant or “asleep” or latent in the body, if the individual is otherwise healthy.

      A primary CMV infection during early pregnancy may be associated in some women with loss of the pregnancy in the first trimester or fetal loss from severe hydrops. If your CMV infection occurred years ago, and a recent pregnancy was lost, then it is unlikely CMV played a role in the pregnancy loss.

      I hope this information is helpful to you.

  115. Tom says:

    Some background…
    • My wife was diagnosed with CMV last fall. She had started not feeling well in early September, and then had a low-grade fever (~101.5) in early/mid-September. It took a while for the doctors to figure out what was wrong, but a blood test from 9/26 showed that she was CMV IgM positive (and IgG negative).
    • She was recovering in early October and by late October was told by her primary that we could resume family planning in 30 days.
    • We conceived around 1/1 (last period on 12/16).
    • A blood test from 1/29 showed that she was positive for both IgG and IgM.
    • An avidity test from 2/8 showed high avidity (.91).

    So knowing that my wife was definitely infected 3-4 months before conception (and knowing that she is still IgM positive as of 1/29), we’re having trouble understanding the level of risk to the baby. We’re also confused about if there is a conclusive test for the baby…if there are no signs of the baby being infected at, say, 18 weeks, how likely is it that the baby might still be/get infected?

    We met with a doctor from maternal fetal medicine, but he seemed a bit dismissive about our concerns. (He also thought it wasn’t worth getting an avidity test.) We have an appointment with an infectious disease specialist this week, but if you have any recommendations for somebody we can talk to in the Boston area, we’d love to hear it.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Tom-

      Thank you for your post on my Texas Children’s CMV blog.

      The risk to your unborn baby is difficult to determine with certainty, so I can understand why there may be confusion, but there is hope that all will be OK.

      There are 3 main categories of maternal CMV infections during pregnancy. They are:

      1) A maternal “proven” CMV primary infection acquired during pregnancy, with CMV IgG seroconversion from negative to positive, carries an estimated 40% risk of transmission to the fetus and if transmission occurs, an estimated 10 to 15% chance of CMV disease in the fetus, with a broad range of outcomes.

      2) A maternal primary CMV infection acquired sometime long before pregnancy, defined as CMV IgG positive CMV IgM negative at time of conception, carries an estimated small risk, < 1% (possibly lower) of recurrent CMV infection in the fetus and even less so for disease in the fetus. This category assumes the CMV infection occurred at least 4 to 6 months prior to conception, likely even longer.

      3) A maternal "presumptive primary" or "near primary"CMV infection acquired around the time of conception, defined as a positive CMV IgG and CMV IgM at the time of conception or near the time, carries an undefined risk to the fetus, that is probably somewhere in between the first two scenarios. CMV transmission and possibly also disease may or may not occur. It is likely this form of CMV infection occurs in the few months prior to conception or soon after conception, but is not proven because previous CMV serologies are not available.

      It appears your wife is most fitting in the third category of maternal "presumptive primary" CMV infection in pregnancy, since she still had CMV IgM antibody positive at time of conception. However, since her CMV avidity index was high near conception, according to your posting, and you knew she had a CMV infection before conception, she may be lower risk category for transmission, but it is difficult to know for sure.

      An amniocentesis performed at 18 to 20 weeks gestation correlates very well with CMV infection in the neonate. That is, if the amniocentesis performed at 18 to 20 weeks is negative for CMV, then congenital infection has not occurred and will, in all likelihood, probably not occur. The mom and fetus should then be followed carefully, and the baby screened for congenital CMV with a test of urine and/or saliva for CMV to confirm no transmission occurred. A repeat amniocetensis for more CMV testing later in pregnancy is not recommended, unless there is another fetal indication to do so.

      If the amniocentesis is positive for CMV at 18 to 20weeks gestation, then CMV transmission to the fetus has occurred and congenital CMV infection has occurred, and the fetus should be monitored closely in utero by a MFM specialist, and fully evaluated at birth, and antiviral treatment considered if CMV disease is present at birth.

      In the Boston area, Dr Ken McIntosh and Dr Gary Fleisher, both pediatric infectious diseases experts at Boston Children's, may be able to provide assistance.
      Dr Ken McIntosh
      Division of Infectious Diseases
      Children's Hospital, Boston
      300 Longwood Ave.
      Boston MA 02115
      (617)919-2900 – FAX: (617)730-0255
      kenneth.mcintosh@childrens.harvard.edu

      Gary R. Fleisher , M.D.
      Chairman
      Department of Medicine
      Children's Hospital-Boston
      300 Longwood Ave.
      Boston MA 02115
      (617)355-5022 – FAX: (617)730-0469
      gary.fleisher@childrens.harvard.edu

      Dr Brenna Anderson, a maternal fetal medicine specialist at Brown University, and head of the Maternal Fetal Medicine Network randomized clinical trial evaluating hyperimmune CMV globulin for reducing or preventing CMV transmission to the fetus in women experiencing a primary CMV infection during pregnancy may also be of assistance to you.
      Brenna L. Anderson, M.D., M.S.C.R.
      Assistant Professor
      The Warren Alpert Medical School of Brown University/Women & Infants' Hospital
      101 Dudley Street
      Division of Maternal Fetal Medicine
      Providence, RI 02905
      Phone: 401-274-1122 ext. 2362; Fax: 401-453-7622 BAnderson@Wihri.org

      I hope this information is helpful to you. Best wishes for a healthy pregnancy.

      I welcome followup if you would be willing to keep in touch. You may use my email listed in this blog for a more personal reply if you wish (cmv@texaschildrensblog.org).

  116. Simona says:

    Hello Dr. Gail!
    First of all, i want to thank You for this wonderful blog. It gives lots of useful information as well as a place for everyone to share their experience.
    I recently had an abortion at 20 weeks because my baby had a severe hydrocephalus. We were told that the reason is unknown and that it was just a bad luck. I was tested for CMV IgM only at 12 weeks of pregnancy and the result was 160 IU/mL. The blood test results weren’t checked by a doctor – I only reported them to the midwives who wrote something at my medical card. When I asked the doctor if he wanted the results he told me to keep them for me and that everything was fine. My baby was fine until my 20-th week ultrasound when they found out that the brain was destroyed, there was only “water” in the skull. I had to make an abortion and we are still waiting for the results from the karyology.
    Is it possible the cause of the hydrocephalus is CMV? Is it dangerous to get pregnant again? When do I have to perform another CMV test?
    Thank You very much!

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Simona,

      Thank you for posting on my Texas Children’s CMV blog. I am so sorry for your loss wit your last pregnancy.

      Congenital in utero CMV infection is one of many causes of severe in utero destruction of the brain of a fetus. An examination for evidence of CMV infection (CMV culture or CMV DNA testing or histopathology under the microscope looking for cytomegalic inclusion cells) of the amniotic fluid or the fetus after termination of the pregnancy may provide you with information about the possible role CMV may have played in the process.

      A positive CMV IgM antibody test is evidence of a recent primary infection with CMV. It may take several months to resolve your CMV infection. Most experts recommend a repeat CMV IgG and IgM and CMV avidity testing ever 1 to 2 months, and wait to try again for another pregnancy when the CMV IgM antibody is negative and the CMV avidity index is high. The CMV IgG antibody will stay postiive for life.

      This usually takes 3 to 6 months, sometimes a little longer for the CMV IgM antibody to become negative. After that, the risk for a serious CMV infection occurring with your next pregnancy is very low to nil.

      I hope this information is helpful. Best wishes for a healthy pregnancy in the future. Take care.

  117. Emma says:

    Thank you so much for your response to my earlier post. In addition to my question regarding transmission through coughing etc, could you let me know whether it can be transmitted by touchig urine of someone who is shedding the virus (if you had cracked skin for example)?

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hello Emma,

      It is highly unlikely CMV will be transmitted from the urine of one person through the open skin of another person. CMV is usually transmitted by:
      – Contact with secretions through mouth, nose, eye or genital mucous membranes
      – Blood product transfusion
      – Organ or marrow transplant

      There are no studies specifically looking at the scenario you describe (urine in contact with hands with a crack in skin), but biologically it is very unlikely. However, touching mouth or nose with hands recently contaminated with CMV may cause transmission, but also in very unusual circumstances. Wearing gloves and good hand washing should prevent transmission from contaminated body secretions on the hands.

      I hope this helpful.

  118. Maria says:

    Dear Dr Gail!
    what a great blog, thank you. I am currently in Australia and are 29 weeks pregnant. My husband has been diagnosed with CMV primary infection with both IgG and M are positive. He has been very sick for 3 weeks but is ok now. I have had a very mild version of what he had for a week or so. As soon I heard what it was we rushed to my maternity hospital for me to be checked. They only tested me for the CMV IgG which was detected. The doctor told me to stop worrying and that they don’t even bother to do IgM if CMV IgG is positive as it shows I am protected and there was no way I was infected while pregnant, I was very happy at first but after reading I realised that is not enough to dicard wether I have had a primary infection or not. Please help! What testing should I be having done considering my husband defintitely had it. I am also very dissapointed on the health system and the lack of information on CMV. I saw my doctor and midwife with the flu-like symptoms, I was at the ED with my husband at the peak of his infection and no one ever mentioned to us CMV. Thank you Gail

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Maria,

      Thank you for your post on my blog post.

      CMV may be transmitted from husband to wife. It is difficult to determine when you acquired your CMV infection- recently or a long time ago.

      Since your husband’s CMV infection is relatively recent – within the last month, and your recent illness is only a week or so ago, then more likely than not, your CMV IgG antibody is from a past CMV infection, like your doctors in Australia surmised. It usually takes 1 to 3 months for person-to-person transmission of CMV to occur within family and close partners. However, without a CMV IgM test, it is difficult to impossible to tell for sure.

      Since your husband’s CMV infection is recent, he may have transmitted CMV to you recently. Perhaps your doctors should consider performing a CMV IgM and CMV IgG avidity index on your blood to try and determine if it was a recent or a long past CMV infection. If the CMV IgM antibody is positive and/or the CMV avidity index is low, then that means CMV transmission and infection occurred relatively recently, and may be relevant to your current pregnancy. If CMV IgM is negative and CMV avidity index is high, then that means your CMV infection occurred at least 3 to 4 months ago, and possibly longer.

      You also should ask your doctors how the management of your pregnancy would change if your CMV IgM antibody were determined to be positive. Would they watch your baby more closely with fetal ultrasounds to assess for affects of possible CMV in utero? Would they consider testing your newborn baby for congenital CMV when he/she is born? If their management of your pregnancy would not change, then perhaps that is why they do not wish to perform the additional testing.

      There are CMV experts in Australia. If you reveal what city you are located, I perhaps can provide you with name of an expert in your country.

      I hope this information is helpful to you.

      • Maria says:

        Thank you Gail. Yes a reference in Melbourne Australia would be great just in case.

        After seeing my GP today and him making some calls he discovered an IgM was done as well which showed to be slightly reactive, plus the positive IgG. They will now test an old sample they have (from the start of my pregnancy) and that should define if I was protected before the last exposure. Fingers crossed it will be good news!

  119. anukriti sharma says:

    I am 28 years old ,its my first pregnancy ,although everything is fine ..in 12 week I have gone through Torch test n its representing CMV IgM 0.2 n CMV IgG 96.79 ,I am scared ….plz help me ,plz reply me Mam !!!

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Anukriti Sharma –
      Thank you for your post on my Texas Children’s CMV blog, and congratulations on your pregnancy!

      The CMV IgG antibody level of 96.79 most likely represents a positive reaction to CMV antibody and the CMV IgM level of 0.2 most likely represents a negative reaction to CMV antibody. It is “normal” to have CMV IgG antibody, since most people at some time in their life will catch CMV and keep the CMV IgG antibody for life without any problems.

      These results indicate a past infection and “immunity” to CMV and very little risk, if any, to your unborn baby.

      I hope this information is helpful to you. Best wishes for a healthy pregnancy.

  120. katherine says:

    Dear Dr. Gail,
    I apparently was IgG (and IgM) negative for CMV at 11 weeks. At 17 weeks, my IgG was positive, and my IgM negative. Amnio PCR revealed no CMV in the amniotic fluid. The fetus looks ok, except for some slightly bright bowel. What is the likelihood that my fetus has been affected, given these blood and amniotic fluid labs? Thank you.
    Katherine

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Katherine,

      Thank you for your post on my Texas Children’s CMV blog post.

      The likelihood that your fetus is CMV infected is probably low, but may not be zero. Some things in your evaluations are confusing, so it is difficult to be sure.

      It is highly unusual to have a recent CMV seroconversion, within 6 weeks, and not have a CMV IgM response that is still measurable. So I wonder about the CMV testing results. Perhaps you should have them repeated to make sure they are accurate and that a true CMV seroconversion and primary infection has occurred. It is possible one of the tests was not accurate.

      Even after a primary CMV seroconversion during pregnancy, only about 40% of the time will CMV be transmitted to the fetus. And even then, most CMV congenital infections produce no or mild symptoms at birth in the baby, and only 10% of babies will have symptoms and sequelae at birth.

      Echogenic or “bright” bowel on fetal ultrasound can be associated with congenital CMV and may be an early sign in utero, but it is also associated with many other things, and may resolve, so it is not specific for only congenital CMV.

      A negative amniocentesis is reassuring that your fetus is not CMV infected, but mauy not be conclusive. If it was done at 20 weeks gestation, and more than 2 weeks after seroconversion is documented, then it correlates very well with CMV outcome in the newborn. If it is done at 17 to 18 weeks gestation, it correlates well, but may miss a few if the amniocentesis was done too soon after the CMV infection in the mother, and the CMV transmission to the fetus may have occurred later.

      I recommend you consult a perinatologist or maternal fetal medicine specialist for guidance in how to proceed and follow your baby carefully throughout the pregnancy and test your baby for CMV at birth.

      I hope this information is helpful.

  121. Sam says:

    Dear Dr. Gail,

    My wife and I are trying to make a baby. My wife underwent a CMV IgM test for the first time last month and the result was positive. She has not taken IgG yet.
    Shall we wait some months or is it proper for my wife to continue to try to conceive?

    Many thanks,
    Sam

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Sam,

      Thank you for your post on my Texas Children’s CMV blog.

      It may be best to stop trying to conceive for now, until you sort out your wife’s CMV antibody status. I also recommend both a CMV IgG and a CMV IgM antibody test be done, and also a CMV avidity test.

      Or if these tests are not available, to wait 3 to 6 months before trying to conceive, and give time for the primary infection to resolve.

      CMV IgM may be positive for the following reasons – A primary CMV infection is occurring now or has occurred in the recent past – the CMV IgG antibody will also be positive if this is the case; the CMV avidity test will tell you how far ago the primary CMV infection occurred and is helpful in determining when it is safe to try and become pregnant. The CMV IgG should be positive and the CMV IgM should be negative and the CMV avidity test should be high for the best outcome.

      A false positive CMV IgM antibody test- this occurs if the CMV IgG antibody stays negative and often the CMV IgM antibody is a very low level positive or equivocal positive and not a high positive range. It is caused by many different reasons, including the test it self or the presence of interfering factors in your wife’s blood at the time the test was performed.

      Best wishes for a healthy pregnancy when it does occur! I hope this information is helpful.

  122. Catherine says:

    Dear Dr Gail
    I am 12 weeks pregnant and just found out that one of my patients was CMV positive 3 years ago. She continues to see her doctor who specialize CMV now that she is almost 4. I don’t have much information regarding if she is still active or not but I will contact her doctor. Also my doctor order the IgG test for me and I will take it today. I had been working with children for 10 years and I don’t know if I am positive or not. I am really concern about this because I work with children with special needs and I know what this infection can cause. I am glad I found your blog and I will let you know about my test results. For now, do you think I should be concern about my baby because of this child that I am working with? Thank you so much for your wonderful blog

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Catherine,

      Thank you for your post on my Texas Children’s CMV blog post and for your wonderful comments.

      Transmission of CMV in the health care settings has not been documented convincingly. The universal precautions we practice in health care settings – good hand washing, personal protective equipment, and avoidance of contact with the patient’s body secretions- all reduce or prevent transmission of many infections, including CMV.

      CMV has however been documented to be transmitted in the family and in day care settings, where close and personal contact with children and their secretions may occur.

      CMV is a common virus, so most children, with and without special needs, may be shedding CMV actively at any time in their saliva or urine, and be potential transmitters of the virus to pregnant women.

      It is therefore important to practice hygienic precautions I mention in my BLOG and that are also available at http://www.cdc.gov/cmv in the home and community, if your are pregnant, and continue, as always, practice universal precautions while taking care of ALL patients in the health care setting, not just the ones you know have had CMV.

      I hope this information is helpful. Best wishes for a healthy pregnancy!

  123. Jaclyn says:

    Hi again Dr Demmler,

    To remind you, my labs are as follows:

    son born with severe symptomatic CMV in June 2012

    my IgM:
    July – 2.05 (Igg 5)
    October – negative
    January – 1.92 (Igg 26)
    March – .3

    CMV Avidity test is 94%

    I think I am now good to try for another pregnancy, correct?

    Thanks again for all of your help. Your involvement is beyond appreciated for those of us going through such a difficult time.
    Jaclyn

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Jaclyn,

      Thank you for your posts my blog and for sharing your experiences.

      A CMV IgM antibody level in the negative range indicates from the CMV perspective it is now fine to start planning your next pregnancy. Please of course consult with your local doctors to make sure everything is fine in other areas of your health before trying again.

      Best wishes for a healthy pregnancy!

  124. Brown says:

    Hi Dr Gail

    I was 21weeks when I want to the doctor and found out that the was no heart beat , Everything was going fine but 2 weeks prior I had a minor fever that lasted for 2 days and was gone as if it was never there,I had the sore throats,headaches and a dizzy spell only once. blood tests where taken and CMV was present with the IGG(+ve) and the IGM(-ve) ,and my white blood cells were skyrocket around 78% and my red blood cells were dropped . My doctor adviced that I can try again after my 1st menstraul cycle to get pregnant , Please advice on what you think.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hello,

      Thank you for your post on my CMV blog. I am so sorry for your pregnancy loss.

      Based on the CMV serology tests you provided – CMV IgG positive and CMV IgM negative, it is highly unlikely that CMV played a role in the recent loss of your pregnancy and the death of your fetus.

      From the CMV perspective, if your CMV IgM test is negative, it is safe to start trying again for another pregnancy, if your obstetrician also feels it is OK from all other standpoints.

      Best wishes for a healthy pregnancy.

  125. Kasia says:

    Dr. Gail,
    My dad is immunocomprimised with CVID and has been treated the past year for CMV. His original count was greater than 176,000. Today his most recent draw a few weeks ago was around 300. I just found out I am pregnant and was wondering if it is safe for me to be around him? He comes over occasionally to babysit for my 10 month old daughter with my mom. Could he continue to do so if I have good hand hygiene? Or should I try to spend minimal time with him the next 35 weeks? Thank you !

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Kasia,

      Thank you for your post on my Texas Children’s CMV blog Congratulations on your pregnancy and for becoming “CMV Aware”.

      You may be around your dad during your pregnancy even though he is CMV infected. It is possible he will intermittently shed or excrete CMV in his body fluids, including his saliva. Therefore, I would avoid kissing him or sharing food or drink after him while you are pregnant. But being in the same room, same house, etc. is just fine. Also giving hugs is OK too.

      I also would like to provide a word of advice about your 10-month-old daughter, and any other toddler age children you may be in contact with during your pregnancy. Young toddlers in a household are a very common source of CMV for women who are pregnant. Therefore, please review the CMV Precautions on my blog, as well as other websites and recommendations, regarding hygienic precautions to reduce CMV transmission risk in the household from young toddlers.

      I hope this information is useful to you. Best wishes for a healthy pregnancy.

  126. Stacie says:

    I contacted Cmv when i was pregnant and my daughter has severe disabilities. She doesn’t walk, talk, or even sit up by herself. I’m thinking of having another baby but wasn’t sure what would happen if i did get pregnant again. Would the baby be exposed to cmv or will it be ok? Thank you.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Stacie,

      Thank you for your post on my CMV blog.

      If your first baby was born with congenital CMV disease, you are now immune to CMV and your risk for your second pregnancy has very little, if any, risk for having another baby with problems associated with congenital CMV. You will transfer this immunity also to your next unborn baby. There are some unusual reports, but most of the time, women do not ever have another baby with congenital CMV disease and problems form congenital CMV.

      I hope this information is helpful. Best wishes for a healthy pregnancy!

  127. Amy says:

    Hi Dr. Gail,

    I heard about cmv for the first time with my last pregnancy, which ended in miscarriage at 10 weeks in December 2012. Here is the breakdown of my labs:
    11/6/2012. Igg 0.15, igm 2.9
    11/14/2012 igg 0.17, igm 3.3
    12/6/2012 igg 0.04, igm 1.9 – they did an avidity test too and avidity could not be measured due to negative igg
    2/4/2013 – avidity still could not be measured due to negative igg. They did not do an antibody draw so I do not know the igm

    I was told these results mean false positive. Is this true or could it be taking me longer than usual to seroconvert?

    I just found out I am pregnant again, only 4 weeks. If I really am negative do you think just following the hygienic precautions is really enough to keep me from getting it from my toddler who attends full time group daycare? I wear gloves when changing him, I don’t share food or kiss his face, I wash my hands 150 times a day, yet I feel like I am still in close contact with his saliva. He’s only 2 and he drools like crazy and spits when he talks (often directly in my face, mouth, eye….) which i guess most 2 year olds do. I just feel like, as a mother, it is nearly impossible to put the amount of distance needed between you and your baby to prevent infection. Because of daycare he is also sick quite often (colds and things like that) and no matter how much I wash my hands, I still catch every cold he gets. My husband and I both do. I’m very worried because how is cmv going to be any different?

    Also, if it turns out that I really did have a primary infection and still haven’t built up igg antibodies, are the risks the same to my unborn baby as if this were a primary infection in the first trimester, if my body is still fighting this initial infection from 5 months ago?

    Thank you so much for any advice. I really am worried and my regular obgyn seems to make light of it. In fact, I had to get all my previous blood work through my primary care physician because my ob practice would not do the tests. They feel they are unnecessary because they say there is nothing you can do about it if you are positive (Which I knows that there is, I was in touch with Dr Adler before and I am aware of cytogam). It’s unfortunate that more doctors don’t take this seriously.

    Thank you,
    Amy

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Amy,

      Thank you for your post on my Texas Children’s Hospital CMV blog.

      A persistently positive CMV IgM antibody with a persistently negative CMV IgG atnibody usually indicates a false positive CMV IgM reaction. Causes for this may be a variety of things.

      It is not likely to represent a true CMV primary infection and CMV seroconversion at this time.

      However, it would be prudent to repeat your CMV IgG and IgM serologies at the end of your first trimester and at delivery to make sure.

      A CMV IgG avidity index is most helpful when both CMV IgG and CMV IgM are positive, and is helpful in determining whether or not the CMV infection was recent or past.

      I recommend you observe CMV precautions during the remainder of your pregnancy since it is likely you are still CMV seronegative.

      Best wishes for a healthy pregnancy.

  128. Cathy says:

    My son and daughter in law are wanting to start a family. My ex-husband has a step child that was infected with CMV and has serious complications as a result. I understand all the preventative measures a pregnant woman should take when being around any young child and will tell my daughter in law about this. However, I am wanting to know if being around this 13 or 14 year old child infected with CMV at birth will have more potential risk of infection for my daughter in law? Thank you!

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Cathy,

      Thank you for your post on my Texas Children’s CMV blog.

      It is unlikely a teenager with a congenital CMV infection will represent a serious risk for transmission of CMV to a pregnant woman since the likelihood of a teenager shedding CMV in large amounts is low and the likelihood of contact with CMV infected saliva through kissing or sharing food or drink is also low.

      Most children congenitally infected with CMV will stop shedding CMV continuously by age 3 to 5 years of age, and the longest continuous CMV shedding we have observed is 8 years. It is possible recurrent CMV shedding may occur, but it is sporadic and unlikely.

      Nonetheless, it would be prudent for your daughter-in-law practice CMV precautions if she is around the young teen with congenital CMV.

      I hope this information is helpful.

      • Cathy says:

        Thank you so much for your answer to my questions! I will let my daughter in law know what I have found out!!

        • Cathy says:

          Dr. – I have one more question. My ex-husband has a six year old daughter with his wife (the mother of the girl with congenital CMV) – since she has been around her half sister will she be a carrier of the infection? I noted you had said the shedding is most predominant until around 8 years of age – so wanted to make sure. Thank you, Cathy

          • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

            Hello Cathy,

            It is possible, and probably likely, the 6 year old sister will have already caught CMV from her older sister if they live in the same household. Most children will acquire CMV at some point in their life, so it is not abnormal to have caught CMV, and most children with acquired CMV infections do not shed CMV as long or in such high concentration as a child born with congenital CMV. The 6 year old sister is more likely to be “immune” now to CMV and not really an active shedder of the virus or able to transmit CMV to anyone at this time.

            I hope this information is helpful.

  129. Rachel says:

    Dear Doctor,

    About 2 months ago, I asked my sister to tes5 herself for CMV because I am currently infected and was worried that she’d catch it from me, as she had never had CMV. At that point she tested negative (<12).

    She is now about 9 weeks pregnant and got her bloodtest resuts back from her testing last Thursday. She is now in the BORDERLINE range (12-14), with her actual number being 12.

    What does "borderline" mean?
    Does it mean nothing?
    Does it mean she should keep testing herself?
    Or does it mean that she is going to be infected? (I hope not!!!! I really hope that it doesn't mean she caught it from me!! I only saw her about once/twice after she was tested, as I was away the past 6 weeks.) If so, would the treatment help, and is it offerred here in Israel?

    I am very anxiously awaiting your response.

    Thank you so much,
    Rachel

  130. Rachel says:

    Dear Doctor,
    In case it wasn’t clear, her IGG and IGM levels were negative about 2 months ago.

    One more thing: Should my stister have her avidity levels checked?

    thank you,
    Rachel

    (PS I’m asking the quest5ions for her because she doesn’t have internet access.)

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hello Rachel,

      Thank you for your post on my Texas Children’s Hospital CMV blog.

      A “borderline” result from CMV IgG when the CMV IgM is negative most likely represents a cross reaction or a nonspecific reaction and not a true CMV IgG antibody response. Sometimes also different labs do tests differently and may get slightly different results, so make sure they are performed in the same laboratory to avoid this confusion.

      It is not likely to represent a primary CMV infection at this time.

      To determine for sure, I suggest your sister have her CMV IgG and IgM antibody tested again in 4 weeks. If both CMV IgG and CMV IgM antibody are positive at that time, then a primary seroconversion has likely occurred. If both remain negative, or the CMV IgG remains same “high negative” or “equivocal” with a CMV IgM negative, then it is most likely a cross reaction or false reaction.

      A CMV avidity index is not really necessary in her case at this time, since we already know she was CMV seronegative in February. A CMV avidity test is most helpful in individuals who are both CMV IgG and CMV IgM positive at the first time when they are first evaluated, and it helps clinicians try and determine the timing of their CMV infection.

      Also, in addition, your sister, should be aware how CMV is transmitted and practice CMV precautions outlined on my blog and the CDC website, since she is CMV seronegative and pregnant.

      Best wishes for a healthy pregnancy for your sister. Take care.

      • Amanda says:

        Dear Doctor,
        I happen to find this post while searching for borderline cmv results.
        3 years ago I tested negative to cmv.
        About 2 months ago cmv test results were: IGM negative, IGG borderline (9).
        I repeated the test after 7 weeks, and it came back: IGM negative, IGG borderline (8).
        Would you consider it – cross reaction or a nonspecific reaction and not a true CMV IGG antibody response? (would that necessarily mean that I was infected with other virus?)
        Since the previous test was 3 years ago, could I have been infected some time during those 3 years (where all antibody action was taking place while I was unaware), and now IGG is showing past infection/immunity?
        Should I take additional test that would confirm/deny the IGG findings, so I would know for certain whether I harbor the virus?
        (I know that in either case my baby is unlikely to catch the disease, but just want to know whether I harbor the virus).

        Thank you,
        Amanda

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          Dear Amanda,

          Thank you for your post on my TCH CMV BLOG. The CMV serologies you describe most likely indicate a cross reactive antibody that is not “real” CMV antibody [other virus, immunizations, etc. may contribute] or a false positive reading on the CMV serology test for some other reason. The lack of CMV IgM antibody and the same indeterminate results makes a recent CMV primary infection very unlikely at this time. More likely than not the CMV serology results described are probably a state of being CMV seronegative. But it is difficult to tell for certain.
          Steps you may wish to take to try and determine for sure if you indeed have or do not have CMV antibody and immunity include
          1) repeat the same CMV serology tests in the same lab in 3 months; by doing so you should have been able to resolve any cross reacting illness or effects of recent vaccination, etc. by then
          2) send blood sample to a different laboratory which uses a different methodology for CMV antibody testing and see if you get a similar result or a clean CMV IgG negative result.
          3) do both 1 and 2 steps if you wish.

          I hope this information is helpful to you.
          Best wishes.
          Gail J Demmler Harrison MD
          CMVDOC

  131. Amy says:

    To Rachel, who posted above me:

    I didn’t want to post this as a reply because I still want Dr Gail to answer your questions, but I was wondering if you could tell me your symptoms, since you said you have cmv? I have been very sick for several months with muscles aches in my arms and legs (like how you feel when you have a fever) and last month I broke out in a viral rash, also just on my arms and legs that looked like tiny red dots under the skin. It lasted a week and then went away. I tested a few months ago for positive igm for cmv but I never developed igg so I was told it was false positive. Now that I am pregnant again, I’m terrified that those symptoms are in fact a current cmv virus. Did you have any similar symptoms?

    Also, regarding your question on the avidity test, I was always told that it is very important to get the avidity test to determine if the infection was recent. However, the avidity cannot be measured unless the igg is positive, so maybe your sister could ask her doctor to rerun the antibody tests and do an avidity test as well? That’s what I was told to do when I started testing igm positive the first time around.

    I wish your sister the best of luck!
    Amy

  132. Amy says:

    To Rachel, who posted above me:

    I didn’t want to post this as a reply because I still want Dr Gail to answer your questions, but I was wondering if you could tell me your symptoms, since you said you have cmv? I have been very sick for several months with muscles aches in my arms and legs (like how you feel when you have a fever) and last month I broke out in a viral rash, also just on my arms and legs that looked like tiny red dots under the skin. It lasted a week and then went away. I tested a few months ago for positive igm for cmv but I never developed igg so I was told it was false positive. Now that I am pregnant again, I’m terrified that those symptoms are in fact a current cmv virus. Did you have any similar symptoms?

    Also, regarding your question on the avidity test, I was always told that it is very important to get the avidity test to determine if the infection was recent. However, the avidity cannot be measured unless the igg is positive, so maybe your sister could ask her doctor to rerun the antibody tests and do an avidity test as well? That’s what I was told to do when I started testing igm positive the first time around.

    I wish your sister the best of luck!
    Amy

  133. Kristin says:

    My husband and I are contemplating having another child. My 14 month old was diagnosed with congenital CMV; however, testing was completed after he was 2 months old so the doctors can not be 100% that it truly is congenital. My son has microcephaly and agenesis of the corpus callosum, and everything else had been fine: hearing perfect, eyes are fine, no calcifications have been seen on an ultrasound, MRI or XRay. We want to rule out that the callosum agenesis may have a genetic factor prior to conceiving. We recently had an appointment with a geneticist and he is attributing the microcephaly and agenesis of the corpus callosum to CMV too, but he wants to test one of the spots from my son’s heel stick card that was done at birth. Currently, the doctor is waiting for a reply from a lab in Milwaukee. I am wondering if you know of any labs that perform such testing? Thank you so much for sharing your expertise.

  134. Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

    Dear Kristin,

    Thank you for your post on my Texas Children’s Hospital CMV blog.

    Many states now allow parents to retrieve their child’s newborn dried blood spot for specific testing, such as CMV DNA PCR testing to diagnose congenital CMV infection. The samples may be sent to a lab for testing. If the DNA in the blood spot is still in good condition and not degraded, then CMV DNA PCR testing can be done for congenital CMV. After a few months to years, the DNA may degrade. Some state laboratories may not safe save the DBS past 1 to 2 years after birth.

    You may wish to consult a pediatric infectious diseases expert in your area to see if they know of a local laboratory for CMV DNA PCR testing of DBS samples. You may also wish to contact your state laboratory, the Centers for Disease Control, or the University of Alabama in Birmingham for testing.

    I hope this information is helpful.

  135. Lynn Maloney says:

    Hello Dr. Gail,
    Your blog continues to be a wealth of information for people dealing with CMV. You were so helpful to me back in January, and now I am back with a follow up question. We lost our last pregnancy at 22 weeks due to CMV. My latest tests showed Igg at 2.0 and my Igm at 3.0, down from 3.7 igm in March. Due to my levels dropping so slowly, (‘diagnosed’ in November 2012)and my desire to try to become pregnant again, my PCP did a CMV DNA Quantitative real time PCR test. It came back <200, which he told me is negative, and that is a much better test at letting us know if I have live virus still in me that could be passed along. Im unsure of what to believe given everything Ive learned here, and read on the internet. We are waiting to get into the ID specialist for a consult, but our appointment is not until July. Any insight as to whether we should disregard the IGG/IGM in favor of the DNA test? Thank you Dr Gail!!
    Lynn

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Lynn,

      Thank you for your post on my Texas Children’s CMV blog post. You ask a very good question and to which at this time there are no good clinical trials or other data to provide a definitive or certain answer. Every woman is unique and there are known variability of how each woman will resolve her primary CMV infection. Some women resolve their infectino quickly, most women usually take at least 3 to 4 months, and for some women up to a year.

      It is true that a negative or < 200 units/mL (which I think is what you posted but I amnot sure) refelcts a low to zero level of CMV DNA in the plasma or blood and therefore represents a low chance of active viremia- virus in the blood. However, the virus may still be active in other parts of the body or active in a low level.

      There are limited to nil data on the predictive value of a maternal plasma or blood CMV quant DNA test on transmission to the placent and fetus in a subsequent pregnancy. A negative CMV DNA quant test on the plasma suggests the active CMV viremia is resolved, however many adults who are otherwise healthy yet still resolving their primary infection will have negative plasma or blood CMV quant DNA tests.It is the first to rise and the first to fall, but it may not be the best to predict transmission to the fetus. There are limited information to date. The best data we have suggests maternal CMV IgM negative is the best circumstance to be in to have the lowest risk of transmission from a near CMV primary infection. In general, we recommend waiting until CMV IgM is negative or one year if the CMV IgM level continues to persist at a low level. This is albeit the most conservative approach. You should make the decision based also in consultation with your own doctors who know you best, to determine what is the best decision to time your next pregnancy, since there are many factors likely to be involved in the decision making process.

      I hope this information is helpful. Best wishes for a healthy pregnancy.

  136. Lynn Maloney says:

    Thank you Dr Gail, for your informative and detailed response. I know you are an expert in the field, and take your opinions very seriously. I think the trouble is, as you said, there is limited data in so many areas of CMV. We know SO much, but yet, so little. I am confused and frustrated. I HOPE that the ID specialist in my area will be able to guide us, but again, its just based on numbers, past studies, and a conservative approach. I never want to be in the position that I was in December, being pregnant at 22 weeks with tough decisions to make, but I am anxious to proceed and want to believe that this just cant happen to us twice. Im sure many many families feel that way, and judging from your blog, its pretty plain to see. My Igm is just dropping so slowly that Im grasping at straws now. I knew youd answer me in the best most honest way you could. I dont want false hope, I just wanted an answer, and I appreciate your honest response. Thank you again Gail. Keep passing along all the knowledge you have…and same to everyone reading this!!!!
    Lynn

  137. Angela says:

    Hi Dr. Gail,

    I would like to ask you some questions regarding my pregency.

    Now, I am 31 and 1/2 month pregrency. In March, I did a blood test. The CMV, IgG was positive, 6.5Iu/ml and IgM was negative.

    1)Will the CMV in my body be reactivated again anytime with out any symptoms?

    2)When should I check the IgG and IgM again?

    3)Should I do breastfeeding? If I do, should I test for CMV first?

    4)Does the BB need to do blood test after born?

    5)Will my IgG be transfered to my BB?

    thanks so much. Pls answer my questions.

    Angela

    • Angela says:

      Hi Dr. Gail,

      There were typos in the previous post

      Now, I am 6 and 1/2 months pregnancy. In March, my test result for CMV : IgG was positive, 6.5 Iu/ml(normal should be < 0.6 Iu/ml) and IgM was negative.

      thanks so much
      Angela.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Angela,

      Thank you for your post on my CMV blog.

      1. Yes an infection with CMV is a lifelong condition, but the virus co exists with us in a latent state for most of our lives. While it is possible it may reactivate, including during pregnancy, most of the time it does not and stays latent or “asleep”. CMV infection is common and most people will be infected with the virus and most people, including pregnant women, do not have any problems from their CMV infection. It may cause problems with the baby if the mother acquires it for the first time during pregnancy.

      2. If your CMV Ig M is negative now, then I do not recommend you re test your CMV antibody tests. Recurrent infections in pregnancy are unusual and occur < 1% of the time. Even if CMV Ig M antibody increases slightly during pregnancy from a recurrent CMV infection, most of the babies are normal and do just fine in these cases of recurrent CMV infection.

      3. Yes you should breast feed your baby if your baby is term and health otherwise, and I do not recommend retesting your CMV antibody. Many women who are CMV antibody positive IgG will reactive their own CMV and transmit CMV to their baby, at the same time they also transmit their serum CMV antibody (immunity to CMV) to their baby. This is a very natural and preferred way of becoming immune to CMV at a young age.

      4. Your baby does not need to have a blood test for CMV at birth. Your CMV antibody IgG will be passed to yoru baby and the result will be positive. You may wish to test your baby for congenital CMV with a urine test for CMV. There is a slight ( approximately 1%) chance your baby may have congenital CMV, and most likely it would be a silent infection.

      5. Yes your CMV IgG antibody will be transferred to your baby and provide protection against CMV infection for a while. It is normal and common to have CMV infection and most of the time it does not cause problems. The risky time is if a pregnant woman catches CMV for the first time during pregnancy.

      I hope this information is helpful to you. Best wishes for a healthy pregnancy.

      • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

        The risk of transmitting CMV to a baby born after a second or any subsequent pregnancies, after having a baby with congenital CMV disease, is very slim.

  138. Bernadette says:

    Hello I’m currently 26 weeks pregnant with my second child at my 20 week ultra sound they found that my baby had a ecogentic bowl and wanted me to get a annimeosentis my husband and I decide we didn’t want to take the risk of losing our baby girl so we decide to get blood work done instead and went back in two weeks for another ultra sound I think it was a level 2 hope to hear good news!! But instead we were overwhelmed with more bad news they found that our baby has a little extra fluid around her brain and it worried them because, of the ecogentic bowl & now the fluid around the brain so she offered us an annimeosentis once again and gave me and my husband time to think it over we decided to move forward with the procedure. A week later I got the worst news of my life our little princess tested positive for CMV and now allready two doctors have told me its best if I termite the pregnacy. I’m so confused and lost at the same time I need advise. I want to do what’s best I don’t want my daughter to suffer . How Limey and Ito get pregnant and invective another baby in pregnacy

    • Bernadette says:

      How likely am I to conceive & pass on cmv to another baby

      • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

        Hi Bernadette,

        Thank you for your post on my Texas Children’s CMV blog.

        The newborn and long term outcome of babies born with congenital CMV infection is quite variable and ranges from severe disabiltiies to normal intelligence with no disabilities.
        It is difficult to predict the outcome from a fetal ultrasound alone and I am not able to tell you for sure your baby’s outcome based on what you have posted. Is her head size normal and is her brain growing? What is meant by a little extra fluid around the brain? Some babies with congenital CMV may have slightly enlarged ventricles, which often do not mean disabilities will occur. However, if your baby has severe microcephaly, many calcicficaitons, abnormal brain formation like polymicrogyria, and very enlarged brain fluid sacks (ventricles) or brain atrophy, then she is at risk for disabilities.

        Echogenic bowel by itself is an early sign of many things, including congenital CMV. This finding usually resolves on its own, or rarely, means a bowel problem that can be treated after birth.

        There are in utero pre natal treatments available with hyperimmune CMV globulin that may be given to the pregnant women as an intravenous infusion to try and help the unborn baby manage the CMV infection. There are research trials evaluating its effectiveness. Some women and their doctors decide to try the treatment in the hopes it may help. Perhaps you can try and see if this is an option for you. Where are you located? Can you try and obtain these treatments?

        The decision to terminate a pregnancy is of course a difficult decision and one that should not be taken lightly and should be made by the mother, her family, her faith, and with consultation with knowledgeable experts who can fully discuss the facts as they are known to us. Termination at 26 + weeks gestation is not an option for most women and their babies, because the baby is at the viability age now.

        Sometimes physicians do not totally understand congenital CMV and its outcomes and assume all babies with congenital CMV will be severely disabled and recommend termination and not just take any chances, while others understand the variable outcomes. Not all babies with congenital CMV infection in the womb will have severe disabilities. Some do, of course, but definitely not all of them, and most actually will ahve normal outcomes if their brains are not affected.

        Perhaps you could get a second opinion or provide me with more information on her brain growth?

        If you have a baby with congenital CMV infection, the next pregnancy is almsot always “protected” because you will be “immune” to CMV and transmit that protection to your next baby. It is usually recommended to wait 6 to 12 months after the first pregnancy, and to have a negative CMV IgM antibody, before trying again to become pregnant.

        I hope this information is helpful. Best wishes to you. You will be in my thoughts and prayers.

        • Bernadette says:

          Well her ventricles were measuring 9 at 24weeks and now at 26weeks and 2days the doctors are saying that they are seeing inflammation? I’m so confused but they are telling me things arent looking so well. And they are trying to get me a MRI. Is this really harmful to the baby & a higher chance of being mental retarted ?

          • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

            Hi Bernadette,

            Thank you for your post.

            Abnormal ventricles with enlargement and inflammation may mean your baby’s brain may be involved with CMV, but it is difficult for me to tell you how severe the involvement may be at this time. How is the brain size overall doing? Small or normal size? Is there calcium deposits or no calcium deposits around the ventricles?

            Neurological outcomes are variable and very difficult to predict just from fetal ultrasounds.
            Have your doctors considered administering hyperimmune CMV globulin to you?
            Fetal MRI imaging studies are frequently performed without any problems and may be helpful to your doctors in determining the effects on your baby.

            I hope this information is helpful to you.

  139. Dawn says:

    Hi,

    I recently had my 18 week ultrasound and the doctor saw a n echogenic bowel. I have had the standard tests and found out today that I have tested positive IGg for CMV with an indeterminate result for Igm. I have had this test twice within 2weeks with the same results. They did however, test my urine the second time and it came back positive for CMV.

    I’m wondering if these results mean that this is a recurrent infection or my first. I did have a mono-like illness many years ago. I have a 3yr old and a 1year old who stay at home with me. I was an elementary school teacher for 11 years before I had my first 2 children.

    I am currently 21 weeks pregnant. Can you please give me some insight on what the blood/ urine test results could mean? I’m frustrated because my doctor didn’t really even seem to know. I am getting the bowel checked again in a couple of weeks.

    Thank you so much. This has been the most informative CMV site I have found so far.

    Dawn

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi Dawn,

      Thank you for your post on my Texas Children’s CMV blog. I am pleased you have found the information helpful. There are so many misunderstandings about CMV in pregnant women and their babies. I am glad to provide some clarity and help. Our blog reaches women with questions about CMV from around the world.

      It is difficult to determine if your CMV infection is a resolving primary CMV infection or a recurrent CMV infection based on the blood and urine results you have given. CMV IgG antibody is common, and most women of childbearing age, about 50 to 80%, will have CMV IgG antibody. The presence of indeterminate CMV IgM antibody is difficult to interpret, but in the context of a positive CMV urine test result it appears you have an active CMV infection, that may be a recurrent infection or a resolving primary infection. Your CMV Ig M results also may mean a cross reaction antibody and not mean much at all. It is somewhat reassuring that your CMV IgM level did not rise in that regard. Most of the time a maternal CMV infection, especially if it is recurrent ( < 1% time) does not reach the fetus. After a primary maternal infection, it reaches the fetus about 40% of the time.

      The important consideration therefore is your baby. The only way to determine if your baby has congenital CMV contacted in utero is to perform an amniocentesis and test the amniotic fluid for presence of CMV by CMV culture and CMV DNA PCR. You may or may not wish to have this test done, depending on how symptomatic your baby is and what options are available for treatment.

      Congenital CMV infection may be asymptomatic or silent, mildly symptomatic and in some cases, temperately or severely symptomatic, and the most involved cases have also brain involvement.

      Isolated echogenic bowel is not likely to cause severe CMV disease in your baby. Echogenic bowel is a common finding and can be an early sign of congenital CMV but also of other things. It often resolves by itself.

      Your baby should have also been evaluated for other abnormalities by fetal ECHO.

      If there are no other abnormalities found ( that is your baby is normal size, the brain is normal size and structure, there are no enlarged organs and no hydrops, etc.) then it is likely all will be fine in the end. If one or more of these findings are present, then your baby should be evaluated further by amniocentesis, with consultation of a maternal fetal medicine specialist.

      I hope this information is helpful. Best wishes for a healthy pregnancy!

    • Melinda says:

      Hi Dawn,
      Your situation sounds very similar to mine. We’re both doing the waiting game with indeterminate IgM antibodies–and we both have babies with echogenic bowels in the ultrasound. I really wish you luck during this stressful time–I’m right there with you.

      If you need someone to talk to who is going through the same thing at the same time, feel free to email me at englgrrl@gmail.com

      ~Melinda

  140. Dawn says:

    Thank you so much for your information. This is truly a stressful time. Apparently I have a saved blood sample from my first prenatal blood work, I believe was done either at week 7 or 11 of my pregnancy. They are going to evaluate this blood sample to my indeterminate samples. Are you able to explain what they can determine from this? They did suspect that I had a bladder infection but couldn’t determine from my urine at that time (tested twice)… Could it have been CMV showing up back then and would I still be shedding it now?

    Depending on the results they have mentioned an IV infusion. Is this a safe procedure if it is unknown whether the baby has been affected? I’m hesitant to do an amino because of the risks.

    At my 18 week anatomy scan, all findings were normal. Brain, heart and size of baby were great as well as placenta. The only abnormality that was found was the echogenic bowel. Is there a possibility of new abnormalities developing three weeks later? I’m going back for another ultrasound on Tuesday?

    This is such a scary experience. I’ve had 2 previous pregnancies and have never heard of this virus! Should I be concerned being around other pregnant women as a result of my positive urine test?

    Thank you again for all of your insight.

    Dawn

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Dawn,

      The older blood sample may or may not be helpful. They may find the same results, which will be reassuring that you did not have a primary infection during pregnancy. If the CMV IgG is negative on the older sample, then it supports more a primary infection during pregnancy.

      Usually CMV in the urine is silent and it does not cause any inflammation and it will not mimic a urinary tract infection.

      If you are shown to be experiencing a primary CMv infection during pregnancy, then one or two infusions of CMV hyperimmune globulin may be of benefit in preventing transmission to the baby and also in reducing disease risk to the baby. Here at Texas Children’s Pavilion for Womenwe have used these infusions. Also, there are many centers that are participating in a randomized national trial (www.clinicaltrials.gov). These infusions are safe. Their effectiveness is variable, and in case series they are promising and they are being evaluated in randomized clinical trials at this time.

      It is possible the echogenic bowel will resolve or remain the same. It is also possible other abnormalities may evolve over the course of the pregnancy.

      Careful clinical followup, like you are doing, is the most important thing to do. Also, concentrate on your own wellness, which will then transfer to your baby.

      Also, no you do not need to avoid to take special precautions around pregnant women.. CMV shedding in the urine is not likely to spread to them under ordinary conditions. There is a slight chance you may have CMV in your saliva, so, if they are close friends or relatives to you, you should avoid sharing food or drinks or kissing them on or near the cheek or mouth.

      Best wishes for a healthy pregnancy and baby!

  141. Melinda says:

    Hi Dr.,
    I am so thankful for your blog! Until this week, I had never heard of CMV, and now it seems like there’s not enough doctors who are informed of this. There is a serious lack of info out there.
    I’m hoping that you can help me out…on Tuesday, I had my 19w2d ultrasound. The baby looked great, except for an echogenic bowel. The maternal-fetal medicine doctors had me take a ton of blood tests. My blood test for CMV came back already showing an igg greater than 8 and an igm of 1. The doctors said that this is borderline, or unequivocal. What exactly does this mean?
    They had me take another blood test that they said would show exactly when I was infected. I am on pins and needles waiting for the test results to come back for that test. When should I be hoping that I was infected? (In other words, if I was infected a month before getting pregnant, is that ok?)
    I’m having another ultrasound in four weeks. If it still shows that the only thing that is wrong with the baby is the echogenic bowel (or if the echogenic bowel goes away), is there a better chance that it won’t suffer from mental problems than if the ultrasound shows problems with the head size, brain, etc?
    Thank you in advance for your response. I am so grateful that you and your blog are here to guide people like me.
    ~Melinda

  142. Melinda says:

    Oops. I meant to say that my IGM level is 1, or equivocal.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Melinda,

      Thank you for your post on my Texas Children’s CMV blog.

      Echogenic bowel is a common finding, and occurs in about 25% of babies with congenital CMV infection that are diagnosed by fetal ultrasound screening. The echogenic bowel may be the only abnormality and may resolve on its own. It is possible other findings may develop as your baby develops. I am sure your MFM specialists will continue to follow your baby carefully with serial fetal ultrasounds. If the fetal ultrasound in 4 weeks shows resolving echogenic bowel and no new findings, then that is reassuring. It is difficult to predict, unfortunately, what will happen at this time.

      A CMV IgG positive and equivocal IgM may mean several things- a past CMV infection and a false positive IgM reading from a cross reactive antibody, a falling or rising CMV IgM antibody from a recent primary CMV infection. Most women keep a positive CMV IgM antibody for 3 to 4 months after a primary infection, and many for up to 6 months. A CMV IgG avidity test is likely the test they sent, and will tell if you have a long past CMV infection or a recent one. A high CMV avidity index is indicative of a past infection and a low index indicative of a more recent primary CMV infection. A repeat CMV IgM test in 2 to 4 weeks or so will also likely help in determining your CMV status.

      If a primary CMV infection is confirmed, you may wish to discuss with your MFM specialists to see if you are eligible for a clinical trial evaluating CMV hyperimmune globulin (www.clinicaltrials.gov) and its ability to reduce transmission of CMV to the fetus. Or consider receiving the treatment, based on results from clinical case series showing some benefit, especially if your baby is shown to be CMV infected by amniocentesis and to have symptoms form CMV.

      The only way to tell for sure if your baby is infected with CMV is to perform an amniocentesis and test the fluid for CMV DNA by PCR and/or CMV culture. There are benefits from the information gained frm the procedure, and also risks to this procedure, and I am sure your MFM specialists will discuss this with you.

      I hope this information is helpful to you.

      • Melinda says:

        Thank you so much for the great explanation–you did a much better job at explaining everything than my maternal-fetal medicine doctors did!
        I just got the call back from my doctors today saying that the avidity test shows that I was infected a long time ago, not recently, so things on this front look very promising. This is such a relief, as you can imagine!
        Even though it looks like I don’t have much to worry about as far as CMV goes, I am so glad that I now know about CMV. I will do my best to educate other women who I know about this infection–and I’ll direct them to your blog. Every woman who is thinking about getting pregnant needs to know about this serious infection.
        Bless you!
        Melinda

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          Dear Melinda,

          I am glad to hear all turned out well!

          And thank you for your kind comments. I am happy to hear, that by providing factual information on a topic, like congenital CMV, that is so misunderstood, that I have helped people along the way.

          Take care. Best wishes for a healthy pregnancy.

  143. Erika Deane says:

    Hello Dr., Thank you so much for all of your research and hard work. I am a NICU nurse and am also 32 weeks pregnant. I have been caring for a premature baby in the NICU for weeks and he recently started deteriorating resulting in respiratory issues (requiring vent) as well as contstantly plumeting platlett count and seriously enlarged spleen. He had been tested for CMV in the urine and it came back negative. His most recent test however came back positive and it seems that CMV has been the cause of all of his problems all along. I am concerned now because despite constant handwashing I have been caring for this baby for weeks and weeks. I wondered if you thought I should get My CMV levels drawn by the hospital and if so should I ask them for IgG, Igm, DNA levels and avidity index or is the IgG and IgM enough in this case? Also if anything comes back unfavorable would you reccomend getting a amnio to make certain or just wait to see if the baby has any issues at birth? Also would you recommend CMV hyperimmune globulin if anything comes back abnormal. Can infants get this immune globulin or is it only something that works when in utero? Sorry for all the questions! And again thank you so much for your time.
    Erika

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Erika,

      Thank you for your post on my Texas Children’s CMV blog.

      Person-to-person transmission of CMV in the hospital setting has never been convincingly documented. This is because CMV requires close and intimate contact with body secretions for transmission and the universal precautions we practice in the hospital setting when caring for patients is sufficient to prevent transmission of CMV from patients to health care workers. Also, CMV does not aerosolize and it does not stay viable on surfaces very long, outside of the body. No doubt you have cared for many babies with CMV infection but did not know they were infected with CMV. This is also the reason patients with CMV infections do not require isolation in the hospital. It is therefore highly unlikely you have caught CMV from your nursing duties with this infant, provided you faithfully practiced universal precautions.

      The more likely source of CMV transmission to women of childbearing age is from individuals in their own families or friend circles, with whom they are in close contact, especially young children, toddlers, and other relatives and close friends. The hygienic precautions outlined in my blog and also on the CDC website will reduce the risk of transmission of CMV to the pregnant woman. Therefore, since you are pregnant, you should consider, if you are not already doing so, adhering to these precautions during the remainder of your pregnancy.

      If you are very worried about CMV infection, you may wish to contact your obstetrician and discuss your situation. Your doctor may wish to test you for CMV IgG and IgM antibody. If the CMV IgG and IgM antibody are both positive, a CMV IgG avidity test can be done also to help with the timing of a presumed primary infection.

      If your fetal ultrasounds show a normally developing baby, then that is reassuring also, and likely nothing else needs to be done. If however, you have evidence of a primary CMV infection and your fetal ultrasounds suggest fetal disease due to CMV, then you should be referred to an MFM specialist for evaluation, amniocentesis and possible other interventions.

      CMV hyperimmune globulin may help reduce risk of transmission of CMV and also reduce fetal disease associated with congenital CMV when given to the pregnant woman. The findings are from case series and not randomized clinical trials, so many doctors await the results of randomized clinical trials before deciding to use the hyperimmune immune globulin in their patients. The immune globulin is not used routinely to treat newborns with congenital CMV disease. However antiviral treatments are helpful for some babies with moderate to severe disease.

      When your baby is born, a CMV urine culture should probably be performed, to rule out congenital CMV infection, just because you are so aware now about CMV and no doubt would be concerned about it. If the results are positive, then further evaluation of your newborn is indicated, along with consultation of a pediatric infectious diseases specialist and neonatologist.

      I hope this information is helpful to you. Best wishes for a healthy pregnancy!

      • Erika says:

        Thank you so much for sharing all of your knowledge! You have made me feel so much better. Now that I am more informed about CMV I will strive to educate others about trasmission and precautions.
        Keep up the good work. You are making a big difference.
        Erika

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          Dear Erika,

          Thanks for your kind words posted on my Texas Children’s Hospital CMV blog. I am glad to hear my efforts to provide factual information (in an area like congenital CMV that is often so misunderstood) is helpful to others.

          Best wishes to you!

  144. Elizabeth says:

    Dr. Gail,

    Thank you for your blog. It is incredibly helpful and your responses are thoughtful and thorough. It is very difficult to find accurate information on CMV and it is something I knew very little about until recently.

    I was hoping that you may be able to give me some advice on my current situation. I am 11 weeks pregnant with my second child. I currently have a 13 month old, healthy daughter who is in daycare.

    At my first OB appointment at 9 weeks, I was offered a CMV test as part of a study being conducted by the hospital where I will deliver. I knew nothing about CMV and the pregnancy-related risks prior to the this point. I agreed to the study without thinking much about it.

    I received a call yesterday from the doctor that my IgM readings came back positive and my IgG readings were negative, indicating a recent primary exposure (I was not given the specific levels). They recommended that I come back in for a retest to rule out a false positive, which I did this morning (2 weeks and one day after the first test). While I have talked to my doctor to some extent about this, I still have a lot of unanswered questions. I have an appointment scheduled for next Friday to see the high risk OB is who is overseeing this study and I will be having the 12 week FIRST screening at that time as well.

    I was hoping that you may be able to answer some questions for me. I have been agonizing over these results for the last 24 hours, unable to do much of anything but research and read as many things as I can find online (not always the best course of action, though your blog has been incredibly helpful).

    First, At what point should the IgG begin to rise if the IgM is positive? It seems that this would have to be a very recent infection for the IgG to be negative. Is that correct? I don’t remember having any flu-like symptoms. I did have some bad headaches a few days prior to the blood draw, but that has been typical for me in pregnancy. Additionally, my husband came down with flu-like symptoms about 5 days after my blood test (low-grade fever, headache, general malaise). The doctor diagnosed a potential tick-borne illness, but I am starting to think that this could have been CMV. We have a daughter in day care, and I know that this increases the risk.

    I am very concerned about the fact that this is occurring so early in the pregnancy. Is it more likely to transfer in utero earlier in the pregnancy? Is it more likely to have worse effects if it is transferred earlier in the pregnancy?

    What is the likelihood that severe issues would present themselves in utero through an ultrasound? Is it likely that I will see any indication of CMV transmission at the 12-week ultrasound? If I do an amnio and it is negative for CMV, how accurate is that and does it indicate that the baby will not have CMV-related issues?

    Are there other factors that contribute to the likelihood of adverse effects from the CMV (ie, how badly my reaction was, etc…)

    Should I wait to start any sort of treatment until I can test for CMV in the fetus or is it best to begin as soon as possible?

    Many many thanks for your responses. It is incredibly helpful.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Elizabeth,

      Thank you for your post on my Texas Children’s Hospital CMV blog.

      CMV IgG antibody usually rises at the same time or within days of the positive CMV IgM result in a true primary CMV infection. After 2 weeks, almost always the CMV IgG antibody will rise and be positive. If the CMV IgG antibody remains negative then the CMV IgM antibody is most likely a false positive reaction, especially the CMV IgM positive reading is low or borderline positive, or if you have an autoimmune disease, or are experiencing a viral illness that is producing cross reacting antibodies. Repeating the CMV IgG and CMV IgM antibody levels in 2 weeks is the correct procedure and hopefully you will know more information in a few days.

      Since your CMV testing may be a false reaction, you may still be CMV seronegative. Therefore, I encourage you to practice the three simple hygienic precautions outlined on my blog and on other websites to reduce your risk of CMV infection during this pregnancy.

      Most primary CMV infections give no signs or symptoms and are “silent”, so the fact that you have not experienced any symptoms does not rule out a primary CMV infection at this time.

      Your husband’s illness is consistent with many different illnesses, including a primary CMV infection. If his serologies for tick borne illness came back positive, and his CMV serologies are negative or indicative of a past infection, then he should have a confirmed diagnosis that way. If they are not confirmatory for tick disease, he may wish to be tested for CMV. There are a few accounts of the husband with primary CMV infection transmitting CMV to a CMV seronegative wife.

      If your CMV serologies indicate a primary CMV infection has occurred (positive CMV IgG and positive CMV IgM and low avidity index), then an amniocentesis may be indicated to determine if CMV fetal infection has occurred. Only 40% of the time will a woman transmit a primary CMV infection across the placenta to her fetus. So most of the time, no CMV transmission occurs from the mom to the fetus. Serial fetal ultrasounds should also be performed.

      If am amniocentesis is performed and it is negative for CMV DNA or CMV by culture, then fetal CMV infection is not present at the time of the procedure. A fetal amniocentesis that is CMV negative best correlates with the presence or absence of congenital CMV infection in the newborn, ultimately, if the amniocentesis is performed after 21 weeks gestation and 2 to 6 weeks after the primary maternal CMV infection has been documented in the mother.

      CMVprimary infection in the first half of pregnancy, if it results in infection in the fetus that causes symptoms, may be more serious, however it is difficult to predict. Many times the virus may infect the fetus without symptoms or cause some symptoms, and brain involvement does not always occur. When brain involvement does occur, then it may be more severe early in gestation. Serial ultrasounds are usually performed to carefully track the development of the fetus and the fetal brain.

      Transmission of CMV from the mother to the fetus is not dependent on the mother’s symptoms. It is difficult to predict.

      CMV hyperimmune globulin may reduce the risk of CMV transmission in women who are experiencing a primary CMV infection during pregnancy. It also may help resolve CMV fetal disease due to proven congenital CMV infection and disease. These results are from a case series by Nigro et al published in 2005 in the N Engl J Med. Case reports have also been published. Other clinical trials that are randomized are in progress to confirm these findings.

      Are you enrolled in this study described below?

      A 14-center NICHD Maternal Fetal Medicine Units Network (MFMU) randomized clinical trial testing the efficacy and effectiveness of hyperimmune globulin for prevention of congenital CMV in women with primary infection i snow underway and enrolling subjects. Brenna L. Anderson, M.D., M.S.C.R. from The Warren Alpert Medical School of Brown University/Women & Infants’ Hospital Providence, RI is the Principal investigator for the trial.

      Here is the link to the clinical trials.gov information (http://clinicaltrials.gov/ct2/show/NCT01376778?term=congenital+cmv&rank=4) for this study.

      In brief, they expect to screen approximately 150,000 pregnant women to find 800 with primary CMV, and no evidence of existing fetal disease. They will then counsel the women with primary CMV infections, and randomly assign those willing to participate to monthly infusions of hyperimmune globulin or placebo until delivery. Since we do not know for sure the treatment definitely prevents transmission of CMV to the fetus, a randomized clinical trial is being done. So far we only have results of case series and case reports that have shown promising results that need further study. If so, then if your CMV testing shows a positive CMV IgG and a positive CMV IgM, you may be eligible for randomization for possible treatment with hyperimmune globulin through the study.

      If you are not enrolled in this study, or this study is not available to you, then you may wish to ask your maternal fetal medicine specialist about CMV hyperimmune globulin infusions, if you are proven to have seroconverted to CMV during this pregnancy, to try and reduce your risk of CMV transmission to your baby. I recommend you wait for the confirmation because your repeat CMV serology testing may show it is all a false positive reaction. If your fetus is shown to be CMV infected, and especially if there if fetal disease, then the infusions may also help reverse some of the findings in some patients.

      I hope this information is helpful to you. Best wishes.

      • Elizabeth says:

        Thank you so much for this information. It is so generous of you to share your time and your immense knowledge on this blog. It is so difficult to find good information on this subject, and so I really can’t thank you enough for your very quick response.

        That study is indeed the one in which I am enrolled. I am hopeful that this turns out to be a false positive, but concerned that exposure could have occurred very closely to the blood draw based on my husband’s symptoms. Time will tell, though the waiting is certainly torturous.

        Thank you again for your response and for all of the information that you have provided on this blog.

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          Elizabeth,

          Thank you for your kind words. I am happy I could be of help by providing some factual information on a topic that is difficult understand and therefore very misunderstood. I am hoping for the best for you and wishing a healthy pregnancy!! Take care!

          • Sandra says:

            Hi Elizabeth I am a CMV mother and I couldn’t help but feel for your story and situation. I am just curious how everything turned out with the second blood draw, hopefully it went well for you. Also I feel such hope for you because if it is indeed symptomatic congenital CMV you will hopefully be able to get started on treatment right away. Sending kind wishes your way!!

  145. Ani says:

    Dear Madam,

    I am Ani. I had six miscarriages (four normal deliveries at the month of 6.5 months) due to TORCH CMV IGG Infection. I came to know about this infection after my first delivery and I had taken some injections to cure also. But still after treatment also, I had further four miscarriages since Doctor advised me this infection is not causing any problem to baby and it is nothing to do anything with pregnancy. It is normal infection. But after my last delivery i.e. on 1st July, 2011 in seven month, my baby was on ventilation for 22 days and expired. I again did my blood test and came to know about this infection virus TORCH Rubella CMV IGG Positive in my body. I am 100% sure due to this infection, i am regularly having miscarriages. After taking treatment now, whether it is advisable for trying for baby or not? and whether it will be 100% guaranteed result of having my own baby since my age is 40 now. Please advise me doctor what to do?

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Ani,

      Thank you for your post on my Texas Children’s Hospital CMV blog.

      I am so sorry to hear about your problems with pregnancy miscarriages. It must be very difficult times for you right now.

      The IgG antibody to CMV in your system will last your lifetime. This is a normal response. Even after your CMV infection is “over” and resolved. It is a marker for your “immunity” now to CMV.

      So a postiive CMV IgG antibody does not mean that you have an active infection with CMV. Also, a positive CMV IgG antibody (as part of the TORCH titer panel of blood tests) in your baby’s cord blood or even your baby’s blood is passive transfer of your maternal CMV IgG antibody and normal. CMV alone is therefore not the cause of your repeated pregnancy losses.

      I strongly urge you to consult a fertility expert and a maternal fetal medicine expert to determine the cause of your inability to maintain a pregnancy to term. At age 40 years you still may have a baby, but you need the advice and care of an expert in high risk pregnancy.

      I hope this information is helpful to you. Best wishes to you!

  146. Brooke says:

    I am so excited to find this blog.. While waiting to hear from my daughters pediatrician, I have been researching myself and have found few answers.

    My 7 month old daughter has been experiencing some mono like symptoms, low grade fever, loss of appetite, tiredness and most of all, extremely swollen lymph nodes on the back of her head/ neck for approximately 2 months now. After running many blood tests, her CMV test came back showing CMV IGg at 4.6 ( positive) and her CMV Igm at 13.8 (negative).

    With her being so young, and her IGM being negative, do you think she has had a previous infection, or is this level from something I passed to her in utero?
    Thanks in advance :)

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Brooke,
      Thank you for your post on my Texas Children’s Hospital CMV blog. I am glad you have found it informative.

      A positive CMV IgG and a negative CMV IgM antibody in a 7 month old infant most likely represents a previous CMV infection and not passive maternal antibody transfer.

      A positive CMV IgG antibody in a 7 month old infant may indicate any one of the following:
      1) A congenital (before birth) CMV infection that is silent and never diagnosed- up to 1% of all normal newborns in the United States may be silently congenitally infected with CMV; most silently infected newborns remain asymptomatic, although 10 to 20% may develop hearing loss
      2) A perinatally (around or shortly after birth) acquired CMV infection from passage through the birth canal or from ingesting mother’s breast milk (both a natural and normal way of acquiring CMV and usually harmless in most otherwise well infants)
      3) Postnatal (after birth) acquisition from another person in the family or in a group setting, such as in day care or in other group settings ( also usually harmless in most otherwise well infants)
      4) Or, rarely, from a blood product transfusion or organ transplant- which is not the case in your daughter.

      A positive CMV IgG antibody in a 7 month old infant does not usually indicate passive maternal transfer of antibody, since CMV IgG antibody from the mother has been shown to disappear by 3 to 6 months of age. Only if the infant acquired a new CMV infection or was congenitally infected should the CMV IgG antibody last over 6 months of age.

      If the CMV IgM antibody is negative, more likely than not, the current illness is not caused by CMV. It is possible the CMV IgM is falsely negative, but that would be unusual.

      I hope this information is helpful to you. Best wishes.

  147. Alicia says:

    Dear Dr.,
    What a great blog- the best and most detailed source of information I have found. I have read through everything and my situation is a little different. I did have a worst flu of my life (sore throat, horrible aches, fever to 102 not much congestion but short of breath) with resulting low platelets around 80 and low white count and inflammation and liver stress indications. I showed pneumonia on chest X-ray. I developed a rash on days 5-7 primarily on my torso. These got better but I am still tired several weeks later. I was on amoxicillin for acne. I had strep cultures, many tests for measles, Epstein Barr etc. cmv also was tested and came back positive 1 week from my initial sore throat symptom with negative Igg and positive Igm of 1.5. Two weeks later tested again and Igg still negative with Igm barely positive at 1.1. At 5.5 weeks Igg tested still negative and Igm also negative down to 0.4. My doctor thinks Igg will turn and another test isn’t necessary but ordered one I could do in 2-4 weeks. So at about 6 weeks from illness I’m trying to figure out whether I could be contagious to my loved one for sharing food, kissing etc, as well as when I can consider getting pregnant. I do not have any auto immune disease, cancer etc but have always picked up secondary infections easily so my immune system is probably not as robust as many. Is it possible to have two false positives on the Igm even with symptoms that seemed indicative? Usually Igg shows earlier and Igm takes longer to resolve from what I have read.

    Thank you very much.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Alicia,

      Thank you for your post on my CMV blog and for your kind comments. I am glad you found it informative.

      Regarding your illness, your symptoms were consistent with an acute CMV infection, which can mimic a mononucleosis syndrome and also pneumonitis and low platelets and liver dysfunction. However, other illnesses may also cause your constellation of symptoms. Also, your CMV serology tests are not consistent with a CMV infection. Both CMV IgM and CMV IgG should rise within the time period you stated if your infection was caused by CMV and assuming your immune system is functioning normally. False positive CMV IgM results can occur during a variety of other illnesses and may cause a transient elevation of CMV IgM while the CMV IgG remains negative.

      If your CMV IgG and CMV IgM levels remain negative, then it will be safe to try pregnancy in the near future. Also, you are not likely to transmit CMV to a close contact at this time since it is more likely your illness was not caused by CMV but rather another infection that produced a transient false positive CMV IgM response.

      I hope this information is helpful to you.

  148. Mary Dillon says:

    Dear Dr,

    I read with great interest your informative article on the internet, after spending a great deal of time on the internet trying to get information. I wonder could you advise me further?

    My brother recently had a child with a serious congential CMV infection. I have taken precautions when near them, similar to that advised in your article. I have, unfortunately avoided them more than I would have during my own pregnancy, but not my own parents who regularly care for their children . I really don’t want to maintain that behavior after I give birth, and I know my sister in law is keen to ‘help out’ and donate baby clothes. I hear that newborns have reduced immunity, but would like to know is it safe to let my newborn baby interact as normal with my brother’s family, once the pregnancy is over? And should I get my own baby tested for CMV once born? I did ask my own obs/gyn but he seemed clueless, and no matter how long I spend on the internet, I seem to get no answers. I would be really really grateful for some advice. It seems to be something that my regular health care advisers know very very little about.

    Kind Regards,

    Margaret

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi Margaret,

      Thank you for your post on my Texas Children’s CMV blog.

      During your pregnancy, please practice the simple hygienic precautions to reduce exposure to secretions that may contain CMV. Young children and toddlers are especially likely to be shedding CMV actively and transmit to vulnerable pregnant women.

      Do not kiss young children on the mouth or cheek Do give young children big hugs and kiss on top of the head Do not share food or drink or utensils with young children Do wash your hands carefully after changing diapers and wiping running noses and baby drool.

      Once your baby is born, and is healthy, there is no need for any special precautions. Your newborn may be in contact with your family, wear borrowed baby clothes, etc. It is really only during pregnancy that transmission and infection (to the fetus) of CMV is a risk. Other special circumstances such as cancer, transplant and disorders of the immune system also confer a risk for CMV. It is common and natural to acquire CMV after birth, and is usually without symptoms, results in a silent infection or mild symptoms, and then confers lifelong “immunity”.

      Many experts are of the opinion that all newborns should be tested for CMV, routinely and policy is moving towards including CMV on the newborn screening panel. So you may wish to get your newborn tested by culture or CMV PCR of urine or saliva. However, it is not necessary if your pregnancy is otherwise healthy and routine.

      I hope this information is helpful to you. Best wishes for a healthy pregnancy.

  149. Anthony says:

    Dear Dr.
    My name is Anthony, my wife and I are so glad to find your blog, thank you so much for your kind help on this subject!

    We have come across a tricky situation here: my wife recently got pregnant (6 weeks + 4 days from LMP)
    – On 28/04/2013, she had a TORCH panel test, both CMV IGM and IGG were negative.
    – She got pregnant around 20/06/2013.
    – On 13/07/2013, she had another TORCH panel test in the same hospital, CMV IGM still negative but IGG turns positive this time.
    We got so baffled that IGM was not positive in both tests, yet IGG changed from negative to positive within just 2.5 months.

    Our serious concern now is whether there could be a primary infection at all between the 2 test dates, during which conception happened.

    We’ve read from various researches including you blog that IGM may remain detectable for at least several months after a primary infection, we are just wondering if this could be a strong piece of evidence in our favour when assessing the risk of this pregnancy being affected by CMV at early stage? Hope you could offer some insightful comments on our situation which we really can’t find elsewhere, we are getting really desperate.

    Thanks again for your time, wish you all the best!

  150. Anthony says:

    Dear Dr.

    Further to my previous post, we have now just got the CMV avidity test result, it is 40.8 (40-60 being intermediate). Does this value, which is at the lower end of the intermediate range, have any meaningful indication of when an acute infection might have happened? Combining the 2 posts can you please help assess the overal risk we are facing? Many thanks!

  151. Anthony says:

    Sorry made a mistake in the first line of my previous post, it should be CMV IGG avidity test. Thank you!

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Anthony,
      Thank you for your post on my Texas Children’s CMV blog.

      The possibilities to help explain your wife’s CMV serology results include one of the following-

      1) Recent primary CMV infection with seroconversion of CMV IgG antibody and a fast decline of CMV IgM antibody – as you so clearly stated and understood correctly, most women will keep CMV IgM antibody for 2 to 3 months after a primary infection, because it declines slowly over time, but there are a few rare exceptions to this, and I have seen CMV IgM decline withing 2 to 4 weeks in a few women, and the range of 8 to 10 weeks between blood tests in your wife’s case is possible it is a primary CMV infection. The positive but low avidity CMV IgG index further supports a likely recent primary CMV infection may have occurred within the last 1 to 2 months, but it is difficult to pin point the exact time of primary CMV infection in your wife.

      2) False CMV IgG antibody result on the second test due to a cross reacting antibody from a similar virus, or laboratory error such as samples being mixed up or mislabeled, or laboratory differences in techniques or methods. For example, if the tests were performed in two different laboratories that also may account for the differences in the CMV IgG result.

      I suggest you repeat the CMV IgG and CMV IgM and also perform a followup CMV IgG avidity test – preferably on all samples in the same lab on the same test run. Also, record the index readings of all three tests as well. If possible, try and obtain any old or archived sera that may be available as well ( this is a long shot but worth asking .

      In addition, you may wish to consult with a maternal fetal medicine specialist experienced with CMV infections in pregnancy, and discuss options for assessing your baby in utero, since it is likely your wife has experienced a primary CMV infection recently. For example, a fetal ultrasound to assess the well being of your baby is in order and may be reassuring. And, since it is possible your wife may have experienced a primary CMV infection during pregnancy, consider an amniocentesis at 18 to 21 weeks to determine if transmission of CMV to your baby has occurred.

      Most of the time, even if a woman experiences a primary CMV infection with a seroconversion, only 40% of the time does the virus get across the placenta and infect the baby in utero. Therefore over half of the time the CMV virus does not infect the fetus and the baby is fine.

      And most CMV infections are silent or mild even in the fetus. Rarely, however, disease may occur. Therefore, most of the time, even if a pregnant woman catches CMV, the baby does OK, but it is best to be cautious and fully evaluate your baby.
      Overall risk for transmission of CMV to the fetus after a maternal primary infection during pregnancy is about 40%, risk of having a baby who is normal or slightly affected is about 85 to 90% if CMV infection has occurred. Between 10 and 15% of babies born with congenital CMV infection will have disease and some of these babies – up to two thirds- may have neurologic involvement of a wide range of severity- some mild and some moderate to severe. Fetal US will help assess any disease involvement over time.

      In addition, prenatal treatment with CMV hyperimmune globulin may help prevent or reduce the risk of transmission to the fetus since it is likely your wife did experience a CMV seroconversion and primary CMV infection during pregnancy. Also, prenatal treatment may help reverse some findings if your baby is shown to to be CMV infected and have affects or disease in utero from the infection. There are published case series showing probable benefit. Also, there are research studies evaluating this prenatal treatment on http://www.clinicaltrials.gov. If you are in the US then you may be able to find a center near you.

      Finally, your baby, at birth or within the first week or so, should be tested for congenital CMV infection with a urine and saliva CMV test- CMV culture or CMV DNA PCR- to assess for congenital CMV infection. If negative, then no worries. If positive, then further evaluations especially for hearing, will be in order.

      If you find your wife did not seroconvert her CMV IgG antibody for some reason, then please exercise CMV precautions with young toddlers, to reduce the risk of CMV transmission, that are outlined in my blog.

      I hope this information is helpful to you. Best wishes for a healthy pregnancy. If you would like, you may repost or email me with followup.

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  153. Skrlaw says:

    I am 36 years and work as a preschools teacher with children who have hearing losses. We are a program that focuses on listening and spoken language, a few of our students lost their hearing due to CMV. My question is, I recently had blood work done to see if I carry antibodies to fight CMV, if I were to get pregnant. The tests came back showing I do not and if exposed potentially could get CMV. If I were to get pregnant, how high of a risk would I be putting myself and potential fetus of getting CMV?

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thank you for your post.

      Teachers of children who are deaf or who have other special needs may be at increased risk for acquiring CMV from close contact with their saliva during the teaching process, which often involves direct contact with the child’s speech muscles in the face and mouth.

      If you are CMV seronegative you are at risk of acquiring CMV from this type of contact, and also from contact with other children in your family or close friends, especially young toddlers who commonly shed CMV in their saliva.

      I recommend you practice these simple hygienic precautions to reduce your risk of acquiring CMV from contact with possibly CMV infected saliva:
      • Do not share food or drink with children
      • Do not kiss children on or around the mouth or lips or cheeks
      • Give them big hugs and kisses on top of the head instead to show your affection
      • Wash hands carefully after changing diapers
      • Wash hands carefully or use gloves if coming in contact with their face, mouth or saliva, especially during any teaching procedures for speech

      Also, contact your obstetrician about any special CMV serology monitoring he or she may wish to perform. If you do catch CMV during pregnancy, then only 40% of the time will the CMV virus be transmitted from the mother to the fetus. And then, if the fetus is infected, only 10% of the time will there be serious disease.

      If you do CMV seroconvert during pregnancy, there are options for prenatal treatment that can also be considered. Consult your obstetrician or a CMV expert if you need this type of information down the line during your pregnancy.

      Best wishes for a healthy pregnancy.

  154. alex from Phoenix says:

    Hi Doc,

    My wife wants to get pregnant, so she went and test her antibodies along with LH, FISH. Her IGG came 10.3 ( positive) and her IGM came as 0.3 (negative). Doc told her that she had past infection. We did not anything about CMV ( Thanks for doc who asked us to test for CMV).
    My wife is completely afraid of the CMV and drop the idea of getting pregnant again.

    Is it safe to get pregnant?, we are blessed with two daughters. It it worth taking the risk.
    Is there any vaccines available currently for pregnant women.

    Thanks for your responses for other stressed parent questions.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Alex,

      Thanks for your post and question.

      Your doctor is correct, your wife has a past CMV infection and the risk to another pregnancy is nil.

      The presence of CMV IgG antibody (and a negative CMV IgM antibody) is normal and not dangerous to a pregnancy. It is what occurs in 50% to 80% of all women of childbearing age. It is actually a good situation to be in, because the pregnant woman is CMV “immune” and will pass this immunity and antibodies to her baby, but will not pass the CMV virus, almost all of the time.

      There is a slight < 0.01% to 0.001% chance her own CMV virus will transmit to the baby thorugh a "recurrent" or "reactiviation" infection, but the baby does not have problems in this case because the antibodies and immunity are also passed along. Very rarely a new CMV virus can infect a pregnant woman who is already immune to another CMV virus, but once again, in these instances, the baby may be CMV infected, but almost always will be OK.

      CMV is the most common virus that nobody has ever heard of. You are not alone in this regard. Hopefully now you are "CMV Aware" and can spread information about this common virus.

      The results of your wife's test should reassure her that everything from the CMV perspective is OK for another pregnancy.

      Unfortunately, there is no CMV vaccine available for routine use for women who are pregnant or of child bearing age. However, research continues to search for a CMV vaccine that would help prevent congenital CMV infection and CMV disease in the babies of pregnant women.

      I hope this information is helpful to you. Best wishes for a healthy pregnancy!

      • alex from Phoenix says:

        Thank so much for your response. I have one more question.
        Is the CMV is contiguous when it is not active

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          Hi Alex,

          Individuals with CMV infection that is latent or inactive or that happed a long time ago, may intermittently from time to time shed low quantities of active CMV in their body secretions, such as saliva and urine, as well as cervical-vaginal in women and semen/sperm in men. It is possible CMV may be transmitted from person to person in these secretions. CMV is not a “contagious” virus per se, because it requires very close intimate contact over a prolonged time to transmit between people. CMV is a common virus that infects most everybody at some time in their life. So it is “normal” to acquire or “catch” CMV at some point in your life. It is potentially dangerous however to catch CMV during pregnancy because it can cause disease in the fetus before it is born.

          Young infants and toddlers shed CMV in large quantities from their saliva and urine even though their CMV antibody tests show a quiet or resolved or old infection. Young children are a common source of CMV infection for their parents, so the CMV virus may be transmitted within the family this way also.

          CMV is not transmitted between people by casual contact, such as hugging, shaking hands, or being in the same room. CMV is also not airborne. CMV also does not stay long on surfaces such as door knobs or tables.

          I hope this information is helpful.

  155. Sandra says:

    Dear Dr. Demmler, Can you please describe the correlation that you have found with congenital CMV babies and the incidence of Polymicrogyris of the brain? Do you feel research on this matter will be published on this matter any time soon? Thanks.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi Sandra,

      Thanks for reading and posting on my CMV blog. Your questions about congenital CMV and PMG are very important and timely!

      Congenital CMV infection may involve the brain and produce a variety of changes in the brain. The most typical changes are periventricular lucencies or immaturity (thinning of the brain), ventriculomegaly (enlarged ventricles which are fluid filled spaces in the brain), cortical atrophy (shrinking of the brain), periventriuclar cysts (cysts in the brain), or calcifications (calcium deposits which represent bain injury). In addition, babies with brain involvement from congenital CMV may have microcephaly (a smaller than normal head size and brain). A few babies with brain involvement from congenital CM may experience vasculitis (inflammation of the blood vessels feeding the brain) and even may have a stroke from the vasculitis.

      Polymicrogyria (PMG), a type of cortical maldevelopment of the brain, is another form of brain involvement associated with congenital CMV, and its association with CMV is less understood and less appreciated than the other well known conditions. Polymicrogyria may be associated with other conditions not related to CMV, such as genetic disorders, and often children with PMG are first seen and evaluated by neurologists and geneticists.

      One of the possible reasons for this current misunderstanding about the association of CMV and PMG in some infants is because PMG is best identified by more sophisticated and relatively newer brain imaging using MRI. The other CMV associated brain conditions, like calcifications and enlarged ventricles, are more readily and traditionally evaluated by brain CT imaging, and CT imaging may miss PMG. Previously the cortical maldevelopment conditions, such as PMG, were known as lissenencephaly, schizenencephaly, neuronal migration defects, and a variety of other names. Through clinical research, as we perform more modern imaging of the brain, and as we diagnose newborns more readily for congenital CMV infection with modern virology testing or newborn screening for CMV, our understanding of the role of CMV in cortical maldevelopment conditions like PMG will improve.

      Children with congenital CMV and PMG also may experience vision problems and progressive hearing loss, similar to children with other types of brain involvement more commonly associated with congenital CMV. So it is important to have their vision and hearing tested on a regular basis.

      If a child has PMG and a genetic condition is not found, then congenital CMV should be considered. Some experts recommend CMV testing be performed early, along with the genetic testing, in infants with PMG, so the diagnosis can be made as soon as possible. If the appropriate CMV testing was not done in the newborn period (CMV culture or CMV DNA PCR on urine or saliva testing in first 3 to 4 weeks of life), then parents may consult with their doctor and request further testing. A simple and inexpensive CMV IgG antibody test on the blood may be performed. If the infant is CMV antibody negative, then congenital CMV infection is ruled out as a diagnosis. However, if CMV IgG antibody is present then congenital CMV is a possibility and further CMV testing is indicated. Parents then may request their child’s newborn screening dried blood spot (DBS) performed as a newborn in the hospital or pediatrician’s office, be retrieved from their state newborn screening laboratory and sent to a special reference laboratory for testing for CMV DNA.

      Here in Houston, in our CMV Longitudinal Study on the long term effects of congenital CMV on growth and development, and our CMV Clinic at Texas Children’s Hospital, we have identified infants and children with PMG associated with their congenital CMV infection, either by testing for CMV as newborns or by retrieval of their DBS for CMV DNA testing. Children with PMG caused by congenital CMV may experience seizures (epilepsy), hemiparesis (inability to use muscles in their arms or legs on one side), delays in their developmental milestones, and speech and langauge delays, as well as hearing loss and vision problems.

      Evidence based medicine from well designed and well executed multi-center randomized controlled clinical trials have shown newborns with congenital CMV infection that involves the central nervous system (brain) benefit from early antiviral treatment with improved brain growth and head size growth and improved developmental milestones. Therefore, diagnosis of PMG associated with congenital CMV is important and early treatment may improve their outcome.

      I hope this information is helpful to you.

  156. alex from Phoenix says:

    Hi Doc,

    Is this CMV is contiguous when it is not active?

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Alex,

      A person who has positive CMV IgG antibody and negative CMV IgM antibody may still reactivate their own CMV strain, which stays with them all their life, and shed it in their body secretions, usually in very low amounts, at any time through their life. This CMV in body secretions can then be transmitted to other people with close or intimate contact. This is the natural way CMV is usually transmitted between people.

      I hope this is helpful information.

  157. Carson says:

    Dear Dr. Gail Demmler-Harrison
    I know you expert in research the CMV virus via your blog. we are a coulpe in China. my wife are pregnant about 15 weeks.
    We check the cmv in hostipal and got the IGG+ IGM+ . Then we further check the cmv DNA in blood, urine and cervical secretion.
    The blood and urine is normal. And the cervical secretion cmv is higer about 7.2 x 10 to the power three.The doctor recommand terminate this pergnancy in China. They said this virus maybe cause many illness to baby. we have no idea about his and we don’t want abort this baby.
    we look forwared hear your prefessional suggestions. Thanks so much

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Carson,

      Thank you for reading and replying to my CMV blog.

      A positive CMV IgG and positive IgM antibody in a pregnant woman like your wife means a recent CMV infection that may have occurred during or just before pregnancy. Only 40% of the time is CMV transmitted to the fetus, so 60% of the time CMV is not even transmitted to the baby. Of those who do have CMV infection transmitted to the fetus, only 10% will have severe disease, and the rest of the babies are infected but have no disease. So, most of the time, everything is fine. It is unusual for CMV to severely affect the fetus. Severe affects can of course occur, so the risk is not zero, but it is low.

      If your wife’s CMV IgG is positive and her CMV IgM is negative, then she most likely has a past CMV infection that occurred at least 3 to 4 months ago, and probably earlier, many months or years before the pregnancy. This is considered a “past infection” and is of nil to almost no serious consequence to the fetus. Having CMV IgG antibody is actually a common and normal condition, since between 50% and 80% of women of childbearing age will have CMV IgG antibody already. Your wife then will pass antibodies to the baby and immunity to CMV.

      There is a very slight (< 0.01% to 0.001%) chance your wife will transmit her own CMV virus to her baby if she has a past CMV infection. This is called recurrent or reactivation infection with CMV. Since she will also pass her own antibodies and immunity too, the baby will not have problems from CMV, even if the virus is transmitted to the fetus. So it is also not something to worry about and there is nothing that can be done to prevent this occurrence.

      A positive CMV DNA in the mother's cervical secretions is normal during pregnancy and does not mean anything about the fetus or baby's risk for CMV. We do not perform that test here in the USA because it is not predictive of fetal infection.

      Cervical secretions that are positive for CMV do not mean anything for the fetus. It is possible when the baby is born the CMV will be given to the baby during birth. This is also a very natural way to catch CMV and also become immune to CMV at a very early age. It will not cause problems in most term babies who are otherwise healthy. We do not monitor for CMV in cervical secretions here in the United States.

      Given these statistics, most couples follow the baby and perform an amniocentesis at 18 to 22 weeks gestation and test the fetal amniotic fluid for CMV DNA. This test will determine if CMV infection has occurred in the fetus. If it is CMV negative, then the baby is not CMV infected. If amniotic fluid is positive for CMV, then the baby is CMV infected. If the baby is CMV infected, then the fetus is followed carefully with ultrasounds, and may also be treated with CMV hyper immune globulin given to the mother.

      We also use CMV hyperimmune globulin transfusions in the mother to reduce the risk of transmission of CMV to the baby when they are CMV IgM positive in pregnancy. You should ask your OB about this treatment also.

      A fetal ultrasound should be performed also to assess the fetus. If the fetal ultrasound is normal, then that may be reassuring that your baby is developing normally. I suggest this be followed carefully at least every month during pregnancy. If the fetal ultrasound shows disease then the degree of disease, and whether or not brain involvement is present, should be assessed.

      The decision to terminate a pregnancy and abort an unborn baby is difficult to consider. Given the likelihood that CMV will probably not infect an unborn baby and probably will not affect the baby with disease, and especially if the fetal ultrasound is normal, most families decide not to terminate and most doctors do not recommend termination, since there is now treatment to give and the risk of serious CMV disease is low. However, every situation is unique and it is difficult for me to give advice based on a brief post from you. If a baby is severely affected by CMV in the womb with severe brain destruction and no hope for survival long term or a near normal life, then some families and their doctors have considered this option to be the best for their family and their baby.

      I hope this information is helpful to you. If you or your doctors need any other information please let me know.

      Best wishes. I hope your pregnancy turns out to be healthy!

  158. Muddita says:

    Hello Doctor,I conceived last year November this August first week was expected date of Delivery but unfortunately I lost my fetus before 3 days of delivery in Uterus.Doctor advised for normal delivery & post Delivery baby weight was 3.1kgs,look wise baby seem healthy to me but there was no heart beats.Doctor Recommended TORCH test & Result was normal other than,CMV IgG@87.00 & Herpes Simplex Virus 1+2 IgG @7.50.Reason for stillbirth is still unknown to me.Can you please guide me which all test should I go further and as my Gynaecologist never suggested me for any tests in first Trimester Australian antigen,HIV,TSH,normal urine test,BTCT,normal ultrasound.Please help so that we don’t face this disaster again.
    Regards

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Muddita,

      Thank you for your post on my CMV blog.

      Please accept my sincere condolences for the loss of your baby. Such a tragedy. I hope time heals your sadness.

      Regarding your question about the reason for your baby’s in utero fetal demise, I am not able to tell you for certain the cause. However, it is not likely to be due to CMV.

      The presence of CMV IgG antibody is a common and normal finding – between 50% to 80% of women will have CMV IgG antibody. Therefore this test results does not tell you that CMV caused the demise of your baby. Also, if your baby looked healthy otherwise, it is very unlikely CMV caused the stillbirth. If CMV causes in utero fetal demise or stillbirth, the fetus is almost always severely affected with disease obvious on fetal ultrasound. If your baby looked fine without obvious disease in the womb, and at delivery, then CMV is not likely to be the cause of the stillbirth.

      If you wish to try and see if CMV was the cause, then the amniotic fluid should be examined for CMV by PCR , as well as the placenta, and the fetus also for evidence of CMV.

      I suggest your doctors examine your baby for causes of the stillbirth.

      Since it is not likely CMV caused your baby’s stillbirth, I suggest other causes be looked for. Did they examine your baby for other causes after the delivery?
      If you have CMV IgG antibody now, the risk for having a baby with CMV disease is nil and should not worry you about your next pregnancy. Your CMV immunity will be passed to your next baby.

      I suggest you please consult a specialist in maternal fetal medicine and high risk obstetrics with your next pregnancy, and have the fetus watched very carefully with fetal ultrasounds and other assessments.

      When you are ready to try again, I wish you the best for a healthy pregnancy and a healthy baby next time around.

      I hope this information is helpful to you.

      • Muddita says:

        Hello doctor just got report of fetus autopsy which states that below mentioned were the disorders in the baby Trisomy 13,15,16,18,21 & 22 in the baby.now which test do u suggest me & my husband should go for finding out the disorders.

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          Hi Muddita,

          It appears then that your baby had a genetic disorder and not CMV. I suggest you consult a geneticist for genetic counseling.

          Best wishes for a healthy pregnancy next time.

  159. maryam says:

    Dear dr.gailI have been reading ur post about cmv and I have been looking for some one with my kind off case.. Im 20years old and married,  i was 18weeks pregnant when I lost the baby, after that my doctor tested me to know what killed the baby, RUBELLA IgG was positive 193.3CMV IgG was positive 482.6TOXOPLASMA IgG was negative 0.130   So my doctor said it was the CMV so I was on medication for 40 days to help me reduce the level of the cmv after the 40 days I was asked to go for another test to see if the medication worked so I went for the test and the result was high again the CMV IgG was positive 631.5 while the first test was positive 482.6 and CMV IgM was negative 0.25 .. was sad about that so she said that she will have to give me human immunoglobulin drip to help me… after the drip she told me I can carry on and get pregnant again and I have been trying for about 2months now to get pregnant and I haven’t.  Please is there a way u can explain better or tell me what to do best..      Thanks a lot 

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hello Maryam,

      Thank you for reading and posting my CMV blog and for sending me your experiences.

      Regarding your question- – a positive CMV IgG antibody does not necessarily mean CMV caused the death of your baby in utero at 18 weeks gestation. CMV IgG antibody positive level result in blood is very common — over half of women of child bearing age may be positive for CMV IgG antibody. It is not abnormal. Also, the level of CMV IgG antibody does not really matter. In fact it may fluctuate and change, or even go higher, without any indication CMV is causing more problems. After a primary infection CMV usually goes latent and the CMV IgG antibody persists for the lifetime.

      Did you have a CMV IgM antibody test or a CMV IgG avidity test done to determine if your CMV infection was recent or long past and resolved? A positive CMV IgM antibody test may indicate a recent infection and may then make it possible CMV played a role in your baby’s death in utero.

      The way to determine if your baby died at 18 weeks in utero from CMV is to examine your fetus/baby and the amniotic fluid and fetal tissues for CMV or evidence of CMV infection. Was this test done?

      Usually treatment with antiviral medication in a normal healthy woman for a positive CMV IgG antibody is not done, unless there are unusual circumstances, high levels of CMV in the blood, or CMV disease of some kind. Also infusions of CMV immune globulin, if you are healthy, will not be needed. Without knowing your medical history, it is difficult for me to comment further on your treatments.

      Request the CMV IgG the CMV IgM and the CMV IgG avidity index be performed. If the CMV IgG is positive, and the CMV IgG avidity index is high, and the CMV IgM antibody is negative, then it is OK from the CMV perspective to become pregnant again.

      I hope this information is helpful to you. Best wishes for a healthy pregnancy!

  160. Lina says:

    Dear Dr Demmler-Harrison
    Hello . I am Lina . I would like to ask about the interpretation of CMV IgG level. I do the TORCH test regurarly every time I plan for my pregnancy. And since I am planing to have my fourth pregnancy this year so I have done the TORCH test at December 2012 and the results for CMV is a positive IgG level (221 AU/ml), a negative IgM and a high avidity of CMV IgG level (89.6%). And on July 2013 I have a blood test for CMV and the result is a positive IgG level 228 U/ml and a negative IgM.
    Previously on 2009 I have done a TORCH test for my third pregnancy and the result for CMV is a positive IgG level (52 AU/ml), a negative IgM and a high avidity of IgG CMV. And I have gave birth to my third child and she is 2 years old and a very healthy girl . For your information all of the TORCH test were done on the same lab except for the CMV test on July 2013 which were done on the different lab.
    So it is seems that my IgG CMV level are increase overtime. Should I take it as a consideration for becoming pregnant again? Please I need your advise since my OB does not seems to know much about this CMV test interpretation and I have read in one of the website that talks about CMV infection and one of the comment says that it is bad to be pregnant with increase level of IgG CMV overtime. And I also plan for my fourth pregnancy carefully since my second child is an autustic child and has a Dandy Walker Syndrome.
    Thank you in advance for your help.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thank you for reading my blog . You pose a very good question about CMV serology results that I would like to share.

      Once you have documented a CMV IgG antibody postive level at any time, with negative CMV IgM and high avidity index, there is no clinical need or indication to retest any of the CMV serology values. CMV IgG levels last a lifetime positive, and also may fluctuate over time or at any time vary a little from year to year. The level of CMV IgG antibody may increase slowly over time, but that is also normal as your CMV immunity also matures.

      The mild difference from 221 to 228 is not a significant difference or increase. The difference from 52 to 221/228 is a significant rise and change, provided the tests were done in the same lab by the same method. Different methods have different positive ranges also. If they were done in the same lab by the same test, then the increases over the several years from 2009 to 2012/2013 likely represent the maturation of your CMV IgG levels and CMV immunity, especially so if your CMV IgM antibody remains negative and your CMV IgG avidity index remains high.

      Therefore, these CMV antibody tests should have no impact on your next pregnancy from the CMV perspective.

      Best wishes for a healthy pregnancy!

      • Lina says:

        Thank you for your information. I would like to ask one more guestion. What is that mean by maturation of CMV IgG level? Is that mean that the virus will not be reactivated or i will not get any new infection from this virus eventhough i exposed to the CMV virus. Can i kiss my toddler in the cheeks or lips since i have a mature IgG CMV level?

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          Hi Lina,
          A mature CMV IgG antibody means you are “immune” to CMV, with only a very slight chance of recurrent CMV infection from reactivation or your own CMV strain or reinfection with another strain from another person. It is fine to kiss your toddler as long as your are not pregnant. If you are pregnant, it is better to use CMV precautions until after pregnancy, to avoid the rare risk of recurrent reinfection.

          • Lina says:

            Thank you so much for your thought. It is very generous of you to share your knowledge and give a very thorough information about CMV infection in this blog.

  161. Tammie Shafer says:

    Dr. Gail Demmler-Harrison,

    My grandson was born on June 3rd (one month premature) and diagnosed with congenital CMV. He was started on a IV treatment therapy and then sent home after a few weeks to take the rest of the treatment orally. About three weeks ago his breathing became labored due to his liver being enlarged and my daughter-in-law brought him to the emergency room. He is currently at Baystate Hospital in Springfield, MA. While at the hospital they put him back on the IV treatment. Since then his liver seems to be getting smaller. Today the doctors met with my son and his wife and told them that they should make a decision to take him off the medication and bring him home managing any symptoms or to keep him on the IV therapy treatment. They also told him he has a good chance of having major disabilities as he gets older. I really feel the doctors are just guessing since the incidence of this virus is so small. I don’t think they really have that much first hand experience with it. I’m thinking my son and his wife should get a second opinion. You are the person I found by conducting research as to who knows the most about this virus. If you could either email me or call me at 413-281-0351 I would greatly appreciate it. I’m willing to do whatever it takes to help my grandson and his parents. I look forward to speaking with you about this. Thank you in advance.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Tammie,

      Thank you for your post on my CMV blog.

      Treatment for infants with symptomatic congenital CMV infection is recommended, especially if symptoms are severe, persistent, or involve the brain, eyes, or if the infant has hearing loss. The medication is ganciclovir by IV and valganciclovir by mouth. Therefore I am glad to hear your grandson is receiving treatment. Treatment may be beneficial and helps improve hearing loss (or reduce risk of hearing loss progressing), and improve brain growth and development during the early years of development. Treatment also helps reduce the level of CMV virus in the blood and helps remove CMV from the internal organs and bone marrow.

      If your grandson has had a setback while on oral valganciclovir treatment, the things to consider include the following:

      1) a ganciclovir resistant strain of CMV may be involved (this has now been documented even in newborns) – his doctors can test for this and there is an alternative medicine

      2) a primary immune deficiency syndrome in your grandson, which means his immune system is not able to fight off CMV very well – his doctors can test for this

      3) he was not absorbing the valganciclovir well – not likely if he is taking oral feedings well now

      4) there was a problem with the medication somehow – occasionally the incorrect medication is prescribed or dispensed by the outpatient pharmacy, or dosage is administered – 15 to 18 mg/kg/dose valganciclovir every 12 hours is recommended for congenital CMV, a little higher dose for newborns is recommended than what some doctors usually use for other types of CMV infection

      4) he may have two things wrong with him, such as biliary atresia or a metabolic disorder, on top of congenital CMV, also rare, but a consideration – his doctors can test for this if they feel it is possible.

      Without knowing more, it is difficult to say for sure why he did not do well on the oral medication.

      Regarding your comments that your grandson will likely have major disabilities or special needs as he grows older, it is difficult to predict the long term outcome of an infant with congenital CMV because the outcomes, even neurologically, are so variable. Not all babies born with congeital CMV disease have developmental disabilities. Our research here focuses on the long term outcome of congenital CMV, and the possible predictors of long term outcomes that are seen in the newborn period. Our oldest study subjects are in their 30s now!

      Some things that help predict outcome include size of the head and brain at birth, lack of growth of brain during infancy and early childhood, severe abnormalities of brain imaging, such as large calcifications, enlarged ventricles, or cortical developmental problems, such as polymicrogyria. Infants with severe eye disease, called chorioretinitis, also often have disabilities as they grow older. Minor abnormalities of brain imaging, such as small or moderate calcifications, or a small size head that grows along a good growth curve, do not necessarily mean disabilities will occur. Some infants with congenital CMV disease do not have any major brain problems and develop normally, especially if their brain imaging is normal or near normal and their brain size is normal and their brain/head grows normally. Others may have special needs and require therapies and interventions as they grow to help them reach their best potential.

      What are the criteria your doctors are using to predict your grandson’s long term outcome at such a very young age?

      In addition, infants with congential CMV disease should have their vision and their hearing tested and monitored closely. I hope this is being done for your grandson.

      I hope this information is helpful to you. I would be available to discuss your grandson’s case with your doctors or his parents, if they wish to do so. I will also contact you via email.

      • Tammie Shafer says:

        Thank you for getting back to me. Is there a prescribed total length of time the ganciclovir by IV and valganciclovir combined that a patient should receive? Sawyer was started on the ganciclovir for about two weeks and then switched to the oral valganiciclovir. I’m not sure if he was getting the oral version regularly every 12 hours. (Could that cause the virus to multiply?) Since he has been in the hospital he has been on the ganciclovir by IV for about 2.5 weeks. I’m wondering if he should be taken off the IV or kept on. They are going to redo his hearing test. The technician that did his test yesterday had a hard time getting a good seal; therefore, he passed some of the tests and some of them she was not sure about because she could not get a good seal. I’m not sure when they are going to redo that test. Hopefully soon. His vision appears to be normal. Other information I know is that when he was born he has two small bleeds in his brain. The doctor at the Portsmouth Navy Hospital, VA (this is where he was born) said that the two bleeds where not anywhere near his ventricals and that the calcifications were small. Also his neurological scan they did in VA seemed normal. Regarding his brain/head growth. Sawyers pediatrician said his head growth was following a curve. I believe he was only in the 5-10 percentile but that growth was consistent with the curve. Also he passed his initial hearing test in VA.

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          Dear Tammie,

          The usual duration of treatment for congenital CMV is at least 6 weeks either IV or oral, and some of the very latest evidence that will be presented in October at a major scientific meeting will likely suggest treatment should extend to 6 months for maximum benefit. Most babies will be well enough to receive the medication valganciclovir by mouth twice a day, and the oral form effects are equivalent to the IV form if provided appropriately. His doctors will be the best judge of the best method of his treatment there.

          If his brain imaging only shows mild involvement and his head size is growing, those are optimistic indicators. Your grandson, however, as he grows, will show everyone as time goes on his true potential and abilities.

          I hope this information is helpful to you.

  162. Kirsten Locke says:

    Hi Dr. Gail:
    I am 30 weeks pregnant. I have an 18 month old son who goes to daycare. I got really sick with a sinus infection/bronchitis/pneumonia. I was very sick for over 3 weeks, the sickest I’ve ever been. Shortly after I recovered, I started having contractions and went into preterm labor. They gave me the steroid shots for baby’s lungs (which usually increases contractions) however it slowed mine down. My Dr immediately knew it was then an infection/virus and ran tests for all of the potentially dangerous ones to the baby. He tested for coxsackie, group b strep, parvo and CMV. I just found out yesterday I am positive for CMV. He said this is what is causing the preterm labor. He said to take Selenium and he’ll monitor me closely. I am pretty sure this is a primary infection as I was never in daycare or anything as a child. I think I may have caught it from my son. I am scared to death for my baby. Because it wasn’t in the first trimester that I either caught it or it reactivated, what are the risks and what should I do? Is there a way to know if it was a primary or reactivated infection? Should I not breastfeed if he is negative when born? I am too scared to have another baby now in case it reactivates in the first trimester. Should I not conceive again? Thanks so much for any help you can offer

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Kirsten,

      Thank you for your post on my TCH CMV BLOG.

      It is possible you are experiencing a recent primary CMV infection. However, just stating you are “CMV positive” does not provide me enough information. Did you have just a CMV IgG antibody test done- if so, 50 to 80% of women of childbearing age may have CMV IgG antibody, so it is a normal finding. If you are also CMV IgM antibody positive, then that is more supportive of a primary or recent CMV infection. That is how you determine if you have a primary CMV infection or not- CMV IgG and CMV IgM antibody both together are positive, or your CMV IgG antibody goes from negative to positive during a known defined period of time- called a seroconversion. A CMV avidity IgG index is also helpful as well. If the avidity index is high, then CMV was acquired a while ago, if CMV avidity index is low, then the CMV infection was more recent.

      If you are pregnant and experiencing a primary CMV infection, then consider consultation with a maternal fetal medicine specialist experienced with CMV infections, to assess the well-being of your fetus by fetal ultrasound and to assess if fetal transmission of CMV has occurred by amniocentesis. Also, there is a clinical trial evaluating CMV hyperimmune globulin for women who are pregnant and experiencing primary CMV infection, to try and reduce transmission of CMV to the fetus (www.clinicaltrials.gov). If your fetus does acquire CMV and has symptoms, then prenatal treatment with CMV hyperimmune globulin may also be indicated to help reduce the fetal symptoms while in utero and help the placenta.

      Your baby should be tested for CMV at birth to see if congenital infection has occurred. Whether your baby is CMV positive or negative for congenital CMV (test urine or saliva for CMV to determine congenital infection, not antibody), you may breast feed your baby, provided there are no other contraindications to breast feeding.

      We encourage breast feeding- CMV infection during pregnancy and even congenital CMV infection in your baby is NOT a contraindication to breast feed, unless there are other contraindications such as extreme prematurity or feeding problems. In that case, your neonatologist and lactation support nurse will help with breast milk processing to reduce CMV or other alternatives. Usually testing breast milk for CMV is not helpful or necessary. Human breast milk likely will have small amounts of CMV in it in CMV seropositive moms, but that is not a concern or problem for your baby if your baby is otherwise healthy.

      Also, babies with congenital CMV or their mothers do not need to be isolated in the hospital. Universal precautions and hand washing is all that is needed.

      I hope this information is helpful to you. Best wishes for a healthy pregnancy and baby!

      Dr Gail Demmler Harrison
      CMVDOC

  163. Tammie Shafer says:

    Dr. Gail,
    Thank you for all your information. My grandson is getting released from the hospital tomorrow and will be able to go home. He is still on oxygen and some medications. I told his doctors about the work that you do and asked that they contact you regarding any evidence that shows keeping him on the valganiciclovir for an extended period of time to help with brain development and growth (they said they have put a call in to you but haven’t heard back yet). His MRI showed that he is lacking adequate folds in the front part of his brain and his head circumference growth has been flat for a couple weeks. I want to be sure that my son and his wife have all the information they need to make the best decisions for their son (Sawyer). If there is evidence that extending the medicine shows improvement in brain development I want them to be aware of it. The doctors at Baystate weren’t aware of this. I don’t want Sawyer to miss out on something that may help him and then finding out later that they should have extended the medicine and it’s too late. I know there is a clinical study that was completed on this called the CASG 112. If you can offer any information on this topic I would greatly appreciate it. Also if you could contact Sawyers doctors at Baystate Children’s Hospital in Springfield MA to give them this information as I well. I would be in great appreciation. I’m trying to give Sawyer the best chance at life. He is a precious boy who deserves the best chance he can get. Thank you again, Tammie Shafer

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Tamie

      It is difficult for me to provide detailed recommendations. I do sympathize with you and your family and your doctors about your grandchild’s condition. Extended 6 months of valganciclovir may provide benefit to some babies, but not to all. Also, consideration must be given to side effects of valganciclovir, and many other medical considerations. If your grandson is severely affected from congenital CMV, then valganciclovir treatment may be just one of many issues of treatment they are considering.
      The doctors and nurses and therapists caring for your grandson are in the best position to know what is best overall for his care.
      I hope this information is helpful to you.
      I wish you and your family all the best.

      Dr Gail Demmler Harrison
      CMVDOC

  164. Kavita Kamath says:

    Dear Dr. Gail,
    Thank you for the information you’ve shared with all of us…. I recently lost my baby in the 16th week of my pregnancy (this was my first pregnancy)..the baby was just 12weeks 6 days at the time…
    My doctor had asked me to get some tests done like TORCH, ACA etc. My CMV IgG is reactive (235.6), however my CMV IgM is non reactive (0.78).
    I’m extremely worried…will this affect my future pregnancy? What treatment and/or precaution do iI need to take?
    How long do we need to wait before trying to conceive again?

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi Kavita,

      Thank you for your post on my TCH CMV BLOG.
      I am so sorry for your recent loss.

      The presence of CMV IgG antibody alone does not necessarily mean your fetal loss was due to CMV. CMV antibody is very common, and 50% to 80% of healthy women will have CMV IgG antibody. The presence of CMV IgM antibody indicates a recent infection, but since your CMV IgM antibody was negative, it makes it less likely CMV played a role in your fetal loss.

      Now that you are CMV IgG positive and CMV IgM negative, there is minimal to no risk for CMV to affect your next pregnancy. Rarely, CMV may reactivate and infect the fetus, but that is unusual and almost always the baby will not have symptoms from the infection. When you are healthy and physically and emotionally ready again to try another pregnancy, from the CMV perspective, at least, things should be fine. You should consult your doctors for the best advice however, since they know your medical history.

      You will remain CMV IgG positive for your lifetime. It is not necessary to repeat the testing any more.

      I hope this information is helpful to you.
      Best wishes for a healthy pregnancy next time.

      Dr Gail Demmler Harrison
      CMVDOC

  165. Kirsten Locke says:

    Thanks Dr. Gail.
    I’m not sure of the numbers. My doctor just told me that when I was really ill with the bronchitis/sinus infection and pneumonia that I also had CMV. He seemed to think I would have caught it as a kid, so maybe he knew by the numbers that is was reactivated. Anyway, he said they’ll check the placenta down the road but that is what is causing my preterm labor. I have weekly appointments so I see him again Tuesday and I’ll ask if it was primary or reactivated.
    Thanks!!

  166. Alen says:

    Respected Dr Gail,

    I am very happy to see your comments and help you provide to those are in need of your information.
    My question is, MY wife had a previous infection of CMV, now she is alright, doctors said she is ready for pregnancy. But my doubt is if the baby born as preterm ( < 35 weeks), if the baby catches the CMV either in birth canal during the delivery or by breast feeding, is it going to create problems to the baby?

    Thanks in Advance.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thank you for your post on my CMV blog. I am happy to hear your wife has resolved her CMV infection and is ready to start again with another pregnancy.

      You ask a very good question, and the answer is somewhat complicated.

      Women who are CMV seropositive remain so for life, and during pregnancy, they may reactivate their CMV infection. This is a normal and natural occurrence. At the same time they reactive their CMV infection, they also have their own CMV IgG antibody, which is also passed to the newborn baby, usually at or around or after 28 weeks gestation. This is actually “Mother Nature’s” way of providing CMV infection and CMV immunity at the same time, and most of the time the baby is then immune to CMV lifelong.

      Healthy term babies and preterm babies may acquire CMV infection from their mothers through the normal birth process and the normal breast feeding process, but they also at the same time receive their mother’s CMV IGG antibody, which is protective.

      CMV may cause problems in extremely premature infants especially if they do not have CMV antibodies.

      If your next baby is born very premature or extremely low birth weight- before 28 to 30 weeks gestation or below 1800 grams, then there is a possibility CMV may be transmitted without antibody from the mother and there is a slight chance it may cause some disease. If it does, then there are treatment medications available – if the CMV infection is severe.

      There is really nothing that can be done to prevent perinatal CMV infection from the birth canal. CMV may be transmitted form the breast milk if it is fresh. Breast milk may be treated by freeze/thawing to reduce CMV in it or pasteurized, but this also lowers some of the immune benefits of breast milk.

      Your lactation specialist may be able to help with alternatives if your next baby is extremely premature.

      However, most likely your next baby will be term or near term, and healthy, and you and your wife will be able to deliver and feed and care for your baby in a normal fashion.

      I hope this information is helpful to you.

      Best wishes for a healthy pregnancy and healthy baby!

  167. Sara says:

    Dr. Gail,
    I am so relieved to have found your blog! Finally.. an expert in this area! I’m hoping you can provide some guidance on next steps for my situation..
    I’m currently 12 weeks 5 days pregnant. My bloodwork came back Igm positive (greater than 2.0) but Igg negative (less than .09). My Ob/gyn is running some follow up tests because she mentioned that it was strange that my igg was negative. Is this indicative of a primary/active infection?
    Can you suggest additional testing to confirm if the CMV is active and has affected the baby? Should I go to a perinatal or infectious disease specialist? Also, any advice on next steps would be greatly appreciated!
    Thanks in advance

    • Sara says:

      One important point that I forgot to mention.. my husband was diagnosed with CMV in late march/early april. It has since gone into remission and is only present as igm negative igg positive in blood work. We conceived in very late June (27-30)or very early July. Thanks again!

      • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

        Dear Sara,
        Thank you for your post on my CMV blog.

        Your OB is correct, the presence of positive CVM IgM antibody and negative CMV IgG antibody is indeed unusual. However, it can occur if the blood test was performed very early in a primary CMV infection. Usually the CMV IgG and CMV IgM antibodies will rise simultaneously, but in some women theCMV IgM antibody may rise 1 to 2 weeks before the CMV IgG antibody has a chance to react. Since you also have had a CMV close exposure from your husband, it is likely, but not yet confirmed, you may be experiencing a primary CMV infection during this pregnancy. Transmission of CMV from a husband to a wife has been documented.

        IF you have experienced a primary CMV infection during yoru pregnancy, then there is about 40% chance CMV may be transmitted to your fetus. There are, however, steps that can be taken.

        I recommend:

        – You repeat your CMV IgG and CMV IgM antibody tests to see if the CMV IgG antibody is now reacting.
        – Have your fetus assessed by ultrasound.
        – Consult a maternal fetal medicine doctor experienced in CMV infections in pregnancy.
        – Consider enrollment in a multicenter randomized clinical trial on the use of CMV hyperimmune globulin to reduce the risk of CMV transmission to your fetus- go to http://www.clinicaltrials.gov and search CMV hyperimmuen globulin – many maternal fetal medicine centers around the country are participating in this clinical trial.
        – If a clinical trial site is not close to you, then ask your OB or your maternal fetal medicine specialist about CMV hyperimmune globulin infusions to be given during pregnancy to reduce risk of transmission to your fetus.
        – Perform amniocentesis at 18 to 22 weeks gestation to test the amniotic fluid for CMV to determine of CMV transmission has occurred to your fetus.
        – If CMV transmission has occurred during pregnancy, your baby should be watched carefully in utero.
        – At delivery, you should also test your newborn for CMV infection with a CMV urine or saliva culture test.
        If your newborn has CMV infeciton, then evaluations and possible antiviral treatments may be recommended.

        I hope this information is helpful to you.

        You are welcome to post again with followup questions as your pregnancy proceeds.

        Best wishes.

        • Sara C says:

          Hi Dr. Gail,
          I hope you have been well! I wanted to give you an update on my situation and ofcourse ask for your advice. My obgyn ran a CMV avidity test (sent to Mayoclinic). It took about 2 weeks to get the results, however, both Igg and Igm came back negative. The test results state…”CMV IgM -Mayo negative, CMV IgG Avidity – The specimen was negative for CMV specific IgG. Thus IgG avidity could not be measured.”
          My OB suggested that the first blood test from total labs may have been a false positive. Do you suggest that I continue to run the CMV or CMV avidity test every two weeks for the next 6 weeks or so to make sure this remains negative? Any advice would be greatly appreciated.
          Many thanks!
          Sara

          • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

            Hello Sara,

            Yes your OB is correct, if a repeat CMV IgG and IgM antibody is negative and a CMV avidity index cannot be run because the CMV IgG antibody is negative, then the first CMV IgM test result was most likely a false positive test.

            Just to be sure, it would be prudent to have one more set of tests done – so that if you have two sets that show negative, then you have your answer.

            Also, if you are pregnant and CMV negative, then practice CMV precautions outlined in my blog post to reduce your risk of acquiring CMV infection during pregnancy.

            Best wishes for a healthy pregnancy.

  168. Anastasia says:

    Hi,
    I am sorry about my English. I am 38 years , live in California and 22 weeks pregnant. I recently had my 18 week ultrasound and the doctor saw an echogenic bowel.
    We didn’t have any other abnormalities on the scan.
    I have had the standard tests and found out that I have tested positive IGg and Igm for CMV. After 2 weeks I did the amnio and I have told that the baby is fine.
    Does this mean that I should not be worried anymore? Can I infect the baby during the delivery if my Igm is positive?
    Do I have to do one more blood test for CMV before delivery?
    Thanks in Advance

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Anastasia,

      Thank you for your post on my TCH CMV BLOG.
      Echogenic bowel may be an early finding of congenital CMV infection in the fetus. However, it is nonspecific and may mean many other things.
      If you had a positive CMV IgG and IgM antibody then you may be experiencing a primary CMV infection during your pregnancy and have a 40% chance of transmitting CMV to your fetus during pregnancy.
      So the combination of CMV positive IgG and CMV IgM in your blood and echogenic bowel finding on fetal ultrasound of your baby suggests, but does not prove, it is possible your baby may have a CMV infection.
      The way to prove your baby may or may not have CMV is by amniocentesis.

      I am happy to hear you had an amniocentesis to check on the status of your baby. When you said “the baby is fine,” what tests were performed? Was CMV DNA PCR or CMV culture performed on the amniotic fluid? That is the test for CMV infection of the fetus. If the CMV DNA PCR on the amniotic fluid was negataive, then that means CMV was not transmitted to your baby and your baby’s echogenic bowel was not due to CMV. If CMV DNA test was positive, however, then that means CMV was transmitted to your baby, and more evaluations and possible treatments may be indicated.

      There is really no need for you to have any additional CMV antibody tests during pregnancy. The important test is CMV DNA testing on the amniotic fluid from amniocentesis to determine if CMV transmission occurred to your baby.

      I hope this information is helpful to you. Best wishes for a healthy pregnancy. You are welcome to post followup responses on my blog.

      • Anastasia says:

        Dr. Gail,
        Thank you for your answer. Yes, I did CMV DNA PCR test on the amniotic fluid and it was <200(negative). But I don't understand, can I infect the baby during the delivery ? And if the answer is yes, whether it is dangerous for the baby?

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          Dear Anastasia,

          A negative amniotic fluid for CMV DNA suggests no fetal infection was present. Good news.

          Any woman who is CMV antibody postive for CMV IgG remains positive for life, and she may reactivate her own CMV infection in her breast milk and her cervical/vaginal secretions. During delivery, there is a small chance your baby may aspirate CMV infected secretions or during breast feeding, ingest CMV infected breast milk. However these are common and normal and natural ways of acquiring CMV infection when the baby also has a CMV IgG antibody immunity, designed by “mother nature,” so the infection is almost always silent or aysymptomatic and not dangerous to the baby, and confers life long immunity. The only times CMV infectton acquired in this manner (perinatally is the medical term) is if the baby is very premature and does not have CMV antibody yet transfered thorugh placenta and from the mother, or if the baby has a primary or acquired immune disorder and an abnormal immune system, so that the baby cannot fight off any infection.

          I hope this information is helpful to you.

          Best wishes.

  169. Jaclyn says:

    Hi Dr Demmler,

    Quick question – my son was born with Congenital CMV in June of 2012 and I have since had the avidity test (94%) and a blood test where my IgG was negative. I am currently pregnant again. Do I need to be concerned about other strains of CMV? My daughter had Coxsackie virus a couple of weeks ago. From speaking with my doctor it seems like I shouldn’t be terribly concerned about Coxsackie. (I am 12 weeks now and my nuchal test was fine). How do I stay calm and not worry about other things harming my unborn baby? What should I be concerned about if anything and what can I do besides wash my hands as often as possible?

    Thank you,

    Jaclyn

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      HI Jaclyn,

      Thank you for your post on my CMV blog.

      A positive high CMV IgG avidty test and a negative CMV IgG antiboyd test do not make sense. I think you meant CMV IgM was negative and your CMV IgG avidty index was high at 94%. If this is what you meant, then these are good values for CMV and puts you at minimal risk of transmission of CMV to your fetus in utero. That is good news. If that is not what you meant, please repost and I will respond again.

      It is possible, rarely, for a recurrent CMV infection to occur in CMV IgG positive pregnant women. Their own CMV strain may reactive, or they may rarely acquire a new CMV strain from another person. This is estiamted to occur <1% of the time. So if you are around toddlers frequently, or other individuals at likely risk of having active CMV infection, you may wish to practice CMV precautions outlined in my blog. But it is not of a great concern for most women.

      Coxsackie virus is an RNA virus not related to CMV. It is a common cause of respiratory infections, diarrhea, and also rashes and lesions in the mouth and skin in children. Teenagers and adults also may become infected. It is common in summertime. It is self limited. It rarely is transmitted to the fetus from the pregnant women, and if it is transmitted, it is usually some time directly after birth. So your pediatrician is correct, you should try to not worry about either one of these viruses during your pregnancy.

      Best wishes for a healthy pregnancy.

  170. Amy says:

    Hello Dr Gail,

    This is probably an unusual question. I am recently pregnant after having several miscarriages. I have seen a reproductive specialist and they often recommend acupuncture to their recurrent miscarriage patients (they do with IVF patients as well) – the theory is that it increases the blood flow to the uterus and helps maintain the pregnancy.

    Here is my question – I am completely CMV negative. I have been tested several times throughout all of my pregnancies and I have no immunity against the virus. I have a 2 year old who attends full time day care so I am taking every precaution possible to prevent getting the infection from him. Do you think I am taking a risk by getting acupuncture? The needles are sterile, single use and in a tube (so her hands never touch the needle) so this day in age the risk of infections from acupuncture are generally low – but I worry that if I had the virus on my skin it could transmit through the needle? How long does it live on your skin outside of the body and can it be transmitted by touching objects, the way a cold or flu can, especially since I live with a toddler who may be exposed to it at day care? Is it easily killed by an alcohol swab? She does swab the insertion points with alcohol the same way a nurse would before drawing blood or giving a flu shot… I still can’t help but worry that I’m taking a risk, because of my negative status.

    Thanks so much for your input.
    Amy

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Amy,

      Thank you for your post on my CMV blog.

      I am happy to hear you are CMV aware and will practice CMV Precautions while pregnant to reduce your risk of acquiring CMV during pregnancy.

      Regarding your specific questions about acupuncture and CMV, if the acupuncture needs are handled with clean/sterile technique and performed by a properly licensed professional, there should be no greater risk regarding CMV transmission from acupuncture. CMV does not stay on the skin very long and after secretions have dried it should not be transmissible. The main route of transmission of CMV from person to person is through close contact with secretions from mucous membranes and not skin. Also, since CMV is an “enveloped virus,” that is it has a soft fragile outer covering called the “envelope,” it does not survive very long outside the body and outside of secretions. CMV is also inactivated quickly by soap and water and alcohol and other disinfectants used to prepare the skin for procedures. Therefore, if your doctor has recommended acupuncture, you should feel comfortable having the procedure, since it will not increase your risk of CMV infection during pregnancy.

      I hope this information is helpful to you.

      Best wishes for a healthy pregnancy!

      • amy says:

        Thank you so much for responding. I feel a little better now that I understand how the virus works, and it’s good to know that it has a short life outside the body. May I ask you something else? Can it be transferred through skin abrasions? My hands appear as if the have a million paper cuts on them, most likely from washing them so much, and I worry about bathing my son? If he spits or pees in the water (he’s a typical 2 year old boy….) Could the virus go right into my bloodstream through little cuts on my hands?

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          Dear Amy,

          There is no evidence to show CMV is transmitted through skin abrasions. Furthermore, once dispersed into soapy bath water, should your son spit or drool or pee in his bath water, CMV should be inactivated. However, if you wish, you can use lotion or Vaseline petroleum jelly to heal and coat your hands and then wear gloves while changing his diapers or bathing him while you are pregnant.

  171. Kate says:

    Good morning,

    I’m 5 mounths child’s mother from Poland. My daughter has been infected by CMV. I write to ask basic question. In polish clinic I’ve not got answer to question below:
    Is my daughter should be treated for cmv?

    Describes the case of daughter:
    The daughter is 5 months, developing normally neurologically, in research and abdominal ultrasound chief: No irregularities. Eyes test: fine.
    Symtom of CMV: a moderate bilateral hearing loss. Research for CMV: IgG positive, IgM negative, blood PCR: presence of the virus, cerebral spinal fluid: no presence of the virus. Virus is excreted in the urine.

    My status in pregnancy: lack of research on the virus CMV. Colds, cough occurs in 7 mounth pregnancy, colds during labor and after birth. Research for CMV after 3 mounth after labor: IgM negative, IgG positive.

    My questions:
    1) Is my daughter should be treated for cmv? (In Poland I received a reply that the treatment is risky, doctors do not want to take treatment of his daughter at the age of 5 months).
    2) Whether during pregnancy or around birth may have been a reactivation of the virus, with the effect of hearing loss in her daughter?
    3) What tests should I do more related to my dougher?

    I would be greatful for information.

    Kate, from Poland

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Kate,

      Thank you for your post on my CMV blog.

      Treatment with oral valganciclovir (oral solution taken by mouth twice a day at a dose of 16 mg/kg/dose — range 15 to 18mg/kg/dose– every 12 hours) is recommended for infants born with proven congenital CMV infection who have evidence of hearing loss in infancy, or evidence of eye disease or other neurological involvement such as abnormal brain size or imaging. Treatment is given in the first 6 weeks to 6 months of life only in most cases (latest information shows 6 months treatment is likely to be beneficial) improves hearing loss risks, improves brain size growth, and improves developmental milestones.

      Since your child is almost 6 months of age, treatment with oral valganciclolvir medication at this time is not likely to improve her outcome starting so late and giving medicine for only a month or so. We do not know whether or not treatment over 6 months of age is beneficial, and most experts do not recommend treating longer than 6 months.

      If the presence of CMV virus in your daughter’s blood is very very high, then treatment may be needed, or if she has something wrong with her immune system that leads to her inability to remove active CMV infection from her blood, then treatment may be necessary. These, however, are rare instances. Your doctors should be able to help with this. A low level of CMV in the blood should gradually decline and disappear over time without treatment in most healthy children. Some studies have shown a correlation of presence of CMV in the blood and development of hearing loss in children with congenital CMV infection, and therefore that is why antiviral treatment early in life may provide some benefit.

      Your CMV IgG positive CMV IgM negative antibody levels done 3 months after birth just show you had CMV infection sometime ago. CMV IgM antibody drops off or falls off to negative within 6 weeks to 6 months usually after primary infection. So it is impossible ot tell if you experienced a primary (first) CMV infection or a recurrent/reactivation CMV infection during pregnancy and infected your daughter. At this point in time, it does not really matter. Moving forward, you will keep your CMV antibody and your CMV immunity and pass it along to your next baby. You may reactivate your own CMV strain of virus and shed it in your secretions and breast milk, and may pass CMV along to your next child this way, but you will also pass along your antibody and immunity, and this type of CMV infection usually has no ill effects or consequences for most children.

      Regarding your daughter, the best to do now is close observation of her hearing and provide speech and language therapy for her speech. Hearing aids may be required if her hearing becomes progressively more severe or she experiences profound loss.

      Careful attention to her development in the language area is important, since she may need tutors, need to learn sign language, or receive special therapy to develop speech normally.

      Other than that, based on what you have posted, she should have normal care. Of course, your own child’s doctors are the best judges of what is best for her, since they know her case and have personally cared for her.

      Best wishes to you and your daughter. I hope information provided here has been helpful.

  172. Helene says:

    Hi,
    First, I would like to thank you so much for all the informations on this blog.
    I was just tested positive for CMV IgM (1.25). My IgG test didn’t come back yet…I know I need to have this result before any interpretation but still have some question.
    We are trying to conceive, I read on this blog that you recommend women to wait till IgM are negative or low, and IgG are high avidity >60% to get pregnant.
    What do you consider a “low IgM”? Is 1.25 low? Is it likely that my infection is almost resolved if 1.25 is low?
    Thank you

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi Helene,

      Thank you for your post on my CMV blog and for your kind comments.

      A low CMV IgM antibody is best interpreted as level that is reported as negative range. If you are CMV seropositive, best profile is CMV IgM negative, CMV IgG positive, and CMV IgG avidity high.

      It is difficult to interpret how “high” or “low” a 1.25 reading is on your test without knowing the reportable ranges. If you were told your CMV IgM level of 1.25 is positive, then you should be able to find out how high above the positive cut off it is. The report should have on one side a “range” of negative, intermediate and positive values. That should help you a little in trying determining how high is your CMV IgM antibody.

      If your CMV IgG antibody is also positive, then that is good evidence your may be experiencing a primary CMV infection at this time, or also possibly a recurrent CMV infection. A CMV IgG avidity index should then be performed. If your CMV IgG antibody is negative when your CMV IgM antibody is positive, then a false positive test is possible, or it is also possible you may be in a very early stage of a CMV primary ifnection. Either way, you should have the tests repeated in 2 to 4 weeks to clarify any trends before you begin starting to try for a pregnancy.

      I hope this informaiton is helpful to you. Please also consult with your own doctors for the best recommendations for your individual situation.
      Best wishes for a healthy pregnancy.

      • Helene says:

        Thank you Dr for your help.
        I just had my igG result and it’s negative (0.33)…
        I was actually suspecting CMV because my baby had a “mono infection” a month ago (she wasn’t tested specifically for mono but only had a regular blood test with counts of cells), and I realized that CMV symtoms could be the same or very similar to a mono: she was very tired, had a small rash, fever during 4 – 5 days, sore throat,…

        So now, I am doing a CMV PCR DNA to check the presence of virus. I am scared that if it’s at the very beginning of the infection, they won’t detect the virus… How early can this test detect infection? Will it give an estimate of when I was infected?

        Also, you are mentionning false positive, is that really common?

        Should I ask for a repeat of the IgG IgM?

        Cheers and thank you again

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          Dear Helene,

          A positive CMV IgM and a negative CMVIgG antibody may indicate a false positive CMV IgM antibody, which actually are fairly common and not rare. A repeat of both of these tests should be performed to see if the same pattern stays or to see if hte CMV IgG antibody is now positive also. Usually both tests are positive during a primary CMV infection, and the CMV IgM levels will gradually decline as the CMV IgG antibody stays positive lifelong. Only rarely will the CMV IgM antibody be positive without the CMV IgG antibody being positive on the first sample. If a true CMV infection is present, then a repeat test should show both CMV IgM and CMV IgG positive by now.

          A CMV DNA PCR test on the blood may or may not be positive at the beginning of a CMV infection, and it is not really the recommended test to perform to determine acute CMV infection in an otherwise healthy adult. It is helpful but not definitive.

          Other infections may cause a “mono” syndrome, and perhaps testing for these other infections should be tested. Please consult your doctors about this issue.

          • Helene says:

            6 weeks later my IgG are still low!
            So I guess my IgM were just a false negative…good thing because I am 9 weeks pregnant!
            Thank you Dr for your help!!

  173. Kate says:

    Good morning,

    Thank You for response.

    At this moment my doughter is supervised by audiologist doctor. She has proven hearing loss in the range of 40-50 dB (in 2 researches). We have resumed PCR blood test to know how a level of viremia is, lower or higher than previous. Now it is 381 copy (72 copy are detectable).
    In polish hospital, doctors don’t know what to do with my doughter, maybe beacouse of negative effect after treatment in her case (I heard it as well). Can be true?

    In my head there are some question/ worries:
    1) When should I worry about my doughter hearing? Have You got any information about childreen with CMV and hearing loss, in the case when this loss incresed?
    2) Is it possible that CMV has been desroying body still? What it could be? When? I mean her future ages.

    Please, if You have any information, lectures, I will be greatful for that.
    If You don’t mind I will discuss wth You future research.

    Kate

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Kate,

      The presence of hearing loss occurs in two-thirds to three-fourths of children with symptoms of CMV at birth and in 15 to 20% of children with congenital CMV who have no symptoms of CMV at birth. Hearing loss is the most common long term side effect of congenital CMV. Some studies have shown the presence of CMV viremia or positive CMV DNA levels in the blood is associated with a higher risk of hearing loss, others have not confirmed the association.

      Treatment with antiviral medications against CMV using valganciclovir or ganciclovir in the first 6 weeks to 6 months of life appears to reduce the risk of hearing loss and hearing loss progression in these infants. However, treatment beyond 6 months of age has not been shown to be beneficial and is not currently recommended for most children.

      Hearing tests should be performed at least every year for the duration of childhood and teenage years. We have seen hearing loss late onset in older children and teenagers and hearing loss progression in symptomatic children into years 20+. So the hearing loss is something that should be followed for the life of your child. Appropriate therapies for speech and language and educational accommodations for hearing impairment should be started now to help these skills develop normally in your child.

  174. Wendy says:

    Dear Dr. Gail,

    Thank you for your blog and persistence in answering questions over the years on CMV. I wish I had known of CMV earlier.
    I am writing from Singapore. I am currently 17 weeks pregnant with a pair of twins. I have had 3 bouts of flu & fever since I got pregnant. My gynae suggested a blood test for CMV and my results are:
    CMV IgG: Reactive
    CMV IgM: Reactive
    CMV IgG Avidity: Low Avidity

    So today, I went for the amniocentesis and am waiting for results.

    My questions are:
    1. If the amnio tests result shows that both babies are not infected now, are there any chances of them getting infected later as I progress with the pregnancy?
    2. I hope both babies are fine but am wondering are there chances of 1 getting infected and the other not? Or will it always be a case of both infected OR both not infected?
    3. My gynae mentioned that if my babies are infected, there is no treatment available and I may have to terminate my pregnancy. I read that you had mentioned “CMV Hyperimmune Globulin”. Is this not available outside the United States yet?

    Thank you in advance.

    • Wendy says:

      I forgot to add that I am having a pair of fraternal twins.
      Also, I just read that Amniocentesis for CMV should not be performed before 20 weeks. I am only 17 weeks today when I did the tests. Does this mean that the tests are futile?
      Thanks.

      • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

        Hello Wendy,

        Thank you for your post on my CMV blog.

        Your CMV antibody profile indicates a recent CMV infection and therefore a risk of transmission of CMV (40% approximately) to your babies. About 60% of the time, however, a recent maternal primary CMV infection is not transmitted to the fetus/baby.

        The next steps usually include:

        1) a fetal ultrasound (US) to assess if any disease is present in the babies and if the placentas are healthy or swollen and

        2) an amniocentesis to determine if CMV transmissin occurred to the babies or one of the babies.

        CMV may be transmitted to one twin and not the other, to both twins, or to neither twin.

        An amniocentesis performed at 17 weeks gestation should be accurate for outcome of CMV transmission, and many times US amniocentesis procedures at 17-18 weeks gestation are performed. Waiting until 20 weeks gestation provides the highest correlation with CMV transmission in most cases, but many obstetricians and pregnant women also do not wish to wait that long into pregnancy.

        Since most (90% estimated) of CMV infections in the fetus/baby are silent or asymptomatic, assessment of the fetal condition with fetal US is indicated to determine if the babies have a silent infection with little or no risk of serious adverse effects, or a symptomatic infection with a higher chance of adverse outcomes, or a very serious condition with high risk of adverse effects.

        Only 10% of babies infected with CMV in utero are symptomatic and at risk for developmental problems. Of those babies born with symptomatic CMV infection, not all of the babies are developmentally disabled — it depends on many different factors.

        Therefore, consideration of termination of the pregnancy based only on the results of an amniocentesis that is positive for CMV does not tell you if your babies are severely affected with CMV disease or just silently infected and will be OK otherwise. The babies should be fully evaluated with US examinations and even MR imaging in selected cases.

        Yes, there is in utero treatment available to try and reduce transmission of CMV to the fetus in a mother with CMV primary infection and treatment options if CMV infection is shown to be present in the fetus. Clinical series have suggested benefit with CMV hyperimmune globulin infusions that are given to the mother.

        There is also treatment available after birth to the baby to reduce risk of hearing loss and improve brain growth and developmental milestones. This medication is called ganciclovir or valganciclovir.

        I hope this information is helpful to you.

        Best wishes.

  175. Antonia says:

    Hello Dr. Demmler:

    I have a set of unique questions I believe that Im’ hoping that you can answer.

    I am trying to get pregnant with a known donor. I am cmv igg positive and have been for at least 6 months. I had my donor tested in July and he actually came up cmv igm positive and it seems it was a first-time infection. What are the risks with us trying to get pregnant through in home insemination while he is igm positive? Said another way – If he is shedding in his semen can that cause me to have a recurrent infection? Can it be passed to the embryo?

    I look forward to any guidance you can provide me.
    With many thanks in advance
    Antonia

  176. vivie says:

    Dear Dr. Gail,

    I had 2 miscarriages in a year and 2 months after my second (July), my OB sent me to lab for TORCH test, i only tested for the IgG because she said it is not necessary to check the IgM because if there is an infection my IgM would be negative by the time the test done.
    IgG Toxo neg
    IgG Rubella 93,1 (>= 10 is positive)
    IgG CMV >259 (reactive)
    IgG HSV neg
    She said rubella and cmv might play a role in my miscarriage, then i had to wait 3months to try again for a baby. Few days ago i rechecked my CMV status, my IgG CMV now is 845. I read somewhere that if the IgG CMV increase 4 times it means that the infection is reactivated (or it is a recurrent infection). My OB said, wait one more month and retest
    I desperately want a baby, but with this condition i feel depressed to try again. What do you think about my condition doc? Should i wait few months more? What would happen to my baby if i get pregnant again this cycle?
    Should my husband get the test too? And if he is positive, what should we do?
    Thanks for your reply

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi,

      Thank you for the post on my CMV blog.

      If a CMV IgG antibody is positive, then a CMV IgM antibody can be done, as well as a CMV IgG avidity index, if available, to determine if the CMV infection is past infection (and therefore safe to become pregnant) or a recent present infection (therefore caution should be taken against pregnancy until the infection is past).

      It is difficult to interpret the meaning of the rise in CMV IgG antibody in your case. It is difficult to determine if it is a recent new infection, with rising new antibody, or a recurrence/reactivation infection with a slight increase in old antibody. The CMV IgM antibody would be helpful as well as the CMV avidity index I mentioned.

      I hope this information is helpful to you.

      Best wishes for a healthy pregnancy.

  177. Jaclyn says:

    Hi Dr Demmler,

    I wrote to you back in September. To continue – Yes, I meant my avidity test was 94% and my IgG was 26 so I have the antibodies at the point (my IgM was negative the last time I tested but positive the time before that and negative the time before that which still confuses me).

    I still have my daughter (now 3.5) in daycare as well as my CMV affected son (in daycare) who is now 15 months and significantly delayed. I care for them both and use gloves when changing my son’s diapers and wash my hands constantly (or use hand sanitizer) whenever I touch a bottle, sippy cup, tissue etc. I am having a difficult time as I am so compulsive about hand washing. I jump down my daughter’s throat when she doesn’t wash her hands right away. I am convinced something else will happen with this pregnancy since my son’s birth was so traumatic and I was so blind sighted (I didn’t know he was CMV infected until he was born and he was very symptomatic). Any suggestions on how to be safe but not completely compulsive? Thank you again for all of your guidance.

    Praying for a typically developing child,

    Jaclyn

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Jaclyn,

      Since you have CMV IgG anibody and a high avidity index and you already had a child born with congenital CMV infeciton, your own immunity to CMV will be protective. You therefore do not need to be so compulsive and fraught with worry regarding CMV. CMV does not “strike twice.”

      Routine sensible and practical hygiene is all that is necessary now. Try to take care. Consider counseling to help you feel better emotionally, especially if your compulsions and worry are interfering with your enjoyment of life or your relationship with your family members.

      Best wishes.

  178. Wendy says:

    Hi Dr. Gail,

    I posted above on 2nd Oct.
    Look forward very much to your advice.

    Many thanks,
    Wendy

  179. Neel says:

    Hi Doctor,
    Can “CMV-IgG Antibodies to Cyto Megalo Virus By CMIA” be diagnosed ? My wife’s report test shows “REACTIVE (ABOVE 2500)”. She had miscarriage recently and these test are done after the miscarriage.
    Thanks,
    Neel

  180. Masha says:

    Dr. Gail,

    On week 13 I received cmv tests. My igm was 1.5 which meant positive. My igg was 8.5 which was also positive. On week 14 I took cmv igg avidity test which showed 61. My doctor said it was high.

    1) What does it mean? Have I contracted cmv 4 months ago (which based on current date is some time in June). Then does it mean that I got reinfected after I became pregnant? I am confused about timing and dates.

    2) What are the chances of passing infection to the baby? Will baby get igg antibodies?

    3) I plan to do amino on week 18. What should I be looking for?

    4) Is there a chance of reinfection if nothing is detected on amino? What about ultrasound?

    Thank you in advance, doctor. Please respond at your earliest convenience.

  181. Masha says:

    Dr Gail, just to continue I got results from other lab saying my igg is 2.74 and my igm is 0.8 and avidity is 0.62. These results are week apart and look very different from my previous one. Do you have any suggestions on what to do at this point, I am 15 weeks meanwhile and very worried.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Masha,
      Thank you for your post on my TCH CMV BLOG.

      I agree, the CMV studies you first posted are very different for the two times you were tested. Please consult your doctor to clarify the interpretation of the results and their validity. Perhaps the tests were done at different labs or there is an error. I am not able to help interpret the results at this time.

      In general, a positive CMV IgG antibody with a high CMV IgG avidity index indicates a past infection with CMV and less risk to the fetus. A CMV IgM antibody level may be high in a first or primary infection, a recent infection or a reactivation infection, or a false positive reaction.

      Your fetus should be assessed by your doctor as well. I hope this informaiton is helpful.

      Dr Gail Demmler Harrison
      CMVDOC

  182. Kate says:

    I continue my post from 25th of September.

    I’ve got second result from CMV PCR’s method from my daugther. It gives information that CMV in blood is negative (before it was 380 copys). Does it mean that CMV doesn’t exist in my daugther body? I add: first test was done when she was 3 months old, second – 5 months.
    What about protection after infecion (related to CMV)?

    Kate

  183. Kate says:

    One more thing…
    I received one opinion (from doctor, who knows CMV) that:
    1. If my daughter did’t have specyfic CMV symptoms after birth (exept hearing loss), she couldn’t have CMV congenital.
    2. Her hearing loss doesn’t have to be related to CMV. There are many reasons of that loss.

    Could You give me any comment to that?

    Kate

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Kate,

      Hearing loss may be caused by many conditions, including congenital CMV infection. Babies may be born with silent congenital CMV infection and only have heairng loss as the only symptom of the infection. Therefore, it is true the hearing loss may be the only sign or symptom of congenital CMV infection.

      A negative blood CMV PCR indicates the active CMV infection in blood is suppressed. CMV will remain in the body for the entire life of the person, but it is usually latent after the active infection is over.

      Dr Gail Demmler Harrison
      CMVDOC

  184. shraddha says:

    Dear Dr.Gail,
    I recently had miscarriage on 23rd October, no heartbeat detected. I was 10 weeks pregnant then.
    Recently went for TORCH test which indicated I have CMV IgG positive level 67 and IgM Negative. Was this the cause for miscarriage? Also a week prior to my miscarriage i had hives all over my body for about 4 days. Any co-relation between the two?
    How long should I wait to conceive? Will i pass this virus to my husband through contact?
    Will these levels pose any threat for future pregnancy? Is there any cause for concern? What precautions i need to take in future? When should i go for the test again?
    Will be grateful for your kind reply.

    Thank you.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi,
      Thank you for your post on my TCH CMV BLOG. Condolences on your loss and recent miscarriage.

      The presence of CMV IgG antibody is common, and over half of women of childbearing age will be CMV IgG antibody positive and CMV IgM antibody negative. Your CMV test results (CMV IgG positive and CMV IgM negative)
      most likely indicate a past CMV infeciton and therefore a recent or acute primary CMV infection is not related to your recent miscarriage.
      CMV is transmitted between close individuals thorugh exchange of body secretions, and it is difficult to tell if CMV has been passed between you and your husband. It is a common virus and is usually transmitted silently.
      Please consult your doctors about the best time to try and conceive again.
      Best wishes for a healthy pregnancy in the future.
      I hope this information is helpful to you.
      Dr Gail Demmler Harrison
      CMVDOC

  185. Helene says:

    Hello Dr,
    I have a question regarding CMV resistance.
    How long can a virus survive outside of the body. Let say, if a CMV infected kid uses a spoon, how long will it take before the viruses on the spoon become “inactive”? Hours? Days? Weeks?
    Thanks

  186. Pani says:

    Hi Dr Gail,
    Thanks for providing so much information. It is very useful.I’m contacting you from UK.

    I got pregnant thru IVF, but the pregnancy ended due to Primary CMV infection in the first weeks of gestation.
    The infection occurred back in August 2013 and the pregnancy ended in October.
    I have been told that I need to wait 6-12 months to get conceive, but because I am almost 36 and need to go thru IVF again I don’t want to wait that long.
    Can you please tell me what tests I need to do before trying to conceive to make sure I’m ready. And when do you propose I should not worry about CMV anymore?

    Thanks so much!

    Pani

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi Pani,

      Thank you for your post on my TCH CMV BLOG.
      It usually takes 3 to 6 months to resolve a primary CMV infection; for some women it may take 6 to 12 months.
      Your doctors know your case best and are the best ones to provide recommendations.
      However, CMV tests that can be used to determine if you have resolved your primary CMV infection include the following–and may be helpful in determing the safe time for next pregnancy try.
      CMV IgG antibody- this will remain positive for life
      CMV IgM antibody- this level should become negative in 3 to 12 months- when it does, it signifies a resolved primary CMV infection
      CMV IgG avidity index- it is low index during a recent primary CMV infection and high index when the CMV infection is past and resolved.

      I hope this information is helpful to you.
      Best wishes for a healthy pregnancy next time around!

      Dr Gail Demmler Harrison
      CMVDOC

  187. adhitya says:

    dear Dr. Gail Demmler-Harrison

    i have big question
    right now my wife is pregnant for 11 weeks.. we have TORCH test and the result is positive in CMV (IgG 100.8, IgM 1.09).
    it that can infecting our fetus?
    what should we do to prevent the infection to our fetus??
    sorry if my English is bad

    thank you very much for your response

    regards,
    adhitya

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Adhitya,

      A positive CMV IgG antibody means CMV infection happened sometime and a positive CMV IgM antibody means the CMV infectio happened recently. If the interpretation of the numbers is positive for both IgG and IgM then there is a 40% chance of CMV infection in the baby, but only a small proporiton (10 to 15%) of the babies who are infected are symptomatic. Most have no symptoms. Administration of CMV hyperimmune globulin may be of help in some cases to reduce risk of CMV transmission and symptoms to the baby.
      Inquire with your doctor about this to see if it is indicated in your situation.
      If the interpretation is positive for CMV IgG but negative for CMV IgM ( I am not sure the number value you indicated is positive fo rthe CMV IgM) then the risk of CMV infection fo rhte baby is <<0.1% or nil.
      I hope this informatio is helpful to you.

      Dr Gail Demmler Harrison
      CMVDOC

  188. sarah says:

    Dear Dr Demmler-Harrison,
    I was so happy when I found this blog. I have some questions regarding CMV during pregnancy. I am currently 27 weeks pregnant with my second child, my first being a 19 month old healthy baby. I am a nurse and work in surgery. I had a patient the other day whose CMV status was not aware to me until after my care for him was over. Our computer systems were down and I could not fully assess his history preoperatively. He is a transplant patient, and his CMV IgG from May 2012 was positive. His plasma PCR from last month was negative. I have been taught on modes of transmission and other things about CMV but the labs are still what are confusing. I know that this means he has been exposed but does not currently have an active infection. I did use gloves for any contact that would have brought me into contact with bodily fluids or anything like that but before we went into the surgery, I touched his hand with my bare hand. After the surgery was over I put a piece of gum in my mouth and cannot remember if I washed my hands or not from when I touched him until then. How possible is it for me to become infected this way? I have been overly paranoid about everything after some of the possible exposures I have had this pregnancy and am just wanting some insight.
    If I do become infected this way, what are the chances that my baby will be affected between here and birth?
    I had the anatomy screening done at 20 weeks and at my last appointment, the results were not back yet. I go next Tuesday for another appointment with OB and assume if there was something on the ultrasound that was alarming they would have contacted me by now. I have been told that everything has been fine up until now regarding my health and this baby’s throughout the pregnancy.
    I also should say that I am unsure of my prior exposure or IgG/IgM. I have never been told that I had been exposed and am unsure of previous exposures. Also, I am not sure if any of my labs my dr has done were for CMV because I have read that it is not usually required or recommended because of its prevalence. I appreciate your answer.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi Sarah,

      Transmission of CMV from patient to health care worker has never been convincingly documented in the era of universal precautions and good handwashing technqiues. Hospitals are not the common venue for CMV transmission between people. CMV is transmitted by blood products and organ and marrow transplants however.

      The presence of CMV IgG antibody is a common occurrence in all ages and does not necessarily mean an active CMV infection is present. Adults usually do not shed CMV in large quanties in their body secretions. Close contact with body secretions ar eneeded for transmission of CMV. Casual contact you described does not result in CMV transmission. CMV does not last long outside the body and does not stay viable on surfaces outside the body for very long.

      The most common source of CMV to pregnant women is most likely their own family and friends, especially young toddlers and children who attend day care, or other group child activity venues where they mix and mingle. Toddlers are Hot Zones for CMV and often shed the virus silently in their saliva and urine.
      Therefore, since you are pregnant and live with a toddler, I strongly recommend, while pregnant, you
      practice the CMV precautions emphasized in my BLOG as well as on the CDC websitesite (www.cdc.gov/cmv).

      I hope this information is helpful to you.
      Best wishes for a healthy pregnancy!

      Dr Gail Demmler Harrison
      CMVDOC

  189. Amy says:

    Hello Dr Gail,

    May I ask you – what is the time frame during the pregnancy when CMV does the most harm?

    From what I understand, I think if you catch it between weeks 2-20 (or something like that), the rate of transmission is lower, but the negative effects on the fetus could be higher. And I think I’ve read that women who contract CMV during the last trimester have something like a 75% rate of transmission, however, the baby is usually born without any symptoms. (although, I do not know if that means they usually do not develop symptoms such as hearing loss or learning problems later – does it?)

    I am 12 weeks pregnant and have a toddler in day care who seems to be sick every other week. I had a false positive scare with a previous pregnancy, which was the first time I ever heard of CMV, so now I am very afraid of catching it. I am completely negative – have never had the virus and have no immunity. I follow all of the precautions and have also been getting tested every month, just to be on the safe side (I’m aware of the globulin treatments if I do contract the virus).

    How long during the course of this pregnancy should I keep getting tested? Is there a point where if I caught it. the odds my child being effected are low? I was thinking of continuing testing every 4-6 weeks until 20 weeks, and then maybe again as I get closer to delivery. I won’t stop taking the precautions, I was just wondering when I can worry a little less about it.

    Thank you so much!!!
    Amy

  190. Tifanie Buchanan says:

    My 3 year old was just tested positive for CMV. What steps should we take next. And should i get my 20 month old tested also.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Tifanie,

      CMV is a common finding in toddlers and preschool aged children. Between 30% to 80% children between ages of 18 months and 3 years may be actively infected with CMV. Most of the time CMV does not cause any signs or symptoms and is shed in their saliva and urine for several months, then resolves.
      It is not necessary to test otherwise healthy toddlers and pre school children for CMV.

      Toddlers and pre schoolers in the home may be sources of CMV for their family, including their mothers who are pregnant with another child.
      If you are pregnant, it is best to assume any toddler or preschooler is actively shedding CMV and practice recommended precautions to reduce CMV transmission while pregnant.

      I hope this information is helpful to you.

      Gail J Demmler Harrison MD
      CMVDOC

  191. Beth says:

    Dr. Demmler Harrison,

    I am currently 26 weeks pregnant and was tested positive for CMV (IGM and IGG). My doctor requested avidity testing. I experienced flu symptoms for 3-4 days during my 22-23 week of pregnancy. We had a good 20 week scan, but I was sick after the scan. My husband and I are very worried. Any thoughts on our case? What are our options other than waiting and praying for a healthy baby girl. We live in the Cleveland, OH area. Thank you.

  192. Beth says:

    Dr. Demmler Harrison,

    I am currently 26 weeks pregnant and was tested positive for CMV (IGM and IGG). My doctor requested avidity testing. I experienced flu symptoms for 3-4 days during my 22-23 week of pregnancy. We had a good 20 week scan, but I was sick after the scan. My husband and I are very worried. Any thoughts on our case? What are our options other than waiting and praying for a healthy baby girl. We live in the Cleveland, OH area. Thank you.

  193. Beth says:

    Dr. Demmler Harrison,

    I am currently 26 weeks pregnant and was tested positive for CMV (IGM and IGG). My doctor requested avidity testing. I experienced flu symptoms for 3-4 days during my 22-23 week of pregnancy. We had a good 20 week scan, but I was sick after the scan. My husband and I are very worried. Any thoughts on our case? What are our options other than waiting and praying for a healthy baby girl. We live in the Cleveland, OH area. Thank you.

  194. Beth says:

    Dr. Demmler Harrison,

    I am currently 26 weeks pregnant and was tested positive for CMV (IGM and IGG). My doctor requested avidity testing. I experienced flu symptoms for 3-4 days during my 22-23 week of pregnancy. We had a good 20 week scan, but I was sick after the scan. My husband and I are very worried. Any thoughts on our case? What are our options other than waiting and praying for a healthy baby girl. We live in the Cleveland, OH area. Thank you.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi Beth–

      A positive CMV IgG and positive CMV IgM antibody test suggests a recent CMV infeciton may have occurred within the last 3 or 4 months. A CMV IgG avidity index may be helpful in determining how recent the infection occurred. Low index means very recent, and high index means past. However, the reliability of the avidity index tests may vary. Someitme sCMV IgM atnibody will elevated to a slight level during a recurrent CMV infection from a past CMV infection. Rarely, positive CMV IgM may mean a false positive reaction.

      The best and most accurate way to assess your fetus is
      1) fetal ultrasound for fetal well being, problems with growth and organs and head and brain growth and placenta size and diameter-sounds like your US was reassuring but before you experienced your illness, so it should be repeated
      2) amniocentesis to test for CMV by viral culture and CMV DNA testing- that is the best way to determine if CMV infection has occurred in your fetus- only 40% of maternal primary CMV infections will transmit to the fetus and only 10% to 15% of CMV infected fetuses will have severe symptoms from CMV requiring treatment and interventions. Most CMV congenital infections produce little or no symptoms in the fetus and newborn, or may only cause hearing loss.

      CMV hyperimmune globulin may be used to reduce risk of transmission of CMV to the fetus after a maternal primary CMV infection; it also may be helpful in reducing the effects of CMV disese in the fetus, if that occurs, and helping hte placenta not be so swollen and inflamed.

      Consult your obstetrician and a maternal fetal medicine specialist with experience in CMV infections for the best approach for your situaiton.

      There also may be a clinical trial available near you on the use of CMV hyperimmune globulin in pregnancy. There is a multicenter trial through a maternal fetal network that is still enrolling patients. Consult http://www.clinicaltrials.gov for more information.

      I hope this information is helpful to you.
      Best wishes for a healthy pregnancy.

      Gail J Demmler Harrison MD
      CMVDOC

  195. Anthony says:

    You have touched some good points here, and I found it quite useful. Maybe you can elaborate those ideas you shared in a future post. Anyway, keep up with your writing! I’m sure more people will be more interested in your website in the future.

  196. Antoinette Coman says:

    My god daughter was born with CMV and is two months on her death bed. The hospital is telling her to plan for hospice as if there isnt anything else they are willing to do for her. Is there any hospital in AMERICA that are willing to work to save her?

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Antoinette,

      If your god daughter’s doctors or her parents would like a CMV consultation regarding your god daughter’s care, we would be happy to provide any needed assistance regarding treatment for congential CMV. I can be reached via Texas Children’s Hospital Infectious Diseases Office posted on our service website — 832-824-4330 or our blog email address posted on this site. Without more details and contact from your god daughter’s parents and doctors, it is difficult to provide specific help.

      Some babies with congenital CMV disease are very very severely affected, and studies have shown approximately 8% of babies born with severe CMV disease will die in infancy, despite all medical measures and treatments.
      For other infants, antiviral treatment and supportive measures and therapies can provide improvement in their condition and hope.

      I hope this information is helpful.

      Dr Gail Demmler Harrison
      CMVDOC

  197. Amy says:

    Hi Dr Demmler-Harrison,

    How long after exposure to CMV do symptoms appear and IGM starts to rise?

    I am currently pregnant, CMV negative (both IGG and IGM) with a 2 year old in day care, so I am at higher risk. I started having a sore throat and fever 11/6. I get tested for CMV monthly during pregnancy, because of my negative status, and my last CMV test was negative 11/15, a little over one week after having my symptoms.

    What concerns me is that my throat still hurts slightly, I still have swollen glands in my neck, and mild pain on my left side (don’t know if it’s pregnancy growing pains or my spleen). It’s been almost a month now. I saw my doctor last week and he said it’s just viral, but did not mention the CMV. I know that CMV is rarely symptomatic, however, when you look up viruses that cause sore throat, fever and swollen glands, CMV is one of the first to pop up.

    If this is a CMV infection and I started feeling ill 11/6, would the IGM have converted by the time I had my CMV test 11/15? I wasn’t sure what happens first in viral infections – if the symptoms appear before the IGM antibodies show on a lab test or if it normally works the other way around.

    Thank you so much!
    Amy

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Amy,
      Thank you for your post on my TCH CMV BLOG.
      The time from exposure to seroconversion (that is turning from CMV IgG negative and IgM negative to CMV IgG and CMV IgM positive) is usually 3 months.
      The time from illness such as a fever, sore throat, swollen glands, etc. that may be caused by CMV and CMV IgG and CMV IgM seroconversion is usually within 2 to 4 weeks, but may be within days, and this is variable and depends on the individual and the type of antibody tests performed by the laboratory (that is some ar emore sensitive than others in detecting a positive response). For some tests the CMV IgM test may convert 1 or 2 weeks before the CMV IgG converts but usually the two tests convert within days of each other in most individuals.
      To be sure, I would suggest you repeat your CMV IgG and CMV IgM antibody tests in a month. If they remain negative then, that supports your minor illness was not caused by CMV.
      Remember to try and practice good hygiene pracautions while pregnant if you are around toddlers and young children, to reduce your risk of acquiring CMV during pregnancy.

      I hope this information is helpful to you.
      Best wishes for a healthy pregnancy!

      Dr Gail Demmler Harrison
      CMVDOC

      • Amy says:

        Thank you so much! I understand your response regarding when IGM and IGG convert after exposure, but can I clarify what you are saying based on symptoms? So, you are saying that symptoms can appear first, and then 2-4 weeks later is when I can see a rise in IGM?

        I did just get another test yesterday, and my IGM is 0.2 and my IGG is 0.08. Hopefully that is promising and I’ll check again in a month.

        Can I ask you another question – My IGM is always 0.2 (with the exception of last year when it was showing false positive for a few months). My husband has been tested for CMV as well, prior to my recent pregnancy, and his IGM is always 0. Is there any reason I always show trace levels of IGM? I know that anything under 0.8 is considered negative, but I’m just wondering why it’s always there, why it’s never 0?

        Thank you so much! I really appreciate the information you have on this blog!
        Amy

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          Dear Amy,

          Sometimes there are products – proteins or other cross reacting antibodies- in a person’s blood or plasma that may cross react with reagents used to test for CMV IgM antbidoy in the blood. Therefore, occasionally, there wil be a “false positive” reaaction, usually at a low level of detection. Sometimes the false reaction is transient and sometimes it is permanent. It is likely that is what happened.
          I hope this information is helpful to you.
          Best wishes.
          DR Gail Demmler Harrison
          CMVDOC

  198. Suparna says:

    Hi there ,
    Very informative blog !!

    I have a 3 and a half year girl going to preschool. We live in India.
    I delivered my second child , a boy on 29 th October, one month back , by elective c section.

    My blood tests done at delivery is reported as below, which I have received only 3 days back.
    CMV Ig G reactive
    CMV Ig M reactive

    I had no symptoms during delivery.
    However , at tenth week of my pregnancy ,that s in first trimester ,I did have flu like symptoms for few days.
    My antenatal scans with fetal sonologists were normal too. And I have had an uneventful pregnancy .

    After delivery , my son is feeding well , on breast milk. He weighed 6.7 Pounds at birth , and now has gained an other 1.7 pounds. Head circumference has also increased from 34 cm to 37 cm in one month . His hearing and vision tests were done at birth and were normal.

    Now that I have received the reports only three days back, is there any test which can be done on me or him to get a clearer picture , to get an idea if my infection was primary or reactivation? Also what are the chances that my son can have any sequelae.. Early or late ?

    Thanks in advance
    Suparna.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi Suparna,

      Thank you for your post on my TCH CMV BLOG.
      The presence of CMV IgG and IgM antibody at delivery means you possibly experienced a primary CMV infection during the last half of pregnancy. It may also mean you experienced a reactivation infection, especially if the CMV IgM level was low positive. A blood sample from earlier in your pregnancy may help determine which one.
      I am not sure why you had the test performed at delivery, if you were well at delivery.
      Only 40% of pregnant women who experience a primary CMV infection during pregnancy will transmit CMV to their unborn baby. And of those babies born with congenital CMV , most have no symptoms or only mild sym[tpms such as hearing loss.
      To determine if transmission has occurred, a CMV urine or saliva culture or CMV DNA PCR test of these body fluids should be performed on the baby – preferably within the first 21 days of life.
      If your baby now at one month of age has a positive CMV urine or saliva test, then congenital infection is possible, but so is transmission from other sources, such as breast milk.
      This very right “window of opportunity” for diagnosing congenital CMV infection is why many CMV experts support moving forward with strategies for routine screening of newborns for congenintal CMV.
      Since your baby is well appearing otherwise, it is likely he will do well. You may wish to check his hearing once or twice more in the first year of life.
      I do not have any other suggestions for you at this time.
      I hope this information is helpful to you.
      Best wishes.

      Dr Gail Demmler Harrison
      CMVDOC

  199. Marsi says:

    Hi,
    I am 7 weeks pregnant and just have been tested for CMV. It resulted IgG positive and IgM negative. I am reading a lot of very concerning information throughout the internet and I am really concerned about my new baby. Is it possible that I could have been sick with CMV during my first days/weeks of pregnancy and having had IgM positive at that time?
    Is there any even minimal possibility that my baby could have any risk?
    I thank you very much in advance

    • Marsi says:

      Just another information to add, I have had chickenpox more than 9 months ago and have been tested for varicella zoster virus before getting pregnant with results IgG positive and IgM negative. Is there any possibility that the CMV result is linked to the varicella result and does not mean that I have really had CMV?

      • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

        Dear Marsi,
        Thank you for your post on my TCH CMV BLOG.
        A postiive CMV IgG and a negative CMV IgM atnibody result at 7 weeks gestation makes it highly unlikley that you experienced a primary CMV infection within the last 12 weeks and it is more likely your CMV infection occurred before this pregnancy. Therefore, the risk of CMV causing serious problems in your baby is very low to nil. Betwen 60 to 80% of child bearing women may have CMV IgG antibody from a previous infection. So it is actually a common occurrence.
        Also VZV and CMV do not cross react their antibodies on serologic blood tests. Even though they are in the same family of viruses, the tests are specific for each of the viruses.

        I hope this informatino is helpful to you.
        Best wishes for a healthy pregnancy.

        Dr Gail Demmler Harrison
        CMVDOC

  200. Sarah says:

    Dear Dr,
    I would to know if miscariage can be linked with recent CMV infection. My sister had 1 miscariage 6 months ago and she was just infected with CMV. She was pregnant again very recently and miscaried again. She was actually still IgM+ even if she thought the infection was over….before getting pregnant. I know that it’s not possible to establish the cause of the miscariage but I wanted to know if CMV infected women have a higher rate of miscariage.
    Thanks

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Sarah,

      Thank you for your post on my TCH CMV BLOG.
      I am so sorry for your sister’s recent miscarriages. I hope she is doing better.
      CMV has been found in tissue from miscarriages and fetal losses and stillbirths, but no studies have confirmed a clear association with CMV and miscarriages, especially repeated miscarriages.
      It is likely CMV may play a role but its exact role is not clearly defined at this time.
      It is recommended to wait until the CMV IgM antibody is negative before attempting another pregnancy, to safely reduce risk of transmitting CMV to the fetus.
      Your sister may also wish to consult a maternal fetal medicine specialist about the next pregnancy.

      I hope this information is helpful to you and your sister. Best wishes for a healthy pregnancy next time.

      Dr Gail Demmler Harrison
      CMVDOC

  201. Georgia Pavlou says:

    Hello Dr,
    i would start with my question and then explain briefly my case. “Once we got the virus, how long does it take for IGM to get negative”
    I am currently 28 weeks pregnant. During the first trimester (10th week) i had the CMV test which showed IGG and IGM both negative
    Two weeks ago (26th weeks of pregnancy) we repeated the CMV Test for routine purposes, which showed IGG positive, IGM Negative and IGG Avidity 0.65.
    My doctor concluded that: 1) i havent got the virus during the second trimester because of high IGG Avidity.
    2) the IGG resutls of the first trimester must have been wrong (that they should be positive and not negative), because, if i got the virus during the first trimester, IGM would still be positive on the examination of 10th week of pregnancy.
    i would appreciate if i had your opinion, as, i am wondering wether i should take the risk and proceed with amnio examination, at this stage, which is very dangerous for my baby, and in case i proceed and shows that the baby is infected, won’t change anything!

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Georgia,

      Thank you for your post on my TCH CMV BLOG.

      It is possible your CMV serology results indicated a primary CMV infection (seroconversion) during your pregnancy. The duration of CMV IgM antibody is usually 12 to 16 weeks, which appears to be the length between the two tests, however it may be in some as short as 2 to 3 weeks and others as long as a year. So the CMV IgM duration response is quite variable.
      It is also possible the first lab test was an error.
      If you are able to retrieve the first blood test from the laboratory, and run both samples together on the same lab test run, that may help clarify the situation.
      If that is not possible, then a fetal ultrasound may be done to assess for fetal well beging.
      A fetal amniocentesis may be done to assess for fetal infection, but if the fetal ultrasound is reassuring, like you stated, a positive amniocentesis for CMV would likely mean a silent MCV infection.
      If your fetal ultrasound shows abnormalities in the fetus, then diagnosis and possible prenatal treatment and carefuly monitoring may be indicated.
      In any event, you may wish to screen your newborn for congenital CMV infection and test the urine or saliva for CMV to diagnose congenital CMV or be reassured there is no CMV infection.
      If congenital CMV infection is diagnosed, even if your baby appears healthy, testing fo rhearing loss and carefuly long term followup for late onset hearing loss is usually recommended.

      I hope this information is helpful to you.
      You have a difficult situation, but I hope all goes well wiht your pregnancy and that your baby is born healthy.
      Best wishes.
      Dr Gail Demmler Harrison
      CMVDOC

  202. ashley teasley says:

    hello,

    I have heard so much about you from numerous support groups on line. I have a few questions that I have not been able to find or get the answers to. I hope that you will be able to answer some for me!

    During my pregnancy, around 20 weeks, I became very ill. upper quadrant pain, elevated AST and ALT liver enzymes, headaches, extreme tiredness, spots in my vision, failure to gain weight during my pregnancy. when I looked up CMV I found that these symptoms could have tipped doctors off that I might have had a cmv infection since I tested negative for mono. I specifically read that those were some telling symptoms in immunocompromised patients. Is this true?

    Also, had I been diagnosed would myself being treated with an antiviral such as ganciclovir reduced the risk of passing the virus through the placenta to my baby?

    are there any signs of CMV infection in a pregnant woman or fetus?

    are there any ways to reduce the risk of passing to an unborn child, or at least limiting the damage to the unborn child?

    If a baby is born with cCMV and is symptomatic with petichiae and low platelets should they have been treated with valganciclovir?

    Thank you so much! I truly appreciate your work! I hope one day all women are educated about this disease.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Ashley,

      Thank you for your questions and post on my TCH CMV BLOG.

      Most CMV infections in pregnancy do not cause any symptoms in the otherwise healthy pregnant woman. When CMV does cause symptoms in healthy individuals, including pregnant women, there is a broad range of signs and symptoms, including fever, sore throat, swollen glands, rash, fatigue and malaise, cough, diarrhea and nausea, tender liver, elevated liver enzymes (mildly), abnormal blood count and platelet count, and other findings. Vision abnormalities are usually not part of CMV infection in normal hosts, but can be present in hosts with abnormal or weakened immune systems. The symptoms of primary CMV infection in pregnancy and other healthy indviduals are similar to EBV mononucleosis and other mono-like illnesses caused by other infections. Also pregnant women may experience liver or gall bladder problems or other illnesses. It is sometimes difficult to say if CMV is causing a particular illness or if the CMV infection is silent and the illness is caused by something else. Blood tests (CMV IgG CMV IgM CMV IgG avidity, for example) may help determine if a CMV infection is recent /primary or old/past. Recurrent CMV infections may also occur and be transmitted to the fetus, and these types of CMV infections are difficult to diagnose and predict because they are usually silent.

      CMV infection during pregnancy in otherwise healthy individuals is not usually treated with an antiviral medication such as ganciclovir or valganciclovir given to the mother. In selected cases, CMV hyperimmune globulin may be administered to the pregnant woman to help reduce risk of CMV transmission to the fetus or to help the placenta and the fetus if there is evidence of CMV disease in utero. Each doctor individualizes this type of prenatal treatment for each patient. There are also clinical trials available (www.clinicaltrials.gov) that may be offered to pregnant women with CMV infections. Consultation with a high risk OB or maternal fetal medicine specialist may be indicated if a woman experiences a primary CMV infection during pregnancy or if the fetus appears ill in utero.

      Most babies born with congenital CMV infection are well appearing and it is a silent infection. It is very common and congenitally infects approximately 1% of newborns. Both primary and recurrent CMV infection may cause symptoms in the newborn or cause hearing loss as the child grows. If a baby is born with congenital CMV infection and has symptoms of CMV, then antiviral treatment with ganciclovir or valganciclovir may be indicated to reduce the signs and symptoms of disease in the newborn period, and also to reduce the risk of hearing loss and to improve head size growth and developmental milestones. Also, if a newborn has a failed newborn hearing screen, a test for congenital CMV among other tests, should be considered to determine the cause. If CMV is found in a newborn, consultation with a pediatric infectious diseases specialist familiar with viral diseases of infants and children is usually recommended, if such a specialist is available, to determine the need for antiviral treatment and other management recommendations.

      I hope this information is helpful to you.
      Best wishes.

      Dr Gail Demmler Harrison
      CMVDOC

  203. Jaime S. says:

    Hello,

    I am currently 11 weeks pregnant with my 2nd child. I found out a week ago that my blood work from my first checkup at 7 weeks shows that I have CMV with IGG negative and IGM positive. I have never heard of CMV and my doctor didn’t give me a straight answer when I asked what the chances are of me passing this to my baby is. I have since been researching and it looks like igg neg and igm pos means this is a primary infection that happened recently (please correct me if I am wrong) and that chances of infecting the baby are 30-50%.

    My son is turning 3 years old soon. He just started preschool in September for 2 mornings a week. I also started potty training him late sept/early oct. From what I read, chances are I got this from him, which would also prove that this was a recent infection.

    I will be meeting with a high risk doctor next week. A big question I have is if I opt for an amnio (dr said no earlier than 16 weeks) and it comes out clear, is there still a chance the baby can still become infected after then?

    I also read there are shots infected mothers can get to help prevent or reverse effects of CMV on the fetus. I am wondering if I should have pushed to see the high risk doctor sooner or if at this point it is what it is since I’ve been infected for a while now.

    I’m completely devastated especially since my husband and I have been trying to get pregnant for a year. If I knew about CMV at all I would have been so careful around my son. I’m constantly sharing food with him and kissing him all over his face. I wash my hands after helping him go to the bathroom but maybe it wasnt enough. I’m just so terrified and upset and am dying to hear information from an expert.

    Thank you so much for your time and help.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hello,

      Thanks for reading my TCH CMV BLOG.

      CMV is a very common virus but it is also commonly misunderstood! Even by health care professionals! So I am happy to help clarify some CMV issues for you and also for your doctor, if needed. Try not to worry. There are some steps you can take to clarify the results of your blood tests, and further steps, thereafter, should it prove you have recently acquired CMV during your pregnancy.

      A positive CMV IgM and negative CMV IgG antibody may mean one of the following-

      VERY recent infection- usually both IgG and IgM rise at same time or within a week or two of each other. I have only seen this type of rise rarely -where CMV IgM was positive alone before CMV IgG- almost always the two antibodies rise together or very close together in a primary CMV infection.
      FALSE POSITIVE CMV IgM reading – as a result of a recent infection, immunization, or underlying illness you may have a false positive CMV IgM reading OR as a result of the antibody test itself showing a false postiive reading. False positive reading is the most common cause of a single CMV IgM antibody positive test without a positive CMV IgG antibody test at the same time.

      It is best to repeat both CMV tests now or for sure by 2 weeks from the first set of tests to make sure the CMV IgM and CMV IgG reading were both correct. Test the first and second sample in same lab, if possible, or another strategy is to try to split the second sample and send to two different labs for confirmation. At very least, just have your doctor repeat both tests now at the same laboratory.

      Since you are pregnant and have a toddler in the home, please review my BLOG and the CDC website also and other CMV websites by reputable non profits or experts who describe CMV precautions that are recommended during pregnancy to reduce CMV transmission as much as possible.

      If your repeat CMV IgG is positive and your CMV IgM is positive– There are available clinical trials and treatment options for primary CMV infection in pregnancy (see http://www.clinicaltrials.gov and search CMV pregnancy hyperimmune globulin). Alternatively if your primary infection is indeed confirmed with a CMV IgG seroconversion, then request your high risk OB/MFM specialist to review CMV hyperimmune globulin to see if pre natal treatment is indicated in your case because the CMV hyperimmune globulin is available for administration by any physician. It may reduce the risk of CMV transmission to your fetus and if your fetus becomes symptomatic may help improve placenta well being and reverse some of the fetal findings. Your fetus and the placenta should be assessed with fetal US as well.

      If primary CMV infection is documented by a CMV IgG seroconversion, then amniocentesis may be performed to determine CMV transmission to the fetus. Amnio performed at 21 weeks or later correlates very well with CMV results in the newborn, and if performed earlier then false negatives may occur. Many doctors however, prefer to perform amniocentesis earlier, around 18-20 weeks gestation. The decision should be between you and your doctor about what is best for you and your baby. Many couples opt not to do amniocentesis if the fetal US is otherwise OK and observe fetal US results instead. Others prefer to perform amnio and know if CMV transmission occurred or not before delivery. Since most in utero CMV infections do not cause serious problems with the baby, the fetal US is likely to be reassuring. I would discuss with your doctor and consider the pros and cons of amnio AFTER you have repeated your CMV serologies to see even if you have seroconverted. If the CMV IgM is a false positive, then there is no real indication at this time from the CMV perspective to perform an amnio.

      Antiviral medications are also available to treat symptomatic newborn with congenital CMV after delivery- but you are not there yet- first must confirm your CMV serology results.

      I hope this information is helpful to you and give you some steps to discuss with your doctors, who of course, know your individual case.

      Dr Gail Demmler Harrison
      CMVDOC
      http://www.texaschildrensblog.org/author/gdemmler/

  204. Jaime S. says:

    So sorry to bother you again. I have 2 questions.

    1) You said amnios performed after 21 weeks are more accurate. But is there still a chance the baby could get infected if an amnio at 21+ weeks is negative?

    2) I have a copy of my bloodwork and if I’m reading it correctly, my IgM is 1.48 (normal is <0.91) and IgG is 0.2 (<0.9 is negative) Even though my IgG is negative, should I be concerned since it isn't 0?

    Thanks again for your help, it is most appreciated.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Jaime,

      A positive CMV IgM with a negative CMV IgG is unusual — and should be repeated. It may be an early primary CMV infection or a false positive reaction and not even a CMV infection at all.
      If amniocentesis at 21 wks gestation is negative, then it indicates CMV transmission did not occur prior in the first trimester of pregnancy or even first couple weeks of the second trimester. It is possible a CMV infection can occur later in pregnancy, in the second half of the second trimester and in the third trimester, after the amniocentesis was performed.
      Practicing CMV precautions will help reduce the risk of catching CMV during pregnancy.

      Best wishes.
      Dr Gail Demmler Harrison
      CMVDOC

  205. Agnieszka says:

    Dear Doctor,

    Thank you for your blog which seems to be the most detailed source of information I have found about CMV infection.

    I’m writing from Poland. Currently I’m 38 weeks pregnant. First time I’ve tested CMV serology (in 10 Hbd) my results for IgG was positive: >500 U/ml (ranges: negative /=0.5 – /=1.0) and for IgM was negative, which indicated “old” infection as my doctor told me.
    Recently (in 36 Hbd) I’ve re-tested my CMV IgM levels and it revealed to be positive: 2.09 (ranges: >/= 0.90 positive). 10 days later I’ve checked it in different lab and results were as follows: IgG positive: 71 AU/ml (ranges: 6 AU/ml – positive, 4-6 AU/ml difficult to assess), IgM positive: 2,00 and CMV avidity test high: 0.712 (ranges: high >/=0.25). As far I understand from this, I’m in a >1% group who experienced reactivation or recurrent CMV infection during pregnancy, am I right?

    I would like to add that in 18 Hbd I was hospitalized for severe pneumonia (pathogen was not found in blood culture test). The USG scan of the baby in 22 Hbd showed two findings: ARSA and “small” tricuspid insufficiency, otherwise normal.

    During the whole pregnancy neither me, nor my husband has any contact with children and I think we’ve taken the important hygienic precautions to avoid infection – that is why I was truly shocked when I saw my recent lab tests. I know that the most dangerous is the infection that firstly occurred during pregnancy, however I am also concern about recurrent CMV infection…

    Could you please help me to dispel some doubts?
    1. Are there any chances that the IgM levels were false positive (even double confirmed)?
    2. Is it possible to assess the onset of the possible CMV reactivation according to the above lab tests?
    3. Is it important for the baby in which trimester the reactivation occurred?
    4. Could the CMV reactivation be related to my pneumonia?
    5. Would the ultrasounds shown any other findings if the baby’s been infected?
    6. Does the c-section recommended in such scenario?
    7. Do you suggest any special lab tests when the baby is born?

    Thank you very much in advance!
    Regards,
    Agnieszka

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Agnieszka,

      Thank you for your post on my TCH CMV BLOG.

      It does appear that you may have experienced a recurrent (reactivation or reinfection both possible) CMV infection, most likely from reactivation of your previous old CMV infection. A new CMV reinfection is less likely, especially if you practiced CMV precautions.

      CMV may reactivate at any time, especiallly during times of stress or other infections, which appears to be the case with your recent pneumonia. It is also possible the positive CMV IgM reaction is related to your pneumonia in another way, and produced a false reaction in your blood.

      Either way, the CMV risk to your baby ahving serious problems is very low.

      Pls see my responses to your specific inquiries, which I answered as best I can with the available information provided in your post.

      Could you please help me to dispel some doubts?
      1. Are there any chances that the IgM levels were false positive (even double confirmed)?
      Yes, it is still possible to be a false positive but you also may be experiencing a recurrent CMV infeciton ( reactivation of your own CMV or re infection with a new CMV strain).
      2. Is it possible to assess the onset of the possible CMV reactivation according to the above lab tests?
      No, not really possible to assess the timing, just to estimate it occurred sometime between the previous first CMV serologies and the new serologies.
      3. Is it important for the baby in which trimester the reactivation occurred?
      No, that does not seem to be an important issue for the baby.
      4. Could the CMV reactivation be related to my pneumonia?
      Yes, it is possible. the stress of hte pneumonia reactivated your CMV strain temporarily. Only < 1% of recurrent CMV infections get transmitted ot the baby, so most of the time, things will be fine.
      5. Would the ultrasounds shown any other findings if the baby’s been infected?
      Perhaps, but they are likely to be normal since fatal infections from recurrent CMV infections are more likely silent but do carry a risk of hearing loss in the baby , even if the baby appears normal
      6. Does the c-section recommended in such scenario?
      No, not at all. From the CMV perspective, you may deliver via a normal vaginal process.
      You also may breast feed your baby.
      7. Do you suggest any special lab tests when the baby is born?
      The baby should have a CMV urine culture and a CMV saliva culture performed within the first two weeks of life – to see if CMV transmission occurred and to see if the baby is congenitally infected with CMV. A positive CMV test in the urine or saliva of hte newborn indicates a congenital CMV infection and if negative, then no congenital CMVinfection.
      If the urine or saliva tests are positive for CMV, the evaluations for hearing, vision and brain and development should be assessed, as well as a blood count and liver function test.

      I hope this information is helpful to you.
      Best wishes for a healthy pregnancy and baby.
      Dr Gail Demmler Harrison
      CMVDOC

  206. Maja says:

    Dear Dr Demmler Harrison,

    thank you very much for your blog.

    I am 37 years old, mum of 15 months baby boy. My doctor was checking CMV levels when I was pregnant with him so I knew that there is a risk associated with this virus.

    Now I would like so so much to become pregnant again. In fact I was suspecting that I might had contact with the virus, and I suggested CMV test to my GP – this Autumn (so 4 months ago) both of us, me and my husband, were sickish for couple of weeks. I suppose we caught CMV from my son who is in the daycare. I can not be sure of course that it was that moment. In the last blood-work it was found out that I have LgG and IgM for CMV (the results were: first test of 10/01/2014 IgG 42.00 AU/mL, second test of 21/01/2014 IgM index 2.76, IgG 16.30 – the tests were done in two different laboratories).

    My question is when we can start trying to conceive? I have read in one of your answers that one should wait for negative IgM. I have read when making this internet research that IgM can stay positive even 2 years after the infection. Would it imply that It may be necessary to wait so long..?

    I would like to ask as well how long it last from the beginning of infection and the moment it is detectable in blood test. I had an early miscarriage couples of weeks before we all get sick, but at that time results of CMV were negative.

    I would be so grateful for your answer. Thank you for what you are doing.

    My best wishes,

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Maja,

      Thank you for your post on my TCH CMV BLOG.

      CMVIgM antibody may be detected between 3 weeks and 3-4 months after a primary CMV infection occurs in an otherwise healhty individual– very variable– and CMV IgM antibody may last on average 3 to 6 months after the primary CMV infection, but some individuals may have CMV IgM antibody response lasting a year or more, but that is unusual.

      Both CMV IgG and CMV IgM usually rise together or very close together after a primary CMV infection.

      A CMV IgG avidity test may be helpful to determine when a CMV primary infection is resolved or past in individuals who have a CMV IgM antibody response; when the CMV IgG avidity index is high then the CMV infection is thought to be resolved and it is therefore safer to become pregnant again, from the CMV perspective.

      Most women wait 6 months to 12 months after their primary CMV infection to try again for another pregnancy. Waiting two years is probably not necessary. However, it is also best to take the recommendations of your doctors, since they know your case the best.

      I hope this informaiton is helpful to you.
      Best wishes for a healthy pregnancy.

      Dr Gail Demmler Harrison
      CMVDOC

  207. Nira says:

    Dear dr. Demmler Harrison,

    Only recently on 22nd Jan I lost my baby (IUFD) in my 32nd week of pregnancy. All the things were normal including all ultrasounds and blood tests ; all showed pregnancy and baby’s growth was fine and perfect. On 14th Jan I took my first tetanus injection post which within one week this thing happened. This was my first pregnancy and I am 38 years old.

    Post this event, doctor advised torch panel to assess the possible reasons which I did on 24th Jan. Results are as follows :

    CMV – IgG Antibodies to cyto megalo virus by CMIA …… Reactive (628.8) AU/ml.

    CMV – IgM Antibodies to cyto megalo virus by CMIA …… Non Reactive (0.12)

    HSV 1+2 – IgGAb to Herpes Simplex Virus, serum by CLIA. ……..Reactive (42.1)

    HSV 1+2 – IgMAb to Herpes Simplex Virus, serum by EIA. ……..Negative (0.2)

    Rubella,Toxoplasma Igg and Igm both nonreactive .

    I had few queries :

    1) Does such a high value of cmv igg indicate recent infection or was it of many months before.

    2) Did Cmv or hsv play part in my baby’s death at 32nd week.

    3) Is it atall possible that I would have contracted cmv or hsv infection from the tetanus injection I got one week before. I have not done torch panel before nor have any history of such infections.

    4) I am suffering from pneumonia since 23rd Jan and my lungs are congested under which I was induced labour and delivered my dearest girl child on 26th jan….post which even now my lungs are full even after taking antibiotic since last week. So, can it be because of my cmv or hsv infection or they are not related.

    5) Are there any more blood or other tests you will suggest.

    I am from India. Will be obliged if you can answer frankly to all my queries and in addition any guidance you have for me.

    Rgds.
    Nira

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Nira,

      Thank you for your post on my TCH CMV BLOG.
      I am so very sorry for your loss of your baby and I wish that time will help heal the pain you must feel over your loss.

      Regarding your CMV questions–

      The blood test results for CMV and HSV viruses tested show evidence of a past infection. Infection with both of these viruses is common. The level of how high the IgG antibody does not help determine a recent from a long past infection.
      It is unlikely that these viruses played a role in the fetal demise of your pregnancy, however, it is remotely possible, and the only way to tell for sure is to examine the amniotic fluid, placenta, and if possible also the baby’s body and internal organs by pathologic examination and cultures for the viruses. Was any of this done?
      The bacteria associated with pneumonia may also be passed to the fetus via the mother’s blood stream and cause problems. Was your baby and the placenta tested for these bacteria to see if that is the cause?
      The tetanus shot did not cause these viruses to be transmitted. Receiving a tetanus shot prior to delivery is recommended so the mother can provide antibodies that cross the placenta to her baby and protect her baby from tetanus (lockjaw) and also pertussis (whooping cough).

      I hope this information is helpful to you.
      Take care and I hope you get well soon.

      Dr Gail Demmler Harrison
      CMVDOC

  208. Sandra Salerno says:

    I just wanted to say hello to you Dr. Demmler-Harrison and thank you again for the time you spend with my daughter Lillian. I wish my daughter never had to go through what she went through but looking at her every day and the positive outcome makes me feel so fortunate to have you and the TCH team caring for my daughter. <3 Even though CMV took 1/2 of my daughter's brain it didn't take away her awesome personality and she is developing wonderfully despite her setbacks!! CMV did not win!! <3

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi Sandra,

      Thank you for such kind comments on my TCH CMV BLOG! I am so pleased Lillian is doing so well! She is awesome!!

      The role of congenital CMV in the condition called polymicrogyria is important to know and understand, and we continue to try and understand how to prevent congenital CMV involvement of the brain from occurring and to treat CMV when it has caused brain involvement.

      Take care!
      Dr Gail Demmler Harrison
      CMVDOC

  209. Peyton says:

    Hi Dr. Demmler,
    I am a 26 year old woman pregnant with my second child. My due date is September 6th (based on measurements), last missed period being November 18th. November 18th was the beginning of miscarriage bleeding from a chemical pregnancy/early miscarriage that was 6 weeks along. We suspect later ovulation as the cause for the discrepancy in dates. I’ve had three ultrasounds thus far and all have noted regular growth and a heart rate in the 170s.

    I am a speech pathologist that works solely with children with hearing loss in Houston. I have a large exposure to children with CMV. I also have a two year old son. I had my CMV status tested this pregnancy when I found out that was an option. Up until I found out that some of my coworkers knew they were negative I had no idea I could even be tested. Oh, how I wish I had known.

    My IgG value was 7.9 and my IgM value was 4.5 on February 4th. I have not had any avidity testing yet.
    My doctor has referred me to an MFM at Memorial City Memorial Hermann, but I am very interested in the TCH team and your work.

    I would appreciate any advice on what steps to take next and who to contact. My OB does not seem to think this is a very pressing issue, but having the knowledge of the effects of CMV I am anxious to have an action plan!

    Thank you so much for your dedication to this field and your time to review my case.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Peyton,

      Thank you for your post on my TCH CMV BLOG.

      A positive IgG and a positive IgM antibody for CMV suggests a recent CMV infection has occurred and may be an at risk situation for your fetus. It is difficult to say at this time based on the information provided.
      Were the values you report interpreted as “positive” lab values? Each antibody test is diffeerent and each antibody test has its own “range” of positive and negative values. It is therefore difficult for me to provide further comment without knowing for sure the interpretation of the values.
      If the values you indicated are both positive, then consultation with a maternal fetal medicine team, ideally one that includes a CMV expert, would be indicated. The link to our Fetal Center at The Pavilion for Women at Texas Children’s Hospital is http://women.texaschildrens.org/Our-Services/Fetal-Center/Our-Approach/ or email me personally to discuss.

      After a primary or near recent primary CMV infection, CMV is transmitted to the fetus about 40% of the time, so good news is that more often than not, CMV is NOT transmitted 60% of the time to your baby after a recent CMV infection. If CMV is transmitted to your fetus, then there is a 10 -15% risk of disease occurring in the fetus, so it would be important to monitor your fetus carefully. Amniocentesis and fetal ultrasounds may be indicated to determine the status of your fetus, but these recommendations will depend on an individual evaluation. Also, prenatal treatments with CMV hyperimmune globulin are indicated for some women as well to improve the outcome in their fetus.

      I hope this information is helpful to you.

      Dr Gail Demmler Harrison
      CMVDOC

  210. ZACHARIAS kOUNTOURIOTIS says:

    First of all I would like to thank you for all the information’s through your posts,

    Just one quick question, My wife is five months pregnant and cmv test on the first month (December 2013) showed to be negative. We are planning to visit her mother who is abroad but she recently (November 2013) notice that she have a cmv. Is any risk to come in contact since now we pass the first three months or we have to wait until her mother CMV IgM becomes negative.

    Thank you in advance

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thank you for your post on my TCH CMV BLOG.
      If your wife is CMV antibody negative and pregnant, then she may contact CMV from anyone who is close to her- her family, her friends, and especially young children or individuals who may be recently or actively infected with CMV. She therefore should use precautions recommended in my BLOG.
      I would suggest that your wife refrain from close contact (kissing, sharing food or drink, changing diapers, etc.) with anyone who may have an active CMV infection (toddlers, young children, or individuals such as her mother who have been diagnosed with CMV recently) and practice the recommended hygienic precautions outlined on my BLOG and also on the website hosted by the CDC (www.cdc.gov/cmv) as well as ohter sources. A visit abroad to see her mother, and even being in the same house or room are OK, and even hugs are OK, as long as body secretions are not exchanged or food/drink shared from the same glass or plate or utensil.

      I hope this information is helpful to you.
      Best wishes for a healthy pregnancy.

      Dr Gail Demmler Harrison
      CMVDOC

      • ZACHARIAS kOUNTOURIOTIS says:

        Dear Dr. Harrison,
        In order to reduce the possibilities of CMV inflection we decide to make a PCR and avidity index test to my wife’s mother. We did that since we have already a baby of 14 months and as a result it will be difficult to use precautions recommended in your BLOG. However the PCR results was negative and avidity index 70.5%. However the opinion of our doctors is that they possibilities for my mother in law to not transmitted is 98%,. So my question is how can be sure 100% that my mother in law is not spread the virus in order to eliminate any risk.

        • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

          The transmission of CMV requires close intimate contact between individuals and sharing or contact with bodily secretions. It is unlikely your wife will have close contact with your mother in law [wife's mother] and it is also likely your mother in law [wife's mother] has a past resolved infeciton with CMV and is very unlikely to be actively shedding CMV.
          I agree with your doctors about a very low risk for transmission of CMV to your wife from her mother at this time, but there is no 100% guarantee for anything.
          I hope this is helpful.
          Best wishes.
          Dr Gail Demmler Harrison

  211. Sandra Salerno says:

    Hi Dr. Demmler-Harrison,
    I just wanted to congratulate you on your front page news article in the Houston Chronicle today. My heart breaks for the family who lost their child but I commend them for their strength to share their story with the hopes of helping others. It was a difficult story to read but I think the tips there are great for anyone to read and follow.

    Sincerely,
    Sandra Salerno

    http://www.houstonchronicle.com/news/health/article/Awareness-of-little-known-virus-is-goal-of-5281484.php

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Sandra,

      Thank you for your kind comments on my TCH CMV BLOG.
      The story is indeed a sad one, but the family, by sharing their story and by spreading CMV awareness about precautions that can be taken by pregnant women to reduce their risk of catching CMV during pregnancy, can perhaps help other families.

      Spread the word of CMV Awareness!

      Dr Gail Demmler Harrison
      CMVDOC

  212. Mohammad Jammal says:

    Dear Dr. Demmler-Harrison,
    I thank you so much for this great blog who opens real education about CMV.
    I would be extremely thankful if you can provide us with your feedback regarding our case.
    My Wife (who is by nature extremely emotional) got pregnant 1 year ago, unfortunately we lost our baby Lana 1 day after traumatic labor due to different reasons (Because of use of High Vaccum and Forceps more than 30 times which caused brain damage on the spot of delivery).
    My wife during labor got 3 units of blood, and after 3 months of recovery from the delivery operation itself (she had vagina’s complication and needed continuous treatment for 3 months), we decided to get a new baby as a way of emotional cure that we were both in need (specially her).
    One day before we conceive, her temperature rose to +39/+40 permanently for 4 weeks NONSTOP with all the CMV symptoms (throat, extra sleep, fatigue, and very serious skin rash). Today we are exactly after 50 days from the first day of CMV noticed infection and her last test results show that her IGG is high (around 13) while her IGM is still positive but love (around 5).
    My wife is nagging to get pregnant after all this period.
    Our doctor said that she can get pregnant as long as the IGG result is high which means she has the required immunity antibodies, irrespective of the relatively low IGM, which in her view can last for 1 year to go back to zero.
    It is easy for doctors to say, just wait for your IGM to go back to zero, but this destroy and depress my wife a lot. Can you please provide us with your recommendation? Thanks a lot.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Thank you for your post on my TCH CMV BLOG. I am so sorry for your recent loss.

      The presence of CMV IgG antibody positive test and a positive but low CMV IgM antibody test may mean her recent illness was caused by CMV. It is also possible the CMV IgM antibody is a false positive, but less likely because you describe an illness suggestive of CMV in your post.

      Usually it is best to wait for at least 3 to 4 months after a proven CMV infection to become pregnant again, to allow the body adequate time to “resolve” the active CMV infection, so it cannot be transmitted to the fetus, or at least the risk will be lower for the fetus.
      CMV IgM antibody may last up to a year or longer in some women, but most will have a negative IgM antibody in 3 to 6 months. If after 6 to 12 moths the CMV IgM antibody does not go to zero, but remains low positive, it is still then “safe” to try for another pregnancy.
      The short time for waiting for a few months for CMV to resolve, compared to a possible time that is a lifelong of suffering for a child born with CMV should be carefully considered by you and your wife.

      Another test, call CVM IgG avidity test may be done — if the avidity index is “high” then the infection is past and it is safe for another pregnancy. If the avidity index is “low” then it would be best to wait a little longer for the CMV infection to resolve. This test may therefore be helpful to you in deciding when it is ‘safe” to try again for another baby.

      As always, please also consider the recommendations of your own doctors, as they know your case and are the best to advise you and your wife.

      I hope this information is helpful to you and your wife.
      Best wishes for a healthy pregnancy next time around.
      Take care.

      Dr Gail Demmler Harrison
      CMVDOC

  213. Kate says:

    Good morning,

    First, I would like to thank You for previous responses.
    My douther is 10 mounth old and she is fine. We test her hearing, eyes, and stomage.
    I’m writing becouse of MY recen test results of CMV and planning being pregnant.
    At this moment: CMV Igm are negative, Igg positive (133.0) with high avidity index.

    Questions:
    1. Reasume my CMV test results I’m safe becouse of antybody Igg, Am I? And I can plan new baby? Please confirm.
    2. Should I test my doughter blood and urine for CMV virus existance (PCR method) again? First was done when she was 3 mounth, second – 6 mounth.(see writings above)
    3. Simple hygienic precautions – what You mentioned in blog about – would be enought at now?
    4. With most interest I would read some articles about CMV and behaviour relation in children. Where can I find this kind of information?

    Kate, from Poland

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Kate,

      Thank you for your post on my TCH CMV BLOG. I am happy to hear your daughter is doing well.

      1. A positive CMV IgG antibody, with high avidity index and negative CMV IgM means it is safe from the CMV perspective to become pregnant again.
      2. Testing your daughter again for CMV is not necessary and not recommended.
      3. Practicing the hygienic precautions recommended in my BLOG is sufficient to reduce your risk of CMV re infection.

      There is very little written on behaviors of CMV affected children. Is there a particular problem about which you wish to learn ?

      Dr Gail Demmler Harrison
      CMVDOC

  214. Mohammad Jammal says:

    Dear Dr. Demmler-Harrison,
    Just wanted to mention as well following what I wrote that most probably she got infected through blood transfusion (when she had to have 3 units of blood).
    Our summarized questions please are:
    1- Is is strictly recommended to wait until the IGM is negative to get pregnant again?
    2- What is the time usually it takes to reach a negative IGM from the day of noticed symptoms? if currently the IGM is 5, how long would you expect from now to become negative.

    Thank you so much.
    Mohammad From Lebanon

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Mohammad,

      Waiting to get pregnant again until CMV IgM antibody is negative is a recommendation to make sure the primary CMV infection is resolved, but individualizaiton is of course allowed and you should best consult your own doctors about this point. Since it may take 6 to 12 months for CMV IgM antibody to resolve, it may be safe earlier, if the CMV avidity index is also high. Specific numbers of levels of CMV IgM antibody ( i.e. 5) are difficult for me to interpret and I am unfortunatley not able to help in this regard. I recommend you consult with your own physicians about the meaning of the CMV IgM 5 value.

      Best wishes.
      Dr Gail Demmler Harrison
      CMVDOC

  215. Medea Tsanava says:

    Dear Dr. Demmler-Harrison,
    I would like to ask you one question about the situation my daughter is in. She is pregnant, in her 6th week of pregnancy. She went through medical tests and she is positive for CMV ( Igg-5 and Igm-1,2). How high do you think is the risk of damage to the child’s development ? and what can be done by us to take measures against it?

    Thank you very much,
    Looking forward to your answer

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      It is difficult for me to answer your question at this time- do you have the interpretations for the numerical values of CMV IgG and CMV IgM you provided? If they are both positive, then there is a potential risk of CMV transmission to the fetus, of about 40%, which should be evaluated. Not all pregnant women iwht positive CMV serologies transmit the virus to their fetus. However, even if they do occur, most CMV infections of the fetus and newborn are without symptoms or disease. Some babies with congenital CMV can have serious problems, but they are less common than silent infections.

      Consultation with an obstetrician or maternal fetal medicine specialist is then recommended to see if further tests of the fetus such as ultrasound or amniocentesis, should be done.
      If the CMV IgG is positive but the IgM is negative, then there is a much lower to nil risk to the fetus at this time.

      I hope this information is helpful to you.

      Dr Gail Demmler Harrison
      CMVDOC

  216. CJ says:

    Hello Dr. Demmler-Harrison,

    I’m not sure if I have CMV (no symptoms), but is there a risk of transmitting it to somebody else if the virus is dormant? Would transmission only be possible if it were to be reactivated? I’m wondering what the risk of transmission was in the following scenario: I had a few drops of urine on my jeans, wiped them with a Lysol wipe, and drove to work. On the way there, I touched the wet spot with my fingers to see if it was almost dry. When I got to work, I should hands with somebody who was eating a bagel. Is there any risk of him getting CMV through his mouth that way? How long does CMV live outside the body? I just want to make sure that there’s no risk of him transmitting the disease to his wife in case they have another baby.

    Separately, my wife and I have a 4-week old son. Again, I have no reason to think that he has CMV, but there are occasions when his urine finds its way to places other than his diaper. We live next-door to somebody with a compromised immune system. To what extent should we clean things that some into contact with his urine? Is it enough to wash our hands and spray the, say, changing table pad?

    Thanks.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      CMV requires close intimate contact with secretions to be transmitted. It does not survive or last in a viable state outside the body for very long at all. Therefore, the risk of transmission from objects or through casual contact is low to nil. There is probably no reason for special precuations around your infant son or his diaper changes at this time. However if your wife becomes pregnant again and your son is an active toddler in day care, then precuations should be done for your pregnant wife to reduce CMV transmision.

      I hope this information is helpful to you.
      Dr Gail Demmler Harrison
      CMVDOC

  217. Mansi Gupta says:

    Dear Dr. Demmler Harrison,
    Maam I had a D&C at 7 weeks of pregnancy after having a TVS U/s which showed absence of Fetal Heartbeat. Later was advised to get blood tests done to rule out TORCH and other infections. The test results show CMV IgG 67 U/ml, CMV IgM 5 U/ml , Rubella IgG 33.60 IU/ml and Rubella IgM 10 AU/ml.Do these results indicate I do not plan for a baby in the near future? I am 29 yrs old with a healthy 5 YR Old son. Kindly guide me as to when I must plan and when i can do a retest and weather these results indicate I must take precautions. THANKYOU.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      I am sorry for your recent pregnancy loss.
      Your blood tests indicated probable past immunity from a past infection with CMV and rubella viruses. It is dfficult to determien for sure however.
      It is likely safe for you to become pregnant again form the perspective of CMV and rubella virus.
      I recommended CMV precautions for ALL pregnant women, even if you are CMV positive there is a low possible risk you may be re infected with a new strain. Your 5 year old child is not likely to be shedding CMV but toddlers and young children are more likely.

      I hope this information is helpful to you.
      Best wishes for a healthy pregnancy!

      Dr Gail Demmler Harrison
      CMVDOC

  218. monique says:

    Hi ive just had blood test that came back I have a cmv viral infection. I just had my 12 weeks scan that showed baby growing fine. Everything was good baby has not yet caught the cvm infection. I have to go back up in 1 month to see if baby still feeding off me. My doctor thinks I caught the cmv viral infection at the start of my pregnancy. Is there a good chance since ive already had cvm infection for 3 months baby going to be fine.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Monique,

      Thank you for your post on my TCH CMV BLOG.
      It is difficult for me to tell if you have experienced a past or recent CMV infection from your BLOG post.
      CMV infections may be past and of little consequence to the fetus (CMV IgG antibody positive but CMV IgM antibody negative) or recent and of more concern for transmission and affliction of the fetus (CMV IgG antibody positive and CMV IgM antibody positive also). Even if you have experienced a recent CMV infection only 40% of the time will the CMV virus be transmitted to the fetus and cause possible complications. Fetal ultrasound findings may occur at any time, even past the 16 weeks morphology scan. It is best to keep a close watch on your fetus with serial ultrasound evaluations and follow the advice of your obstetrician regarding the possible need for amniocentesis or more careful evaluations of your baby.

      I hope this information is helpful to you.
      Best wishes for a healthy pregnancy.

      Dr Gail Demmler Harrison
      CMVDOC

  219. monique says:

    If baby does catch cmv viral infection will I see any sign of it before 16 weeks morphology scan

  220. mika says:

    Hi. I am sorry. My english is really bad. I am 35 years old. I gave birth one healthy girl 16 years ago. I know that i made really stuiped things. Because i had abortion 7 times after her and i had 2 miscarrieges (both 8th weeks pregnancy) in last 2 years. One of them was in 2012 in july another one just few days ago. I just knew that i have cmv igg possitive 85. I really want to have another baby. What should i do. Please give me some advice. If there is any chance that i can have normal pregnancy.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Mika,

      CMV antibody is a common thing and not usually a serious problem.
      A positive CMV IgG antibody test just means you have had MCV at some time in your life. Most of these CMV infections are old and past and of little to no consequence to another pregnancy.
      You should have a CMV IgM antibody test done, if possible, also. If the CMV IgM test is negative, then your CMV infection is definitely old and past and of no problem to your next pregnancy.
      The reasons for your recent miscarriages, especially following so many terminations, may be something else, besides CMV. You should consult your obstetrician or a specialist in high risk obstetrics for some advice.
      I hope this information is helpful to you.
      Best wishes for a healthy pregnancy next time.

      Dr Gail Demmler Harrison
      CMVDOC

  221. Samar Sinno says:

    Dear Dr. Demmler-Harrison,
    I have lately got infected with primary CMV (I have witnessed all kind of CMV symptoms and it was really hard: high continuous fever, skin rash, fatigue, etc…). Now I m much better and I would like to get pregnant as soon as possible. I have been infected around 2 months and a half ago and today’s test results show that my Avidity Index for CMV IgG is 0.6 which is considered I guess in the “high range” which is safe I believe for pregnancy though my IgM is still low positive.
    Can you please advise if it is safe now for me to try to get pregnant? Thank you a lot for this helpful blog.
    Regards,
    Samar

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Samar,

      Thank you for your post on my TCH CMV BLOG.

      A high CMV avidity index indicates the CMV infection occurred likely around 4 to 6 months or longer in some women. This test is usually used to help determine a recent CMV primary infection from a past CMV infection in women who present with a positive CMV IgG and positive CMV IgM test results, but no history of CMV associated illness. Doing an avidity test helps the clinician determine if the CMV infection is recent or a reactivation or a resolving older past primary infection.

      A 0.6 range is just entering the high avidity index range and is the lowest value considered positive in most avidity tests. You may need a little more time for your index to increase. It is difficult for me to tell you for sure at this time.

      Since you have had a recent illness diagnosed as primary CMV infection, then your circumstances are a little different.
      In general, it is best to wait at least 3 to 6 months after a primary CMV infection, or until the CMV IgM antibody is negative as well as the avidity index is high to start another try for pregnancy. If your CMV IgM antibody lasts more than 12 months, then it is also likely safe to try agian for a pregnancy after that time even if your CMV IgM antibody is positive in the low range but still coming down or stable at a very low level.

      Your circumstances appear to be safe to try for another pregnancy in the near future, from the CMV perspective, in consultation with your obstetrician. It is also recommend you discuss all issues, CMV and otherwise, with your obstetrician, regarding when it is best to start trying again for another pregnancy.

      I hope this information is helpful to you.
      Best wishes for a healthy pregnancy.

      Dr Gail Demmler Harrison
      CMVDOC

  222. nitisavy says:

    RESPECTED DR.

  223. nitisavy says:

    RESPECTED DOCTOR
    I am from India. I WAS PREGNANT last year but due to hydrocephalus in baby, aborted in 5th month. my baby was aborted on 30 august 2013, about 6 month before, now i want to conceive again but doctor recommend me TORCH test on 31/3/2014 and the reports are
    toxoplasma IgG 3.00
    toxoplasma IgM 3.00
    Rubella IgG 23.30
    Rubella IgM 10.00
    Cytomegalovirus, IgG 95.50
    Cytomegalovirus, IgM 5.40
    Herpes Simplex virus 1+2, IgG 0.50
    Herpes Simplex virus 1+2, IgM 0.56
    please tell me what should i do, weather to concive or not, if not when i can concive and what other test should be done
    please reply soon thanks

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Nitisavy,
      I recommend you take the advice of your doctors in India regarding when to best time your next pregnancy.
      For CMV infections, if your CMV IgG antibody is positive and your CMV IgM antibody is negative, and you feel healthy, then it is safe to try again for another pregnancy from the CMV perspecitve
      I hope this information is helpful to you.

      DR Gail Demmler Harrison
      CMVDOC

  224. Phyllis Sang says:

    Dear Dr. Hemmler-Harrison,
    First, I would like to thank you Dr. Hemmler-Harrison for always responding to many people searching for answers. I’m 15 weeks pregnant and I just went over my lab results with my OB/GYN doctor. The IGG 2.10 (Positive) while IGM was <8 (Negative). I know the risk is nil based on your previous responses since it is a past exposure and I'm asymptomatic. I have three questions.
    1.Will it be safe to breastfeed once the baby is born ?
    2. Can I donate blood to anyone ?
    3. What are the chances of being infected again working as a nurse ?

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hi Phyllis,

      Thank you for your kind comments and for posting on my TCH CMV BLOG

      A CMV IgG positive and negative CMV IgM indicates past resolved CMV infection. It is definitely safe [and encouraged] to breast feed your infant. If your baby is extremely premature or immune compromised, then consult with your doctor about options to specially pasteurize or treat your breast milk.
      Breast milk is a common mode of transmission of CMV and is of usually no consequence or problem in the healthy term infant, and it provides lasting immunity to the virus.
      CMV seropositive donors can donate blood, and it will be useful to many patients who need transfusions. Only in circumstances, such as extreme prematures, or immune compromise patients, or transplant pateints, others, etc. will the patient will need CMV seronegative blood . CMV negative donors are very valuable and encouraged to donate.
      CMV can rarely infect another time but almost always it is a silent infection,b ased on our current understanding. Universal precautions, including good handwashing and avoidance of contact with bodily fluids, during your work as a nurse, is sufficient to prevent transmission of CMV. CMV is usually transmitted during intimate close contact, usually within family units, friends, day cares, etc. That form of transmission is well documented. The transmission of CMV in the hospital setting has not been documented convincingly.

      Hope this information is helpful to you.

      Dr Gail Demmler Harrison
      CMVDOC

  225. Gabriela Bustamante says:

    Dear Dr. Hemmler-Harrison;

    My name is Gabriela Bustamante, I´m 8 weeks pregnant. My first result in Torch tests give a result of IGM 1.46. I repited the test a week later an the result was IGM 1.35.
    I went with a Infectius diseases doctor here in Guatemala, and had a PCR test in bood and urine, and gave a positive result.

    I was told about the avidity test, to know if it´s a first infection or a reactivation of a previous one, because a had Mononucleosis when I was a kid. This test is not available in this country, so my fist option would be going to the Texas Hospital to get tested if it´s possible.

    I will appreciate any advise or suggestion form someone as experienced in this field as you.

    Thanks in advance.
    Gabriela Bustamante

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      A positive CMV IgM antibody and a positive CMV IgG antibody together, may indicate a primary CMV infection or a recent infection with CMV. Did you also have a CMV IgG antibody tested? If the CMV IgG antibody also is positive, CMV infection is likely. If CMV IgG is negative, then it is possible a false positive CMV IgM antibody has occurred.

      Here is the link to the Pavilion for Women website where our external referral patient forms can be located.

      http://www.women.texaschildrens.org/forms/

      Please fill out the Maternal Fetal Medicine Referral form on the website. It is the second set of referral forms so you will need to scroll down a little on the website to find them. Then send the back to them as soon as possible. I also have contacted the Maternal Fetal Medicine team here at the Pavilion for Women at Texas Children’s Hospital, and let them know you will be contacting them.

      You may also email me directly to help facilitate the process.

      Dr Gail Demmler Harrison
      CMVDOC

  226. Selena Nelson says:

    During my pregnancy there was no concern and we had a full scan ultrasound that did not show any abnormalities. My daughter was born with jaundice that would not go away. After birth we did many tests to check for her eye vision, hearing, and a cat scan to check her brain and it all came back normal. Her pediatrician’s charts say CMV. I have never been tested for CMV and my daughter who is now 5 years later shows no sign of CMV. The jaundice ended up going away after about 8 months and after seeing many specialists, two liver biopsy’s, and blood transfusions, the Riley Children’s Hospital diagnosed her with neonatal jaundice. My concern is that now I am pregnant again, and would hate to go through what my first daughter when through. My ob. doctor seemed to be a bit confused about CMV when I spoke with him of my first birth and problems. I am not sure if I should get tested for this and what my steps should be and if my daughter would be able to pass it along to me, and then me to my unborn baby. Any tips would be greatly appreciated!

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Selena,

      The diagnosis of congenital CMV infection must be made at birth, with a urine or saliva CMV viral culture or CMV PCR test, done within the first 21 days of life. After that time period, it is difficult to prove CMV was involved in a congenital infection, since it is so commonly and naturally acquired after birth from so many different sources, including breast feeding.
      You may wish to ask your doctors how the diagnosis of CMV was made so you can better understand your daughter’s condition. The symptoms you describe can be associated wtih congenital CMV. Children with congenital CMV infection are at risk for progressivie hearing loss and other neurodevelopmental and sensory disabilities, and they should be carefully followed.
      Regarding your current condition, it would be recommended for you to have your blood tested for CMV IgG and CMV IgM antibody. A positive CMV IgG antibody with a negative CMV IgM antbiody test would indicate a past, resolved CMV infection and relative “immunity” to CMV infection causing any significant problems in your next pregnancy. A CMV IgG antibody negative test would mean you never had been infected with CMV before at any time, and that your daughter’s condition was not congenital CMV infection. A negative CMV IgG antibody test would also mean you would be vulnerable to a first or primary CMV infection during pregnancy, and therefore you should be aware of CMV and practice the recommended three simple hygienic precautions to reduce your risk of acquiring CMV infeciton during pregnancy. It is the first intial infection with CMV during pregnancy that causes the most harm. The recurrent and infections are much less likely to cause any serious problems in the baby.

      I hope this information is helpful to you.

      Dr Gail Demmler Harrison
      CMVDOC

  227. Jaclyn says:

    Hi Dr Demmler,

    I have posted on your site several times before about my son being born with Congenital CMV and my wish to get pregnant again. My antibodies were present, my active infection was low and avidity test 94% before I tried to conceive. I got pregnant a year after I had my CMV affected child and recently gave birth to a seemingly healthy son. He is now presenting with mild hearing loss (he hears at 45 decibels and not 35). I would prefer not to have him tested for CMV (I don’t want to go through all of this a second time) but am concerned about the hearing loss being due to CMV and it potentially increasing the loss. What are the risks and odds of a recurring infection? Would hearing loss from a recurring infection be progressive?

    Thank you,
    Jaclyn

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Jaclyn,

      Thank you for your post on my TCH CMV BLOG.
      There are many causes of a hearing loss in an infant.
      If the hearing loss is from birth, that is, he failed his newborn hearing screen, then genetic causes ,anatomic or structural problems or fluid, or congenital CMV infection {silent or asymptomatic if he is otherwsie well appearing] are all possibilities. The treatment for each is different.
      Most genetic causes are not treatable, but are diagnoseable.
      Some anatomic problems require an ENT sepcialist to see if there is fluid or blockage of the middle ear or an atretic or small auditory nerve canal.
      Congenital CMV may be helped with antiviral treatment to reduce the risk of hearing loss progression.
      Congenital CMV as a result of a maternal recurrent CMV infection can be associated with problems, especially hearing loss. Hearing loss associated with any form of congenital CMV infection is almost always progressive in nature, and antiviral treatment has been shown to reduce the risk of the progression.
      If you do not test your newborn son for congenital CMV [urine or saliva CMV culture or CMV PCR in first 21 days of life are required] and he has hearing loss, then you may be passing up an opportunity to help reduce the progressive loss if it is caused by CMV.

      I hope this information is helpful to you.
      Best wishes.

      Dr Gail Demmler Harrison
      CMVDOC

  228. Brendan says:

    Hi,

    I am in Cambodia and having a very hard time getting a proper explanation of these results.

    My wife is 11 weeks pregnant, and has tested as follows:
    CMV IgM – Negative
    CMV IgG – Positive ( > 500 iu / ml)

    My concern is that the titer level is so high… Could she have been infected after becoming pregnant with this high level?

    Any info is greatly appreciated. :)

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Hello Brendan,
      Thank you for your post on my TCH CMV BLOG.
      The presence of CMV IgG antibody, even if it is “high” level and the absence of CMV IgM antibody (that is IgG positive and IgM negative) usually indicates a past CMV infection that likely occurred many months to years ago.
      The height of the CMV IgG level usually does not mean anything significant.
      It is unlikely CMV will be a problem for this pregnancy since your wife appears to have a past CMV infection and not a recent infection with CMV.
      Regular prenatal care is important to assure your baby and your wife are staying healthy.
      I hope this information is helpful to you.
      Best wishes for a healty pregnancy.

      Dr Gail Demmler Harriosn
      CMVDOC

  229. Selena Nelson says:

    Thank you so much for replying, in regards to my daughter now, she is completely healthy and shows no damaging signs of CMV after having hearing, eyes, and brain checked. Her doctors also told me I would not have to worry about CMV doing anything to her later in life as she gets older. Should I be concerned and get her checked out more now? I feel bad since I am just now reviewing this and she is now 5, but based on her doctors I had nothing else to worry about.t.

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      I am happy to hear your daughter is doing well. I recommend you follow advice of her local doctors. If she is doing well, the likelihood of CMV causing serious problems is low from now on. The only long term complication she may have from congenitl lCMV at thsi point if she is doing well otherwise is late onset hearing loss, which can be followed by hearing tests.

  230. shalu says:

    Hello dr.
    I am an indian woman 25 years old. Had a miscarrige in january and m again 7 week pregnent, my rubell, cmv and herps igg are positive and i m worried about my unborn baby. Is that they can cause any harmful effects to my infant before and after birth? Should i continue my pregnancy or not?

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      The presence of IgG antibody alone to CMV and the other infectious virus agents you mentioned means a past infection has occurred. and this is common, and should be of little to nil risk to your current pregnancy. If you have concerns, then an IgM antbody to the viruses postiive by IgG could be performed. Your fetus should also be assessed by fetal US by your obstetrician and you should continue your normal prenatal care.
      I hope this information is helpful to you. Best wishes for a healthy pregnancy.
      Dr Gail Demmler Harrison CMVDOC

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  233. Sonia says:

    Hello Dr,

    I am 17 weeks pregnant and have been tested for cmv at the beginning of my pregnancy. I have no immunity.

    After quite a difficult year (professionally), I am offered a very interesting job with a group of 8 children aged 02 to 07 years old.

    Before I went for my “trial day”, I couldn’t reach my gynecologist, so I phoned the “Midwives Association”, the Emergency room of our local hospital and the secretary of the gynecologist who shares her settings with my Doctor. They all said with good hygiene mesures I could go and work there safely. After I my “trial day”, I phoned my gynecologist and the secretary again said that with good precautions, I could work there.

    So I accepted the job, and should be starting within a week. The problem is I went to my gynecologist last week for a check-up and when I mentioned the new job, she said it really didn’t sound like a good idea that I would work there as I have no immunity to CMV.

    I have been reading about CMV and child care providers being at higher risk and I feel really guilty that I am even considering going for the job. I really don’t know what to do? I don’t want to reject this offer as I don’t know if I will get such a good offer again soon, but I am 37 years old so time is not on my side and I really don’t want to put my baby at risk of this awful disease.

    What do you think? You seem to think the risks can be controlled with good hygiene measures, but all the horror stories on the Net seem to say that women caught CMV in spite of any good measures they took, just by being exposed to small children. My job would be to take care of these children day and night two days a week. At some times I would be alone, so I can’t just pass on the nappy changing to someone else.

    I’m sorry for any english mistakes I made, as english is not my main language.

    Thank you for your attention and keep up the good work!

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Sonia,
      Thank you for your post on my CMV TCH BLOG.
      As a working mother I understand the importance of career choices and opportunities.
      The ultimate decision about your professional career choices, of course, is yours.
      However, if you are CMV aware, which you are, and if you practice the hygienic precautions mentioned and recommended [which you plan on doing –[do not kiss children on or near mouth, do not share food or drink, and wash hands carefully after contact with body secretions] your risks should be very low. Perhaps also use gloves if available when changing diapers and wiping noses, for added protection. The greatest risk of CMV transmission appears to be in the home setting especially if the pregnant woman is not aware about CMV and not practicing precautions.
      Also, CMV is ubiquitous and you should practice the recommended precautions when around any potentially CMV infected individuals, especially young children, including those in or around your family and close friend settings. Also, if any of your close contacts who are older/adults have diagnosed with acute CMV infection, you should refrain form close contact with them as well while pregnant.
      I hope this information is helpful to you.
      Best wishes for a healthy pregnancy.
      Dr Gail Demmler Harrison
      CMVDOC

      • Sonia says:

        Thank you very much for your answer.

        I feel very reassured. I have tried to reach my gynecologist so we could discuss it again (we only briefly went over the issue). I’ll see what she sais about it. It’s so hard to know what is risky from what is not when you’re pregnant!

        Best regards!

        Sonia

  234. Gugu Madalane says:

    Good day Doctor,

    My sister-in-law has been diagnosed with CMV. She is 23 weeks pregnant. What can she do to prevent infecting her unborn child during pregnancy…Is it possible?

    Kind regards,
    Gugu M

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Gugu M,

      The risk to the fetus depends on the CMV test results. Is it a recent/primary infection or a past resolved CMV infection?
      If a primary or recent CMV infection is present in a pregnant woman who is 23 weeks pregnant, then there is about a 40% estiamated chance of CMV being transmitted to the baby. Most of the time however, CMV is not transmitted to the baby during pregnancy, even during a primary recent CMV infection. If there is a documented recent infection ( CMV IgM positive and CMV IgG positive) then infusion of CMV hyperimmune globulin may or may not reduce the risk of transmitting CMV infeciton. It is also recommended to consult with a maternal fetal medicine specialist about the next best steps in management of the pregnancy.
      If the CMV infection is past and old, then the risk to the fetus is very low and routine prenatal care is recommended.

      I hope this information is helpful to you.
      Best wishes.
      Dr Gail Demmler Harrison
      CMVDOC

  235. bavaria says:

    It’s wonderful that you are getting ideas from this piece of writing as well
    as from our discussion made at this time.

  236. Sandra Salerno says:

    Dear Dr. Demmler-Harrison,
    I am sure you already saw this news article posted today in Connecticut headlines. I just wanted to share it with you and those who read the CMV blog in hopes to continue to spread the word about congenital CMV. Hopefully the more awareness we can raise, the fewer families that will have to walk the long path of congenital CMV and the aftermath.

    Here is a link to the news story:

    Take care,
    Sandra Salerno

    • Sandra Salerno says:

      I guess we can not post links on this blog but the news story is located on the CTNOW website under the “Mommy Minute” section.

  237. Tyrone says:

    Dear Dr. Demmler-Harrison,

    My wife is now full term with our third child (due in two weeks). I came down with a mono-like virus on March 30th 2014 that was determined is not Epstein-Barr. I am still waiting for my cmv results (two weeks now) due to backlog at Ontario public health. My symptoms were identical to an acute cmv infection (hepatitis, abnormal lymphocytes, swollen spleen, swollen glands, sore throat, extreme fatigue, fevers for the first two weeks 100deg-104). I now have no more symptoms other than some tiredness, and my liver is now normal. My question is, if I do have this virus, how long am I contagious for? I could not find any definite answers, via internet, my own Dr. really had no idea, and my wife’s midwives have not been able to find out either. My wife and I have had no “close contact” (if you get my drift, not even kissing) for five weeks now. She was previously tested prior to our second child being born and the testing was negative. We are scared of harming our unborn child due to this illness. Does this mean I can not kiss my wife until the baby’s born or even further on than that if she is breastfeeding?
    Thank-you so much for your blog, and assistance on this illness. The world needs more Doctors like you!!!

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Tyrone,
      Thank you for your post on my TCH CMV BLOG.
      The symptoms you described certainly are consistent with a mononucleosis syndrome of some type and CMV is one of the many causes possible. Hopefully you will find out soon about your CMV test results. A positive CMV IgG and positive CMV IgM antibody result would indicate CMV as a likely cause. Your CMV cultures of saliva and urine also would likely be positive if these tests were done also.
      CMV mononucleosis in otherwise healthy adults occurs but is unusual, since almost 90% of the time CMV infections are silent and asymptomatic, but it does occur. It may cause CMV shedding of the virus in saliva, urine and body secretions, including semen for men and cervical vaginal secretions for women, consistently for several weeks. Many adults however stop shedding CMV after their primary CMV infection in about 3 to 6 weeks [most all by 3 months after primary infection ] but then may normally shed CMV intermittently at any time hence, like any CMV seropositive individual. It is possible you have stopped shedding CMV consistently and moved into the intermittent stage, but it is hard to tell for sure.
      The transmission of CMV from husband to wife has been clearly documented to occur, so until you know for sure your recent illness is not CMV, you should avoid close contact with her secretions until her baby is delivered. Big hugs now instead of kisses and sexual intimacy until after delivery is prudent if you are shown to have had a recent CMV infection.
      After delivery, however, there is no neeed to abstain from close contact, and you can let nature take its course. Even if your wife acquires CMV post partum, it is usually a silent infection. It is possible she may shed CMV in her breast milk if she catches CMV while nursing your child, but that is actually nature’s natural way of transmitting CMV to newborns and infants and usually is of little to nil problems in otherwise healthy newborns. Only in infants who are premature or have underlying conditions of hteir immuen system is avoidance of CMV infection during infancy required.
      I hope this information is helpful to you and your family.
      Best wishes for a healthy rest of your wife’s pregnancy and the birth of your third child!

      Dr Gail Demmler Harrison
      CMVDOC

  238. Samantha Polk says:

    Dr. Gail Demmier-Harrison,
    I am very concerned about this CMV virus and have mixed emotions about what I am being told by numerous people. At 17 weeks my US revealed an echogenic bowel, so my physician ordered a ton of blood work one test being CMV, my results were IgG < 0.2, and IgM < 0.2, so my doctor at that point ruled out possible CMV infection and all my other blood work was negative also. So she at that point said there was no need for an amnio due to the simple fact that I had to test positive in one of those tests in order to justify testing baby at this point she attested there was no chance baby would be infected. Okay so since this conversation I have spoke with two people that basically said the blood test is irrelevant in the mother and one never even had the test done due to her doctor saying the sensitivity is so low and they just performed the amnio and they found positive results. My question is, do I need further work up or just not listen to those around me I am currently 20 weeks and 3 days and of all the research I have done I read treatment should be started before 20 weeks for optimal outcomes. Thank you for any insight on this matter,
    Samantha Polk

  239. Samantha Polk says:

    Dr. Gail Demmier-Harrison,
    I forgot to mention that my husband had an active infection of shingles when we conceived in December. My office feels that is irrelevant to CMV, since CMV they said is not caused by the varicella virus. Any clarification of the virus that actually causes this virus would be beneficial also, I have read the herpes virus including those of the chicken pox family is related to CMV. Thank you,
    Samantha Polk

    • Dr. Gail Demmler-Harrison, Infectious Diseases Dr. Gail Demmler-Harrison, Infectious Diseases says:

      Dear Samantha,

      Thank you for your post on my TCH CMV BLOG.

      The presence of echogenic bowel in fetal ultrasound is a nonspecific finding and may resolve on its own.
      It also has been seen as an early sign of congenital CMV infection or other disorders however, so it should be investigated and followed up with testing and repeat fetal ultrasounds.

      CMV serology testing in the mother, like you had performed, would be indicated. Most CMV experts would recommend amniocentesis to determine fetal CMV infection only if positive results for both CMV IgG and CMV IgM antibody were found in the mother of a baby with echogenic bowel on fetal ultrasound.
      If both CMV IgG and CMV IgM antibody are negative and the laboratory that performed the testing was felt to be reliable, then fetal infection with CMV would not be expected to occur.

      There is of course a slim chance of a false negative reading on your CMV serology test results due to a laboratory error or a very recent CMV infection that was not detectable in your blood by the laboratory.

      For reassurance and peace of mind, you may wish to confirm the results and repeat your CMV IgG and IgM serology results 2 to 4 weeks after the first set of CMV serology tests to be sure you have not seroconverted recently and had a false negative CMV result initially. Also, follow the well being of your fetus and the recommendations of your obstetrician, since your own doctor knows your own case the best.

      Best wishes for a healthy pregnancy.
      I hope this information is helpful to you.

      Dr Gail Demmler Harrison
      CMVDOC

  240. Cisa says:

    Dear Dr. Demmler-Harrison,
    Congratulation for your great job in increasing awareness about CMV and answering the questions on TCH BLOG!
    I’m from Roumania.

    My sister is 39 years old, with one miscarriages due to thrombosis. Now she is pregnant again, in 17 weeks. For her thrombosis she is takin Clexane 0.4ml on the daily base.
    Recently her CMV test results are:
    CMV IgG = 600 U/mL (positive)
    CMV IgM = 0.24 (negative)
    CMV IgG avidity = 0.92

    Does she has to perform a amniocentesis to assess for virus in amniotic fluid?