Cytomegalovirus Cmv

Overview

Cytomegalovirus (say: sy-toe-MEG-a-lo-virus), often called CMV, is a common virus that belongs to the herpes family. Once you get it, the virus stays in your body for life, usually in a dormant (sleeping) state. Most people who have CMV never notice it, and it causes no harm. But in some situations—especially during pregnancy or for people with a weakened immune system—CMV can cause more serious illness.

Yes, CMV is extremely common. In many countries, around half to three-quarters of adults have been infected by the age of 40. Most do not remember having it because it causes no symptoms or only a mild illness.

Anyone can get CMV. It causes serious illness mainly in babies infected before birth and in people with a weak immune system, such as organ transplant recipients, people taking immunosuppressive medicines, or those living with advanced HIV. Older adults can sometimes feel more run down than younger people.

Symptoms

Common symptoms

• No symptoms at all
• Mild fever
• Feeling very tired (fatigue)
• Sore throat
• Swollen glands in the neck or under the arms
• Muscle and joint aches
• Mild headache

Symptoms in children

• Many children with CMV have no symptoms at all.
• Some may have a mild fever, sore throat, tiredness, or a slightly upset tummy.
• Babies born with CMV (congenital CMV) may need special hearing and development checks, even if they look healthy at birth.

Symptoms in older adults

• Older adults may feel more fatigued than usual and have aches and fever.
• Sometimes CMV can make existing health conditions feel worse.
• If confusion or severe weakness develops, medical help should be sought promptly.

Causes

Main causes

• CMV spreads through close contact with body fluids, such as saliva, urine, blood, tears, semen, and breast milk.
• Kissing someone who has CMV or sharing cups, cutlery, food, or toothbrushes can pass the virus on.
• Touching an infected child's saliva or urine and then touching your eyes, nose, or mouth can spread it.
• A pregnant person can pass CMV to their baby during pregnancy.
• It can also be spread through organ or bone marrow transplants and, rarely, through blood transfusion.

Risk factors

• Being pregnant, especially if you also care for young children
• Working in a childcare setting, such as a nursery or preschool
• Having a weakened immune system due to illness or medicines
• Having an organ or bone marrow transplant
• Living with HIV infection, especially with a low CD4 count
• Close contact, such as kissing or hugging children who attend group care

When to see a doctor

See a doctor urgently if:

• If you have a weakened immune system and develop fever, tiredness, or flu-like symptoms
• If you are pregnant and have a persistent fever or think you may have been exposed to CMV
• If you have new vision changes or severe headaches
• If you are caring for a baby who seems floppy, very sleepy, or is not feeding well

Book a routine appointment if:

• If you have had fever, extreme tiredness, or swollen glands for more than a week or two
• If you are planning pregnancy and want to talk about CMV risk
• If you are pregnant and worried about CMV from contact with young children
• If you take medicines that suppress your immune system and feel persistently unwell

Diagnosis

CMV is not always easy to diagnose because symptoms can look like other viruses. A doctor may arrange a blood test if CMV seems possible. The test checks for antibodies (the immune system's response) or for the virus itself. Tests on urine, saliva, or other fluids may also be used, especially in babies.

Tests that may be done

• Blood test for CMV antibodies or virus DNA
• Urine or saliva test, often used for babies
• Additional tests if CMV has affected a specific part of the body, such as a chest X-ray if there are breathing symptoms
• In pregnancy, a specialist doctor or midwife may discuss further testing and ultrasound checks

What to expect at your appointment

Most people do not need any tests for CMV. If testing is done, results usually come back within a few days. Your doctor will explain what the results mean and whether you need follow-up. If you are pregnant, your maternity team will guide you through any steps, including extra scans, in a supportive way.

Treatment

For healthy people, CMV usually gets better on its own. There is no specific treatment that cures the virus. Treatment focuses on easing symptoms, resting, and letting the body's immune system fight the infection.

Self-care at home

• Rest as much as you need, and do not rush back to normal activities too quickly.
• Drink plenty of fluids, such as water or hydrating drinks.
• Use simple over-the-counter pain and fever relief that your pharmacist or doctor says is suitable for you.
• Stay away from work, school, or nursery while you have a fever and feel unwell.
• Wash your hands often, especially after using the toilet or touching your own mouth or nose, to help prevent passing the virus to others.

Medical treatments

For serious CMV infections—such as in newborn babies with symptoms, or in people with a weak immune system—doctors may use antiviral medicines (medicines that fight viruses). These are usually given in a hospital or through specialist care. The exact medicine and course length depend on the person's situation. There are no specific medicines that you can buy over the counter for CMV.

When is surgery considered?

Surgery is not used to treat CMV itself. In very rare cases, surgery might be needed for a complication, but this is uncommon and would be discussed fully by your doctor.

Living with this condition

Take things at your body's pace. Even after the initial fever goes, fatigue can last for several weeks. This is normal for CMV. Gradually return to work, study, and exercise as your energy comes back. If symptoms drag on, check in with your doctor.

Lifestyle tips

• Wash your hands regularly with soap and water.
• Avoid kissing young children on the lips, and avoid sharing cups, cutlery, or food with them, especially if you are pregnant.
• Get enough sleep and try to manage stress with relaxing activities you enjoy.
• If you have a weakened immune system, follow your specialist team's advice about avoiding infections.
• Avoid touching your face, especially your eyes, nose, and mouth, with unwashed hands.

Diet and exercise

Eat a balanced diet with plenty of fruit, vegetables, and whole grains to support your immune system. Gentle movement, like short walks, can help you feel better, but listen to your body and rest when you need to. Staying hydrated is important, especially if you have had a fever.

Mental health and emotional wellbeing

Being tired for weeks can feel frustrating and may affect your mood, work, or family life. It is completely normal to feel low when you are recovering. If these feelings last or get in the way of daily life, talk to your doctor. you are not alone, and support is available.

Prevention

There is no way to completely prevent CMV, but good hygiene greatly reduces the chance of catching it or passing it on. This is especially important during pregnancy and for people with weakened immune systems.

Vaccines

There is no vaccine for CMV currently available.

Screening programmes

CMV is not part of routine screening for most people. If you are pregnant, your doctor or midwife can talk to you about whether any testing is suitable, especially if you have been in contact with young children or have had an illness.

Complications

If left untreated

• In healthy people, untreated CMV rarely causes serious problems.
• In people with a weakened immune system, untreated CMV can affect the eyes, lungs, liver, or digestive system and can be serious.
• Babies born with CMV may have a higher chance of hearing loss, vision problems, or developmental delays, which is why early monitoring is important.
• In pregnancy, CMV can very occasionally cause complications for the baby, but most babies whose mothers have CMV are born healthy.

Long-term outlook

The outlook for most people with CMV is excellent. Healthy people usually recover fully with no long-term effects. For those who need treatment, doctors now have effective approaches to control the virus and reduce complications. For babies born with CMV, early hearing and development checks mean that any challenges can be found early and support can begin as soon as possible. With the right care, many people and families live full, healthy lives.

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