CMV IgG IgM
CMV IgG/IgM. Cytomegalia virus CMVG and CMVM from serum method CLIA
Screening of pregnant women is not useful because of the lack of options for treatment. For the pregnant person herself, when infected with CMV, there is no additional risk of serious illness (Jacquemard 2007).
CMV is transmitted through direct and indirect contact with infected body fluids such as saliva, urine, semen, cervical mucus, breast milk and blood. It usually progresses without symptoms, but sometimes there is fever and fatigue.
Diagnostics rely on serology. Sometimes the interpretation of serological results is difficult. Therefore, it is important to consult with a physician-microbiologist and base the diagnosis on a combination of clinical data and various laboratory tests.
Risksto the unborn child
Anyone who comes into contact with CMV for the first time during pregnancy (there is less than 1% chance of this happening) can transmit the virus to the child. Of these infected children, 5 to 10% already have more or less severe symptoms at birth. In 10-15% of the infected children born apparently healthy, symptoms still develop in the course of the first years of life in the form of motoric or mental retardation or deafness.
Infection earlier in pregnancy is more likely to cause more serious damage.
Congenital CMV infection occurs worldwide in 0.5%-2% of live born children. Congenital CMV infection occurs in the Netherlands in 1 in 200 newborns (approximately 0.5%). This means that approximately 1000 children with symptomatic or non-symptomatic congenital cytomegalovirus infection are born annually in the Netherlands. 180 of these will have permanent consequences.
Young children in particular excrete CMV in urine and saliva for a long time (years) at high levels. With increasing age the frequency and extent of excretion decreases.
In a home situation with young children, transmission of CMV is difficult to avoid, but exposure can be reduced by good hand hygiene. This is because infection occurs mainly through the mucous membranes.
Pregnant women are advised to maintain good hand hygiene when coming into contact with saliva and urine of young children. Avoid contact with saliva of young children by not sharing food, cutlery and cups.
No vaccine against CMV is available yet.
Pregnants in the Netherlands are not routinely screened for CMV carrier status. In the population, the risk of contracting a first CMV infection in pregnancy is limited, less than 1%. Moreover, the application of good hand hygiene is the only way to further reduce this risk.
Complete protection against CMV is not possible. However, it is possible to determine that a pregnant woman has previously had a CMV infection by demonstrating IgG antibodies against CMV. CMV remains latent in the body and can regularly re-activate, even in the presence of antibodies. If no IgG antibodies are detectable, there may be a primo infection with CMV in pregnancy, with an approximate 50% chance that the pregnant person will transmit the virus to the child.
If IgG antibodies are detected, the virus can also be transmitted to the child during re-activation. However, the chance of this happening is extremely low. The presence of IgG antibodies therefore offers a large measure of protection, but not complete protection. In addition, re-infection with another (geno) type of CMV can occur.
If (primary) CMV infection is suspected in a pregnant woman, it is possible to support this by means of IgM and IgG determinations. If present, measurement testing of the first trimester serum is useful.
An infection with CMV in a pregnant woman usually proceeds asymptomatically. If CMV infection is suspected, blood tests will be performed on a pregnant woman. However, the absence of IgM or the absence of a significant titer increase of IgG in the mother does not exclude a congenital cytomegalovirus infection in the fetus.
Approximately 40% of women of childbearing age in the Netherlands are seropositive for CMV infection. This is higher in women originally from the Caribbean (96-100%) and the Mediterranean (85-97%). Congenital CMV infection occurs in the Netherlands in 1 in 200 newborns (approximately 0.5%). This means that approximately 1000 children with symptomatic or non-symptomatic congenital cytomegalovirus infection are born in the Netherlands each year. 180 of them will have consequences (De Vries 2011). Congenital CMV infection is more often seen in the Netherlands in areas with more than 15% young children and in areas with more than 30% migrants.
If there was (suspicion of) a primary CMV infection in the mother or there is clinical suspicion of congenital CMV infection in the newborn, you should turn to your family doctor.
