How many people live with active CMV. What is dangerous cytomegalovirus. Terrible non-terrible cytomegalovirus. Prevention of infection development

Cytomegalovirus was discovered by researchers in the twentieth century and was named a combination of the Greek word "cytos" - cell, "mega" - large and the Latin "virus" - poison. By the very name of cytomegalovirus, it is clear that it has a toxic effect on the cells of the body, is a poison for the cell.

The structure of CMV It is a representative of the genus of the human herpes virus of the fifth type. Three strains of cytomegalovirus are known. Like all types of herpes viruses, cytomegalovirus can be in the human body for a long time, asymptomatically, but at the same time a person is contagious to his partners.

Cytomegalovirus has a tropism in the cells of the salivary glands, so doctors often start searching for it from the salivary glands.

The virus develops in human connective tissue cells (fibroblasts). Infected cells increase, reaching gigantic sizes, as viral particles accumulate. Cytomegalovirus replication occurs in white blood cells and ends with the formation of daughter virions that break the affected cells, enter the bloodstream and attack healthy cells.

Epidemiology

Cytomegalovirus is widespread throughout the globe, antibodies to cytomegalovirus antigens are present in 57.9% of people over the age of six. In the older group, 91% of the population is strongly positive by serology.

Ways of infection:

• Contact household
• Sexual
• Vertical
• iatrogenic

There are several types of antiviral drugs with marked clinical efficacy in neonates, immunocompromised people, and pregnant women.

Ganciclovir is used in patients with secondary immunodeficiencies or having severe systemic diseases, malignant neoplasms. There is a drug that antiviral action even when taken orally (Valganciclovir). Now scientists note a decrease in its effectiveness, due to the emergence of resistant types of the virus. In the presence of resistance to ganciclovir, cidofovir is used, it is toxic, affecting mainly the kidneys.

Prevention of infection development

Prevention is the observance of personal hygiene for those who are in family contact with a patient with cytomegalovirus infection. This is especially true for women. Usage barrier contraception(condoms) reduce, although they do not exclude the possibility of infection with cytomegalovirus infection.

Since this infection is especially dangerous for the fetus in the first trimester of pregnancy, a vaccine has been developed that is used only for pregnant women. The effectiveness of the vaccine does not exceed 50 percent, so researchers are now working on improving it.

Cytomegalovirus (CMV - Cytomegalovirus) is one of the most common viruses in the human population. More than 90% of the urban population of the entire planet, more than half of children of any age and a significant number of the rural population are infected with it. At the same time, medicine still does not have the means to completely destroy it in the body, and therefore everyone infected with cytomegalovirus at any age is a carrier of it.

All these qualities of cytomegalovirus are due to the peculiarities of its structure and biology. Which, by the way, were studied in detail relatively recently ...

The history of the discovery of cytomegalovirus

The CMV virus itself was discovered in 1956 by researcher Margaret Gladys Smith. She also owns the first detailed description of the virus. As often happens in science, almost simultaneously with it, the virus was discovered by a group of scientists led by Smith and Rowe in the urine of a sick child.

Long before that, in 1881, the German pathologist Ribberts discovered cells in the kidney tissues of a stillborn child that were very large and had a clearly visible nucleus. It is Ribberts who authored the name of these cells "owl eyes" and the assumption that their appearance is associated with the action of some kind of infection.

A little later, scientists Tolbert and Goodpastur called such cells cytomegals, which later gave the name to the virus itself.

The virologist Weller, discovered by Margaret Smith, connected the virus and cytomegalovirus in 1957. He studied the properties of the virus in detail and found out that it is precisely because of its action that the cells turn into “owl eyes”.

Description of cytomegalovirus

Cytomegalovirus belongs to the herpesvirus family and has a structure similar to most of them.

The CMV virus particle, the so-called virion, has a spherical shape. The outer shell of the particle consists of two layers: the inner protein and the outer - lipoprotein. Inside the particle, densely packed, is a viral DNA molecule.

Most of the lipoprotein molecules protrude above the surface of the particle and form a kind of "wool cover" of it. The task of these molecules is to analyze the surfaces with which the particle comes into contact during its wanderings through the body. As soon as the virion collides with the cell wall, which is quickly recognized by lipoproteins, the particle attaches to it, pierces the cell wall and injects its DNA inside.

Then everything happens according to the scenario familiar to all viruses: DNA penetrates the cell nucleus, and the cell itself, together with the proteins it needs, begins to produce viral proteins. From the latter, new viral particles are collected, which leave the cell and go in search of the next “victims”.

Infection with cytomegalovirus and methods of its transmission

Cytomegalovirus most actively multiplies in the cells of the mucous membranes - in the salivary glands, nasopharynx, in the vagina. And through them most often penetrates into the body. In this regard, the main ways of its transmission are:

• direct contact path. Very often, the virus is transmitted by kissing and sexual intercourse, less often by contact of children with each other or with adults.
• Airborne.
• Transplacental from mother to fetus
• With a blood transfusion or reusable medical instrument without sterilization.

Unlike many other herpesviruses, cytomegalovirus has a weak ability to infect the body, therefore, for its transmission, the contact of the carrier and the infected must be sufficiently dense and long.

Cytomegalovirus in humans

CMV is capable of affecting almost all organs and tissues. Most favorable environment for its reproduction are epithelial cells, so most often the infection affects the membranes of the organs. The severity and extent of lesions depends on the state of the immune system and the method of infection.

In adults, after contact with the mucous membranes, the virus enters the bloodstream. Here it multiplies and persists for a long time in leukocytes. The ability of some types of leukocytes to migrate into tissues leads to the spread of the virus throughout the body. Reproduction of the virus in the cells of the bone marrow gives new generations of infected leukocytes, which makes it almost impossible complete removal pathogen from the body.

With reduced immunity, the virus can cause inflammation of the gastrointestinal tract with the formation of ulcers of the esophagus, stomach, colon and small intestine. These patients often develop hepatitis, pneumonia, spleen involvement, peripheral nerves, retinal necrosis. Occasionally, inflammation of the heart muscle, joints, membranes of the lungs and brain is observed.

When CMV is transmitted from mother to fetus through the placenta, the infectious process begins with the mucous membranes of the respiratory tract. Most often, this leads to the development of atypical pneumonia with the replacement of normal lung tissue with connective tissue (scarring). Cytomegalovirus can also invade the kidneys, brain, and spinal cord, causing fetal developmental defects.

A characteristic sign of the reproduction of cytomegalovirus in the body is the appearance of giant cells. Their nucleus contains accumulations of viral particles, which greatly increases in size, giving the cell a resemblance to an owl's eye:

Tissue damage during cytomegalovirus infection is caused by the reaction of the immune system - the destruction of virus-infected cells by T-lymphocytes. In a severe form of the disease in the blood and organs in large quantities immune complexes are formed - aggregates of antibodies with viral particles. These complexes are dissolved by the complement system, which is accompanied by damage to surrounding tissues and the development of inflammation.

The body's immune response to CMV

Immediately after a surge in the number of viral particles in the body, the immune system produces special proteins - immunoglobulins (Ig), which are able to bind and destroy virions. First of all, class M immunoglobulins appear, after them - IgG, specific specifically to cytomegalovirus. The former do not live long and provide short-term protection for the body. The second after the appearance in the body remain in it for life, providing lifelong immunity.

Cytomegalovirus infection and its complications

When severely infecting the body, cytomegalovirus causes symptoms, collectively called cytomegalovirus infection . It is characterized by inflammatory processes in different parts of the body, and depending on the strength of the body's immune system, it can show almost nothing, or it can cause serious complications:

• mononucleosis-like syndrome, manifested by symptoms of a cold, sore throat, malaise and fever
• inflammation of the liver
• pneumonia
• encephalitis
• retinitis.

All these diseases are characteristic almost exclusively for people with immunodeficiencies and occasionally for newborns. In the majority of cases cytomegalo viral infection proceeds in the body asymptomatically, and a person may not even know that he has become infected and has been ill with it.

Diagnosis of cytomegalovirus infection

For accurate diagnosis cytomegalovirus infection, one should resort to rather expensive and complex methods of analysis. This is relevant only for pregnant women, immunodeficient patients and infants. In them, the presence of CMV in the blood is determined using:

• ELISA method trying to find antibodies developed against the virus
• PCR- a polymerase chain reaction method that allows you to find virus genes in tissues and blood
• cultural method based on determining the nature of the virus by the nature of its damage to a special nutrient medium.

Based external symptoms and examination unequivocally establish the nature of the virus is almost impossible.

The fight against cytomegalovirus

The fight against cytomegalovirus is justified only if a person has enough severe symptoms illness. There are two different approaches to the fight against cytomegalovirus, which should be applied in a complex manner.

The first method of struggle is the use of antiviral drugs. Their action is to suppress the CMV replication cycle and prevent it from replicating freely in the body. Have been developed special means, which selectively penetrate into infected cells without damaging healthy ones. But it should be borne in mind that taking these drugs is contraindicated for pregnant women, as they have a toxic effect on the body and may have a number of side effects. Therefore, the dose of the antiviral drug (especially Foscarnet, as the most active) must be accurately adjusted by the doctor.

Foscarnet, Ganciclovir, Viferon, Cidofovir are best known against cytomegalovirus.

The second method is the use of immunoglobulins. These are special proteins derived from blood plasma that are capable of infecting foreign cells. Immunoglobulins act selectively: a specific type of immunoglobulin infects one type of virus. As a result, immunoglobulins are more effective in combating cytomegalovirus than antiviral drugs, the dose of which should be much higher. In addition, immunoglobulins are preferred because they do not have a toxic effect on the body and reduce the risk of re-infection.

To combat cytomegalovirus, drugs Megalotect, Cytotect are used.

CMV infection during pregnancy

Prevention of complications of cytomegalovirus infection

The main rule for the prevention of cytomegalovirus infection is the support of strong immunity. This ensures that the initial outbreak of infection is easily tolerated, and the absence of relapses in the future.

Prevention of complications of cytomegalovirus infection in people with weakened immune systems is the regular introduction into the blood human immunoglobulins or the use of antiviral drugs, but in smaller doses than is used to treat the disease. However, only a doctor should determine individual doses and schedules for the use of drugs.

A little more than half a century has passed since the discovery of cytomegalovirus (CMV) in 1956, after which his photos and pictures appeared. This unusual microorganism was immediately assigned to the family of herpesviruses, where the virus of the 1st and 2nd type, causing herpes on the lips and genital herpes, had already been identified much earlier. Some of its properties are similar to those of the representatives of this family. One of them is a lifelong stay in the body. infected person predominantly in latent form. Although cytomegalovirus is still not a thoroughly studied microorganism, there is enough information about it, so it's time to answer the main question, what does cytomegalovirus mean.

What is cytomegalovirus disease?

Carriers of cytomegalovirus infection are about 90% of the population, but few of this number know what cytomegalovirus means and how it looks in photos and pictures. CMV was discovered by Margaret Gladys Smith, who gave a detailed description of the microorganism.

The effect of CMV is ambiguous. It can, like other types of herpes, be in the body all the time, being in a latent form. With reduced immunity, cytomegalovirus infection, which is also called cytomegaly, is active. As soon as it enters a healthy cell, it begins to increase in size. That is why cytomegaly means when literal translation"giant cell" Cells affected by CMV quickly change their structure and swell excessively. The main habitat of the virus is salivary glands.

Ways of infection with the cytomegalovirus virus

When CMV infection was first identified, it was defined as "kissing sickness" and was thought to be transmitted only through saliva during kissing. After a more detailed study of the virus, other ways of its spread became known. CMV infection usually occurs at any age. Children during early childhood are infected by household means from their parents or friends in kindergartens, sexual partners transmit the infection to each other during intimacy. Such routes of infection as infection of the fetus with the virus in utero or transmission of CMV to the infant through breast milk are not excluded. Household contacts of transmission of the virus are practically not observed, perhaps only patients who do not have very weak immunity are able to be infected through common objects.

Symptoms and signs of the presence of cytomegalovirus

Most often, cytomegalovirus infection in children is asymptomatic. And the signs depend on how strong the immune system of the carrier of the infection is. If the virus does not show any activity, it is completely safe for the one in whose body it has taken root. Its only danger is in such a form that it can cause illness to those who are nearby and at the same time have a weakened immune system.

Sometimes symptoms of cytomegalovirus may appear after infection. By all indications, it resembles colds:

• Feeling worse
• Weakness
• Temperature rise
• Cough
• Runny nose
• Increase salivary glands
• Pain when swallowing

Soon the symptoms disappear, the state of health returns to normal, and antibodies appear in the blood of the infected patient. They will be reliable defenders against the virus that remains in the body.

In patients with immunodeficiency, CMV infection causes severe complications, which will take a long time to be treated. Among the consequences of such activity of the virus may be sepsis, pneumonia, lesions of various internal organs. Often in children, against the background of active reproduction in the body of CMV infection, cytomegalovirus rhinitis occurs, in which patients first experience blurred vision, which, as inflammation of the retina develops, leads to complete blindness.

The most dangerous manifestation of cytomegalovirus, as in the photo, is brain encephalitis. If left untreated, it leads to loss of limb mobility.

Diagnostics and tests for cytomegalovirus

A healthy person does not need to look for the cytomegalovirus disease in his body. Such a diagnosis is prescribed for pregnant women who have an immunodeficiency or are unable to bear a child, patients with oncology, with atypical pneumonia, and frequent groundless temperature rises.

AT laboratory conditions it is possible to determine both the presence of the virus itself or its DNA in the test material (sputum, saliva), and antibodies in the blood. To diagnose the virus, it is effective to conduct a smear study, bakposev of the patient's test material. Since CMV has DNA, a PCR study is prescribed for a severe form of the disease. To detect antibodies to cytomegalovirus, blood serum is examined. The presence of IgG antibodies indicates past illness and the presence of immunity, the presence of IgM antibodies to CMV infection is alarming, since such a result indicates a current infection, which is dangerous for patients at risk.

Treatment of CMV infection

If a cytomegalovirus is found, as with herpes in a latent form, treatment is not required with a strong immune system that properly copes with the body's defense against the manifestation of the virus. After the infection has been transferred, protective immunoglobulins will be developed that will not allow you to get sick with cytomegaly in the future.

The situation is quite different for those who have a weakened immune system. They will have to treat the disease with antiviral agents, as well as strengthen immunity. The doctor prescribes only those drugs that are able to block the active reproduction of the virus, preventing it from infecting new cells. As effective medicines, cidofovir, foscarnet, viferon are offered for the treatment of a disease caused by cytomegalovirus. Panavir is considered universal to combat cytomegalovirus infection, which is administered as an injection. These drugs cannot be prescribed on their own, because they have a number of contraindications and require a specific dosage for a particular patient.

Immune therapy is carried out in combination with the main treatment. As a drug that strengthens the immune system, cytotect is recommended.

Prevention of cytomegalovirus infection

Preventive measures will help protect people with weakened immune systems from contracting cytomegalovirus infection, as well as herpes and other diseases. You don’t have to do anything supernatural, it’s enough to show elementary rules taking care of your health and the virus will not rise:

• The use of a condom when dealing with an unfamiliar partner, regardless of what type of sex is practiced (vaginal, oral, anal).
• Develop the habit of never using other people's things. It is especially unpleasant and dangerous to use towels and washcloths belonging to others.
• Do not use other people's dishes, bedding, razors for personal purposes.
• Avoid close contact even with people you know well, if you know that they may be carriers of viruses.

People who have a strong immune system, eat right and lead healthy lifestyle life, there is no need to be afraid of infection with cytomegalovirus. They are simply not afraid of CMV.

Not everyone knows cytomegalovirus. Symptoms of this disease may not express themselves for a long time It all depends on the immune system of the human body. In the event that immunity is normal, and the virus is present in the body, then the person is a carrier and can infect others without knowing that he himself is sick.

If there is a decrease in immunity under the influence of provoking factors: hypothermia, stress, then the disease begins to manifest itself.

Cytomegalovirus (CMV) belongs to the herpesvirus family. There are currently 80 known varieties. herpes viruses. A person is subject to eight types, which are divided into groups:

• a viruses. This group includes herpes simplex types 1 and 2, chicken pox and shingles. This group affects the nervous system and affects it;
• v-virus. herpes type VI. Affects the kidneys and salivary glands;
• Y virus. VII and VIII type of Herpes, Infectious mononucleosis(Epstein-Barr disease).

These diseases affect the lymphocytes in the blood and the human immune system suffers.

Transmission routes

Consider how you can get infected with cytomegalovirus, what are the consequences of this disease.
The disease is congenital and acquired.
The congenital route of infection is when the virus is transmitted through the placenta, amniotic fluid.
Acquired for a baby is the birth canal and breastfeeding. When breastfeeding, the virus is transmitted from the mother through milk.

The entrance gate for cytomegalovirus in a healthy person is the mouth, genitals, gastrointestinal tract.

The virus is transmitted from a person: through kisses, through someone else's dishes, bed linen, sexual contact and personal hygiene items, during surgery - organ transplantation, through blood donation. Very rare, but still possible airborne transmission.

Pathogenesis

With the penetration of cytomegalovirus through the oral cavity, esophagus or genital organs, the virus is localized in the salivary glands, the epithelium of the lungs and kidneys.

Rarely, monocytes and blood lymphocytes are affected. When the virus penetrates the cell membrane, it tends to the nucleus, wedged its DNA, causing changes in the structure of a healthy cell. The cell becomes three times larger. The edges of the cell are stained with light shade, and a dark inclusion appears in the center of the nucleus. Therefore, under a microscope, it will look like a bird's eye. Once inside the cell, the virus does not kill it, but covers it with its cellular secretion. Therefore, human immunity cannot recognize it, and in such a latent state, the virus can exist for a long time. As soon as the immune system weakens, the number of unhealthy cells begins to grow. The consequences of cell growth are the symptoms of the disease.

Symptoms

The disease is transmitted imperceptibly, sometimes when infected, mononucleosis can develop, which stops itself. Typical symptoms:

• the temperature rises to 37-38 degrees;
• throat red, painful;
• nasal congestion, runny nose;
• headache, weakness, malaise.

All symptoms are very similar to Acute Respiratory Viral Infection. If the immunity is normal, then the symptoms disappear in a few days and the disease becomes latent, i.e. latent form. In violation of immunity, cytomegalovirus proceeds much harder. The severe course of the disease is affected by factors such as HIV, taking glucocorticoid drugs, radiation sickness, oncology, stressful situations and lack of vitamins in the human diet.

The disease interferes with the functioning of the lymphatic system. Mostly affected cervical lymph nodes, behind the ears, sublingual, submandibular. Sialoadenitis may develop, where the salivary glands are affected.

Severe course

Consider the dangers of cytomegalovirus.

With poor immune function, a severe course of the disease leads to complications. There are forms of complications:

1. Respiratory. After an operation to transplant organs from a sick person, pneumonia develops. Statistics show in 90% of cases - a fatal outcome.
2. Cerebral. Inflammation in the brain. cerebral form flow leads to dementia.
3. Gastrointestinal form. The disease is manifested by symptoms of colitis, peptic ulcer. Often the consequences lead to perforation of the ulcer, peritonitis.
4. The hepatobiliary form of the course of the disease, in which hepatitis is a complication, the liver increases in size.
5. Renal course of the disease. In this form, cytomegalovirus damages the urinary organs.
6. The hematological form, where the function of creating blood suffers, sepsis can become a complication.

At weak immunity the virus can cause eye damage and retinitis disease. Necrosis appears on the retina of the eye, which can lead to blindness. Cytomegalovirus disease in men is manifested by symptoms of testicular inflammation. In women, the disease is characterized by vulvovaginitis, endometritis, colpitis.

Diagnostic study

To determine the type and form of the disease, laboratory diagnostics of blood is carried out, saliva, a smear of the genital organs, and urine are examined.

A biopsy is performed and the tissues taken are examined. Breast milk is taken, if necessary, as well as flushing after bronchopulmonary lavage.

The most accessible diagnostics is a blood smear microscopy study. This method detects altered cells, but its accuracy is up to 70%. To make a diagnosis, it is necessary to determine antibodies to cytomegalovirus infection. There are laboratory methods by which this can be done. RIF is an immunofluorescence reaction, PCR is a polymerase chain reaction, ELISA - linked immunosorbent assay. The most modern and effective method detection of the disease is PCR - it allows you to detect cytomegalovirus in the early stages, even if obvious symptoms will be absent. ELISA - allows you to determine the concentration of immunoglobulin in the blood. At high rates it is possible to reveal the significance of the active process of the disease. If class G immunoglobulin is detected in the blood, we can talk about a latent form of carriage.

In addition to these blood tests, the doctor will prescribe an ultrasound of the kidneys and liver. It is recommended to consult with a neurologist, with a gynecologist, for men with a urologist.

Therapeutic measures

You need to know that cytomegalovirus is resistant to many medicines, which are used for herpes, therefore, in order to cure the disease, it is prescribed:

1. Ganciclovir drug. The dose is selected individually according to the age and severity of the disease. Children under the age of 5 years and in severe cases of the disease are prescribed intravenous administration of 5 to 10 mg per 1 kg per day. For a milder form, adults are prescribed the drug in tablets. Dosage - 3 gr. During the day. Treatment continues up to three months. The use of this drug is accompanied by many side effects on the part of hematopoiesis - the number of platelets and granulocytes decreases. noted allergic urticaria, impaired kidney function, headaches, the liver suffers, convulsions appear.
2. Foscarnet is contraindicated in children infancy. Has the risk of developing multiple complications. It is practically not absorbed in the stomach, so it is prescribed by injection. Adult dose - 180 mg per kg. Children 120 mg/kg for the first three days, then reduced to 90 mg/kg. The course is three weeks.

These drugs inhibit the process of synthesis, renewal of cytomegalovirus DNA, but have a bad effect in case of a disease of the digestive system, pulmonary system, and brain disease. In pregnancy, these drugs are contraindicated, but are prescribed if the benefit to the mother outweighs the risk to the life of the fetus. Contraindicated during the lactation period.

These drugs showed good results with the simultaneous administration of recombinant interferons, such as Viferon, Reaferon. Interferons increase the effectiveness of essential drugs.

Against the background of the disease, a person often develops secondary infections, in the treatment of which antibiotics are prescribed. The doctor will prescribe additional treatment: B - vitamins, magnesium, hepatoprotectors - drugs to restore the liver, antioxidants, drugs to prevent damage to brain neurons (neuroprotectors), blood circulation agents. Appoint antiviral drugs: Amiksin, Cycloferon, Tiloron.
To prevent the disease, immunoglobulin - Cytotect is used. It is indicated for immunocompromised people, two weeks before organ transplant surgery - 1 ml per kg.

CMV in pregnancy

If a disease is detected during pregnancy, doctors recommend interrupting and taking measures to treat the woman.

During pregnancy, female immunity weakens due to hormonal changes, so a woman runs the risk of contracting CMV. If she is already a carrier of cytomegalovirus, and the disease is in dormant mode, then during pregnancy the virus is activated. The consequences become dangerous, because infection of the fetus through the placenta can cause its death or disruption of the overall development of systems and various pathologies. Also, CMV infection can occur already at the embryonic stage, through semen. Often the baby becomes infected in tribal activity when it passes through the birth canal. Dangerous Consequences diseases for the fetus will be in the 1st trimester to the 23rd week of pregnancy.

When a fetus is infected with cytomegalovirus during the prenatal period, the following pathologies can develop:

• intrauterine death of the child, premature birth;
• pathology of the development of the heart and vascular system;
• hearing loss and vision loss may be total loss these functions;
• underdevelopment of the brain;
• liver enlargement, hepatitis;

• underdevelopment of the musculoskeletal function;
• CNS lesions;
• microcephaly, dropsy.

Prevention during pregnancy

For those planning a pregnancy, prevention plays a big role, therefore, before conception, all tests for CMV should be taken and, if necessary, treated. If a woman previously had a baby with a disease, then the next birth can be planned only after two years.

Basic Prevention Measures

In order not to become infected with cytomegalovirus, you must follow the rules of personal hygiene. Be aware of the transmission of the disease and be careful with direct contact of body fluids. Towel, dishes, toothbrush, bed linen, etc. must be individual. Frequent hand hygiene is the most effective defense against the virus. Protective equipment (condoms) should be used during sexual intercourse. Taking vitamins is a strengthening of the immune system, which will help in preventing the disease and will not cause complications when infected. Remember that any stress can lead to a decrease in the immune system, which means waking up a dormant virus. Therefore, it is worth learning not to be subjected to stressful situations and deal with them.

Avoiding crowded places during outbreaks of respiratory diseases will also be good preventive measures. Try not to get SARS, so as not to expose your body to the risk of CMV infection. A protracted cold or some symptoms of acute respiratory infections: runny nose, cough or subfebrile temperature, are an indication for testing for a virus of this etiology. With any herpes, you also need to get tested, since frequent herpetic reactions on the skin can be a wake-up call to a more dangerous viral infection. If mononucleosis is detected, this is also the reason for referral to laboratory research CMV.
It must be remembered that the presence of symptoms of a severe course of the disease is typical for HIV-infected patients, so it is recommended to undergo an HIV test if it occurs.

Be sure to follow the diet and increase immunity by physical activity.

Summing up, we can say that CMV is especially dangerous for weakened immunity and for children whose infection occurred in the womb. Take care of your immunity, carry out diagnostics in time, and then the terrible virus will bypass.

The child was diagnosed with cytomegalovirus. Despite the wide distribution of this agent on the planet, there is practically no knowledge of ordinary inhabitants about it. AT best case, someone once heard something, but what exactly, I can’t remember anymore. Doctor Yevgeny Komarovsky told in an accessible form that it is a virus, why it is dangerous and what to do if this “terrible beast” is found in a child’s blood tests. We give you the opportunity to get acquainted with the information from a famous doctor.

About the virus

Cytomegalovirus belongs to the family of herpes viruses of the fifth type. It is quite interesting when viewed through a microscope - its shape resembles a round prickly shell of a chestnut fruit, and in the context it looks like a gear.

Affecting a person, this virus causes the occurrence of cytomegalovirus infection. However, it is not so aggressive: after entering the body, for a long time it can quite peacefully exist there, without indicating its presence in any way. For this "tolerance" it is called an opportunistic virus, which goes into reproduction and causes disease only under certain factors. Chief among them is a weakened immune system. The most susceptible to infection are people who take a lot of medicines for any reason, live in an ecologically polluted area, and often and in large quantities use household chemicals.

Cytomegalovirus loves to settle in the salivary glands. From there it travels throughout the body.

By the way, the body gradually produces antibodies to it, and if enough of them have accumulated, even a weakened immune system can no longer cause a cytomegalovirus infection.

Transmission routes

If for adults the main route of infection is sexual, then for children it is kissing, contact with the saliva of a person infected with the virus, which is why it is sometimes called the kiss virus.

Also, the mother, with a large cytomegalovirus infection, passes it on to the fetus during pregnancy, and this can cause quite serious malformations in its development. The child can become infected during childbirth through contact with mucous membranes birth canal. In addition, the baby can get an infection with mother's milk in the first days of his life.

Another way of transmission of cytomegalovirus is blood. If the crumbs had replacement blood transfusions from a donor who has such a virus, as well as organ transplantation from an infected donor, then the child will definitely become carriers of cytomegalovirus.

Danger

Yevgeny Komarovsky cites the following fact: on the planet, 100% of the elderly in one way or another had contact with cytomegalovirus. Among adolescents, about 15% of those who already have antibodies to this agent are found (that is, the disease has already been transferred). By the age of 35-40, antibodies to CMV are found in 50-70% of people. By retirement, the number of those who are immune to the virus is even higher. Thus, it is quite difficult to talk about some kind of excessive danger of the fifth type virus, because many who have been ill do not even know about such an infection - it went completely unnoticed for them.

The virus is dangerous only for pregnant women and their unborn children, but also provided that the collision future mother with CMV during gestation arose for the first time. If a woman has been ill before, and antibodies are found in her blood, then there is no harm to the child. But primary infection during pregnancy is dangerous for the baby - he may die or there is a high risk of congenital malformations.

If the infection of the baby occurs during pregnancy or immediately after childbirth, then doctors talk about congenital cytomegalovirus infection. This is a pretty serious diagnosis.

If a child has caught the virus already in his own conscious life, they speak of an acquired infection. It can be overcome without much difficulty and consequences.

Parents most often ask the question: what does it mean if antibodies to cytomegalovirus (IgG) are found in the baby’s blood test and + is put opposite CMV? There is nothing to worry about, says Yevgeny Komarovsky. This does not mean that the child is sick, but that there are antibodies in his body that will prevent the cytomegalovirus from doing its "dirty deed". They developed on their own, because the child has already had contact with this virus.

You need to start worrying if the child has IgM + in the results of a blood test. This means that there is a virus in the blood, but no antibodies yet.

Symptoms of infection

The presence of cytomegalovirus infection in a newborn is determined by doctors children's department maternity hospital. Immediately after the birth of the crumbs, they do an extended blood test.

In the case of an acquired infection, parents should be aware that the incubation period lasts from 3 weeks to 2 months, and the disease itself can last from 2 weeks to a month and a half.

The symptoms of even a very attentive mother will not cause the slightest doubt and suspicion - they are very similar to a common viral infection:

• body temperature rises;
• appear respiratory symptoms(runny nose, cough, which quickly turns into bronchitis);
• signs of intoxication are noticeable, the child has no appetite, he complains of headache and muscle pain.

If everything is in order with the child’s immune system, then it will give a powerful rebuff to the virus, its spread will be stopped, and the same IgG antibodies will appear in the baby’s blood. However, if the peanut's own protection was not enough, the infection can "hide" and acquire a sluggish, but deep form, in which the internal organs and nervous system are affected. With a generalized form of cytomegalovirus infection, the liver, kidneys and adrenal glands, and the spleen suffer.

Treatment

Treat cytomegalovirus infection by analogy with herpetic infection, unless they choose drugs that do not affect herpes in general, but cytomegalovirus in particular. There are two such funds - "Ganciclovir" and "Cytoven", both are quite expensive.

During the acute phase of the disease, a child is prescribed plenty of fluids and vitamins. Antibiotics are not needed for uncomplicated cytomegalovirus infection because antimicrobials do not help against viruses.

Antibacterial agents can be prescribed by a doctor in case of a complicated course of the disease, when there are inflammatory processes from the internal organs.

Prevention

The best prevention- strengthening immunity, good nutrition, hardening, sports. If a pregnant woman did not suffer from cytomegaly and her registration does not show antibodies to this virus, then she will automatically fall into the risk group.

The speech of the senior researcher of the FBSI "Central Research Institute of Epidemiology" of Rospotrebnadzor, Ph.D. Vasily Shakhgildyan.

Cytomegalovirus infection (CMVI) - chronic infectious disease viral etiology. Pathogen this disease is cytomegalovirus (CMV), which belongs to the herpesvirus family. CMV contains DNA and is capable of infecting almost any human organ and tissue.

CMVI is widespread in Russia and in the world. In our country, the number of people with this virus is 32-94%. In a healthy body, the virus does not manifest itself in any way, but can be deadly for people with reduced immune protection: patients after organ or bone marrow transplantation receiving chemotherapy infected with HIV.

Pregnant women are a special risk group, since during this period there is a physiological restructuring of immunity, which can contribute to a more intensive development of the virus and cause various serious complications. CMVI is the most common intrauterine infection, one of the causes of miscarriage, the birth of unviable children, the occurrence of congenital pathologies.

Infection with CMVI can occur through close contact with its carrier or patient. The virus is released into the external environment with various biological fluids (saliva, urine, semen, etc.) and is transmitted by airborne, food, sexual, vertical (from mother to fetus during pregnancy) routes. In addition, infection is possible during organ and tissue transplantation and blood transfusion. Once infected, a person, as a rule, remains a carrier of cytomegalovirus for life.

Depending on the mechanisms of infection, CMVI is classified into antenatal (congenital) - infection of the fetus occurs during fetal development, intranatal - infection of the fetus during childbirth, postnatal - infection of the child after birth. The prognosis of the disease largely depends on which of these periods the infection occurred.

Frequency antenatal infection fetal cytomegalovirus infection ranges from 0.2 to 3% among all born babies. For example, in Moscow alone, 120-130 thousand children are born annually. If we assume that about 1% of them are born with congenital CMVI, a rather large figure is obtained. The birth of a child with CMVI can be a tragedy for the whole family, since it is extremely difficult to predict the consequences of the infection.

In terms of teratogenic significance (the ability to disrupt embryonic development with the occurrence of morphological abnormalities and malformations), CMV ranks second after the rubella virus. The most typical malformations in case of infection of the fetus up to 20 weeks are: anencephaly, microcephaly, pulmonary hypoplasia, esophageal atresia, heart septal defects, etc. Malformations are in most cases incompatible with life.

The statistics are harsh: approximately 10% of deceased children under the age of one year had CMV pathology. Among the children who died in the second half of life, about 60% had CMV lesions of the internal organs. The maximum mortality from CMVI occurs at the age of 2-4 months.

CMV infection is the main cause of congenital malformations, mental and mental retardation in children early age, who do not have chromosomal disorders. In addition, CMVI main reason congenital sensorineural hearing loss.

The tragedy also lies in the fact that you can face long-term consequences congenital CMVI: decreased intelligence, deafness, cerebral palsy, epilepsy, etc. Moreover, problems can overtake not only when the child suffered from a manifest, clinically expressed form of CMVI. In about 5-15% of cases, the asymptomatic course of the infection leads to the formation of late neurological complications.

Intranatal infection CMV occurs when the fetus passes through the infected birth canal due to aspiration (entering the lower Airways) infected amniotic fluid and (or) secrets of the mother's birth canal, through damaged skin. Frequency of detection of CMV in cervical canal, vaginal secretion of healthy pregnant women from 2-8% to 18-20%, by the time of delivery - 28%. The risk of intranatal infection of the child in the presence of CMV in the genital tract of the mother is 50-57%.

In full-term infants, this usually does not lead to serious clinical consequences. But premature, weak, low-birth-weight babies can get sick in 3-5 weeks. interstitial pneumonia, hepatitis with prolonged jaundice, cholestasis and other fairly severe diseases. They have a long recurring character. The maximum mortality from CMVI occurs at the age of 2-4 months.

At postnatal infection CMV virus transmission occurs, as a rule, through breast milk. This is the main way of infection with cytomegalovirus in a child up to a year. Up to 20% of seropositive mothers (whose blood contains antibodies to cytomegalovirus - CMV IgG) have CMV in breast milk. Between 40 and 76% of their children who consume milk for more than one month become infected.

In young children, clinically expressed CMVI is rare - in 1-2% of cases. And basically it is associated with the manifestation of a congenital infection.

CMVI in children of the first year of life most often occurs asymptomatically or with clinical manifestations of a protracted acute respiratory disease with obstructive syndrome.

CMV infection can occur in several clinical forms: acute (primary infection with CMV), latent, active (due to reactivation or reinfection of the virus), manifest (clinically expressed CMVI, CMV disease).

The greatest risk to the fetus is primary infection mothers on early dates pregnancy. On average, 2% of women experience a primary infection during pregnancy, with approximately 40% of cases being transmitted to the fetus. With the development of acute CMVI, the risk of transmission of the virus from mother to child depends on the gestational age and is about 30, 40 and 70% in the first, second and third trimester, respectively. As can be seen, although greatest risk for the fetus, the infection presents in the early stages of pregnancy, however, in the first trimester, its transmission from the mother is the least likely.

Women who do not have antibodies to cytomegalovirus either before or during pregnancy are seronegative, they have no immunity to CMV. They are in a group maximum risk, because they can have a primary cytomegalovirus infection at any stage of pregnancy.

Such women especially need to protect themselves and follow preventive measures. If there is an older child in the family, then during pregnancy it is important to use separate dishes, do not eat up food, do not lick the nipple, spoon after the baby, do not kiss on the lips, wash hands with soap after changing diapers. This will help to avoid transmission of the virus from the child, which may be the source of the infection, to the mother. In addition, it is very important to avoid unprotected sexual contact.

reinfection or reactivation CMV in the mother causes infection of the fetus much less often: with reactivation - 0.15-0.2%, with reinfection - 0.5-20% of cases. However, reinfection also plays a significant role in the infection of the child. In 30-50% of children with congenital CMVI, mothers had IgG class antibodies to CMV by the time of pregnancy.

In the United States, it has been calculated that the maintenance of a child with congenital CMVI requires annually 800 thousand dollars. In Russia, this figure looks more modest, but nevertheless it is clear that the state will spend significant funds on such a child.

That's why special meaning acquire diagnostic examination standards that need to be constantly improved. Conducting modern and timely laboratory diagnosis of CMV infection in a pregnant woman will prevent infection of the fetus or significantly reduce its consequences in the future.

It is impossible to make a clinical diagnosis of CMVI, since there are no classical, pathognomonic (certainly characteristic, distinctive) signs for this disease. In addition, in about a third of cases, there are no clinical manifestations at all. Therefore, a pregnant woman should be offered a clear examination algorithm that can determine the likelihood of infection of the fetus.

In the laboratory diagnosis of CMV infection, serological (primarily ELISA) and molecular biological (primarily PCR) methods are used. ELISA is used to detect antibodies of classes G and M to CMV antigens in the blood, as well as to determine the avidity index of IgG antibodies. The avidity index indicates the age of the infection.

The results of the ELISA are designed to determine the form of CMVI - acute, latent, active. At acute infection detect IgM antibodies and (or) low avidity IgG antibodies. In latent infection, only highly avid IgG antibodies are present in the blood. With active CMVI due to reactivation or reinfection of the virus, it is possible to detect IgM antibodies (in a lower titer and for a shorter period compared to acute CMVI) and highly avid IgG antibodies.

The generally accepted standard for examining a pregnant woman for congenital infections is only serological methods. This is of great diagnostic value for primary infection and the development of acute infection during pregnancy.

But in the case of active CMVI due to reactivation or reinfection, the determination of antibodies to the pathogen is not enough to detect active infectious process capable of infecting the unborn child. Here it is necessary to use the PCR method, which makes it possible to qualitatively and quantitatively determine the cytomegalovirus DNA in various biological fluids. A study for the presence of CMV DNA in the blood, urine and amniotic fluid is primarily indicated for women with a complicated obstetric history, in the presence of clinical symptoms of acute infectious disease, detection of fetal pathology.

CMV DNA in the blood, urine and saliva of a pregnant woman is a criterion various activities CMVI. The presence of CMV DNA in the saliva of a pregnant woman is only a marker of infection and does not indicate significant viral activity (the risk of congenital CMV infection is 21.9%). The presence of CMV DNA in the urine proves the fact of infection and a certain viral activity (risk - 29.2%). But the presence of CMV DNA in the blood leukocytes of a pregnant woman is reliable sign high activity of cytomegalovirus and serves as an important marker of a significant risk of antenatal infection of the fetus with the virus (58.3%).

Direct evidence of fetal infection is the detection of CMV DNA in the amniotic fluid and cord blood. This study is recommended for pregnant women who have laboratory markers of acute CMVI.

However, these studies, as already mentioned, are not included in the survey standard, the state does not pay for them. On the part of the doctor, this can only be a recommendation to the patient. Therefore, it is especially important to argue the need for these studies. And for this, the doctor must know clinical significance laboratory markers (signs of the disease), which is not always the case in practice.

With the diagnosis of CMVI in children, things are easier. The presence of CMV DNA or virus antigen in any biological fluid of a child in the first two weeks of life indicates antenatal infection. And if they are found after four weeks of life, with a negative result in the first two weeks, then this is intranatal or early postnatal infection. Of course, not all children should undergo such a diagnosis. But if the child has some kind of clinical trouble, pathology, it is imperative and quickly to examine him for CMVI. And the same examination of the child should be offered in the case of a complicated obstetric anamnesis in the mother, if she has clinical symptoms of an acute infectious disease during pregnancy.

There must also be valid reasons for prescribing a specific treatment. It is necessary when the expectant mother has been diagnosed with acute CMVI, the fact of active reproduction of the virus or intrauterine infection has been established. If the fact of antenatal infection is detected in a child, even with asymptomatic or asymptomatic forms of CMVI, therapy is mandatory.

Pregnant women are contraindicated in treatment with antiviral drugs due to their high toxicity. For newborns and children under 12 years of age, direct-acting antiviral drugs are prescribed only for health reasons. They require special treatment.

The drug of choice, aimed at suppressing the reproduction of the pathogen, is Neocytotect, an intravenous immunoglobulin with high content antibodies against CMV. Necessity of appointment this drug recorded in the protocols and recommendations of the Russian Ministry of Health. The drug neutralizes the virus, prevents infection of unaffected cells, inhibits the further spread of CMV in the body and is well tolerated.

Neocytotec reduces the risk of fetal infection and the development of congenital CMVI, and also reduces the consequences of intrauterine infection CMV child. Treatment of active CMVI in children is aimed at preventing the manifestation of the disease, at preventing late complications with asymptomatic CMV infection and for the prevention of other infections, for the development of which CMV infection is a predisposing factor.

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Protocols for the diagnosis, treatment and prevention of intrauterine infections in newborns. Ed. 2nd, revised. and additional M.: GOU VUNMTs MZRF, 2002. 104 p.

Cytomegalovirus infection (CMVI) is the most common intrauterine infection, one of the causes of miscarriage and the occurrence of congenital pathologies. In Russia, 90%-95% of expectant mothers are carriers of the virus, many of whom have almost asymptomatic disease.

Vasily Shakhgildyan, PhD, Senior Researcher, Federal Scientific and Methodological Center for the Prevention and Control of AIDS FBSI "Central Research Institute of Epidemiology" of Rospotrebnadzor: “Cytomegalovirus is the most common congenital viral pathology and the main cause of congenital malformations of the central nervous system, mental and mental retardation in young children who do not have chromosomal disorders. Every year, 120-130 thousand children are born in Moscow alone. From 1% to 3% of them - with congenital cytomegalovirus infection".

The greatest risk to the life of the fetus is the primary infection of the expectant mother during pregnancy. If it happened in the early stages of pregnancy, intrauterine death of the fetus, the formation of malformations are possible. Mother's infection later dates pregnancy can cause serious illness child, the development of long-term neurological consequences.

As a rule, CMVI is transmitted from person to person sexually, as well as contact- household way(through saliva at close contacts). In this case, infection can be completely avoided if a number of recommendations are followed.

Vasily Shakhgildyan: “If a woman does not have antibodies to cytomegalovirus in her blood, that is, she has not met with it before and may become infected for the first time during pregnancy, then you need to protect yourself and follow preventive measures. Namely: if the family has an older child, then during pregnancy do not take him to preschool . If this is not possible, then it is important to avoid transmission of the virus from the child, which can be a source of infection, to the mother: use separate dishes, do not eat up food, do not lick the nipple after the baby, do not kiss on the lips, wash hands with soap after changing diapers. Try not to visit crowded places and families where there are sick children. In addition, very it is important to avoid unprotected sex» .

In addition to prevention, in order to prevent infection of the fetus or significantly reduce its consequences in the future, it is necessary to conduct modern and timely laboratory diagnosis of active CMV infection in a pregnant woman. AT this case of particular importance are the diagnostic standards of examination, which must be constantly improved.

Vasily Shakhgildyan: "Accepted standard for screening pregnant women for laboratory signs congenital infections involves only a blood test for the presence of antibodies to the pathogen. This, indeed, is of great diagnostic value in the case of primary infection and the development of an acute infection during pregnancy. But in the event of an exacerbation of the disease or re-infection with the virus during pregnancy, the detection of antibodies is not enough to detect an active infectious process. In this case it is necessary to use modern molecular biological diagnostic methods(in particular, the PCR method), which make it possible to determine the presence of the pathogen itself in biological fluids. First of all test for the presence of CMV DNA in the blood, urine and amniotic fluid indicated for women with a complicated obstetric history, in the presence of clinical symptoms of an acute infectious disease, the detection of fetal pathology. It is extremely important that laboratory examination a pregnant woman was as informative as possible, because the birth of a child with CMVI can be a tragedy for the whole family, since it is extremely difficult to predict the consequences of the infection”.

In the case when the expectant mother has been diagnosed with acute CMVI, or the fact of active reproduction of the virus has been established, effective treatment is necessary.

To date the only way treatment, significantly reducing the risk of fetal infection and the development of congenital CMVI, is the use of intravenous antimegalovirus immunoglobulin in pregnant women. The need to prescribe this drug is recorded in the protocols and recommendations of the Ministry of Health of the Russian Federation. Neocytotec neutralizes the virus, prevents infection of unaffected cells, inhibits the further spread of CMV in the body and is well tolerated.

Most adults and a significant number of children are infected with this virus. Statistics show that half of the villagers and up to 90% of the urban population under the age of 40 are infected with cytomegalovirus. CMV can be transmitted during pregnancy from mother to fetus. This viral infection is most widespread in developing countries, where the standard of living of the population is extremely low, and social and hygiene conditions Residents leave a lot to be desired.

In most healthy people who are infected with CMV after birth, the virus causes only a few minor symptoms, while CMV does not cause any serious diseases and damage to internal organs. And in some cases, even until the end of life, CMV does not manifest itself in any way. Isolation of the virus from a sick person occurs, as a rule, completely asymptomatic.

Three risk groups for which CMV is dangerous:

1. People with immunodeficiencies developed as a result of radiation or chemotherapy for oncological diseases, when taken in significant doses of corticosteroids, immunosuppressive therapy for organ transplants, HIV infection;

2. The fetus, if he was infected with CMV in the womb;

3. Persons working with children: educators, teachers, nannies, nannies, etc.

Under certain circumstances, in these individual representatives of the groups, cytomegalovirus can cause pneumonia, damage to the brain, liver, heart, and retina.

How infection occurs:
The virus is transmitted from person to person. It enters from the external environment with the saliva of a sick interlocutor, with urine, with blood, with lacrimal fluid, with transfused blood (extremely rare), breast milk(the most common transmission method in the world). If people have sex, the virus can be transmitted both with male semen and with secretions from the vagina and cervix. Although the virus does not have a high ability to infect (contagiousness), it can cause infection both within the family and children attending organized children's groups. According to our American colleagues from the CDC, CMV is transmitted by contact. First any biological fluid from a patient with CMV enters the hands of a healthy person. And only then a healthy person himself transfers the infection from his hands to his mouth or nose, thereby infecting himself on his own.

Disease Prevention:
To reduce the risk of CMV infection, you must strictly observe the rules of personal hygiene - wash your hands regularly with soap and water. CMV quarantine is not carried out in kindergartens and schools. There is no point in placing hospitalized CMV patients in infection boxes.

To reduce the risk of CMV infection during sex, you should practice sex with one partner (monogamous relationships) and use condoms.

Transmission routes:

1. Contact and sexual:

Contact with newborns, including daily care for them (children infected during childbirth, during the first 5 years of life, the virus is excreted from the body);

sexual route ( early start sexual life, multiple sexual partners, homosexual relationships, previous sexually transmitted diseases)

2. Nosocomial infection:

When transplanting organs from persons infected with CMV.

When transfusing blood and blood products from a person infected with CMV. (AT Russian Federation blood products and whole blood are not tested for CMV).

The virus enters the human body and enters the bloodstream. But the guardian of our health, the immune system, does not sleep, it kills the virus in the blood, "driving" it into the glands that produce saliva / salivary glands / and kidney tissue, where the virus goes into an inactive state and "sleeps" for many weeks, months or years. ". A "sleeping" virus cannot be recognized by the immune system.

When immunity is impaired, reactivation occurs: cytomegalovirus destroys the structures of a human cell, causing the formation of lumps from nuclei, mitochondria, the endoplasmic reticulum, the Golgi apparatus, lysosomes - known to you from a school biology course. After such destruction, the cell, like a sinking ship, fills up with liquid and swells greatly.

Course of the disease:

The disease can appear in three guises:

1. Symptoms of mononucleosis;
2. Multiple lesions of internal organs in people with severe immunodeficiency (AIDS, people with transplanted organs: Bone marrow, kidneys, heart). The lungs are predominantly affected - CMV pneumonia;
3. Inflammation of the urinary tract and intrauterine infection and fetal damage.

In the first case patients complain of weakness, general malaise, fatigue, headaches, runny nose, inflammation and enlargement salivary glands, with profuse saliva and whitish coating on gums and tongue. Within 2-3 weeks, these symptoms disappear on their own and, as a rule, do not require treatment.

With a generalized form of the disease(point No. 2) there is inflammation of the liver tissue, adrenal glands, spleen, pancreas, kidneys, esophagus. It is accompanied by frequent causeless pneumonia, a small number of platelets in the blood, damage to the vessels of the eye, intestinal walls, brain and peripheral nerves. Enlargement of the parotid and submandibular salivary glands, inflammation of the joints, skin rash. According to the statistics of the World Health Organization, a generalized form of cytomegaly is the cause most deaths in the world after influenza and acute respiratory infections.

Cytomegalovirus infection is a major cause of complications and death in organ transplant patients and patients with AIDS. Mortality from cytomegalovirus pneumonia in HIV-infected people in the United States is up to 90%.

The third flow option disease involves the development of a woman's inflammation of the cervix / cervicitis /. The disease is acute. women complain about pain and whitish-bluish discharge from the genital tract.
In men, cytomegalovirus infection is usually asymptomatic. In some cases, there are discomfort when urinating

CMV is dangerous if virus infection occurs during pregnancy. This is extremely rare - in 1-3% of all pregnancies. 80-90% of children born to mothers infected with CMV during pregnancy have health problems

The newborn baby may be delayed mental development deafness, epilepsy, cerebral palsy, muscle weakness.

If the fetus is infected with CMV in the first 12 weeks of pregnancy, a miscarriage is likely.

If the mother is not infected with CMV, then the fetus may be infected at the time of conception by the virus contained in the semen.

The second option is when, already during pregnancy, the virus penetrates through the placenta into the baby's body.

The third - the most common way, is the penetration of the virus from the inner layer of the uterus through the membranes of the fetus and amniotic fluid.

The fourth option is infection during childbirth.

Options 2, 3 and 4 are relatively favorable for the fetus. In this case, CMV pneumonia and hepatitis can be observed.

Diagnostics: If nothing bothers you, then there is no need periodically examine yourself or your children for CMV and watch the antibody titer. Firstly, it is expensive, and secondly, it has no diagnostic value.

The patient is taken blood, saliva, semen, discharge from the cervix and vagina, amniotic fluid. This material is urgently delivered to the laboratory, because the CMVirus does not live for a long time on outdoors and die in the sun. The doctor examines the taken material under a microscope and detects swollen cells - a symptom of "owl's eye". For diagnostic purposes, you can try to grow the virus in cell culture human body- fibroblasts. The PCR reaction is considered the most reliable.

There are serological diagnostic methods aimed at identifying special education produced by the immune system - antibodies.

A 4-fold increase in Ig G titers in tests taken from a child with a difference of 30 days may indicate activity CMV infection him.

Treatment: A person has a life-long carriage of the infection. It is impossible to remove the virus from the body. Carrying CMV to people with normal state the immune system is not in danger, and drugs for CMV treatment have very strong impact on the body. Based on this, treat healthy people in whom CMV does not cause any symptoms is inappropriate.

IN PREGNANCY

Before pregnancy every woman who is diagnosed with cytomegalovirus is recommended to visit a gynecologist and donate blood for antibodies to CMV. If there are protective antibodies in the blood - Ig G immunoglobulins, then there is nothing to fear and you can safely get pregnant.

To prevent the disease, a pregnant woman should refrain from visiting children's groups, because CMV-infected children under 5-7 years of age secrete the virus into environment. A pregnant woman should carefully follow the rules of personal hygiene, wash her hands with soap and water after contact with children, children's toys, diapers and diapers. After childbirth, the mother should not stop breastfeeding.

Chief Physician of the Medical Center "Healthy Generation" Grigoriev Dmitry Viktorovich