Cytomegalovirus

Cytomegalovirus or CMV is a common virus that infects people of all ages. Most CMV infections are “silent,” meaning most people who are infected with CMV have no signs or symptoms. However, CMV can cause disease in people with a weakened immune system and in babies infected before birth. About 1 in 150 children is born with congenital (present at birth) CMV infection. The word “Cytomegalovirus” comes from the Greek word cyto meaning “cell”, and the Greek word megalo meaning “large”.

Other members of the herpes virus family cause chickenpox, infectious mononucleosis, fever blisters (herpes simplex type I) and genital herpes (herpes simplex type II). Like other herpes viruses, CMV infection can become dormant for a while and may reactivate later. The virus is carried by people and is not associated with food, water or animals.

Although the virus is not highly communicable, it can be spread from person to person by direct contact. The virus is shed in the urine, saliva, blood, breast milk, semen and to a lesser extent in other body fluids. Transmission can also occur from an infected mother to her fetus or newborn and by blood transfusion and organ transplants. People who have received an organ transplant are particularly susceptible to CMV infection because they are given drugs that suppress the immune system (immune-suppressants) to prevent rejection of the transplant. In people with a weakened immune system, disease often results from reactivation of the dormant virus.

Types of CMV

• Acquired CMV, or primary CMV – a first-time infection.
• Recurring CMV – the patient is already infected, the virus is dormant and then becomes active due to a weak immune system.
• Congenital CMV – CMV infection occurs during pregnancy and affects the fetus (unborn baby).

Causes

CMV can spreads from person- person in Acquired or Primary CMV, through – Saliva – includes coughs and sneezes

• Semen
• Blood
• Urine
• Vaginal fluids
• Breast milk – the benefits of breastfeeding far outweigh CMV risks. If the baby is born premature the medical team will advise on how the baby should best be fed.
• Sexual Contact

If the surface was infected with saliva or urine, somebody touches it and then touches the inside of their nose or mouth,  there’s a possibility of getting infected with CMV by touching the infected surface.

Recurring CMV is possible under following cases –

• Organ transplant recipients who are taking immunosuppressant medication
• Patients with HIV
• Patients receiving chemotherapy
• Patients who have been taking oral steroid for over three months.

Congenital CMV cases occur when the woman is infected with CMV for the first time, either during her pregnancy or shortly before it starts.

At times the mother may have a previously dormant CMV infection, which recurs during pregnancy. The mother most likely has a weakened immune system. In such cases the virus may be transmitted to the developing embryo/fetus.

Symptoms

In Primary CMV –

• An elevated body temperature (fever), often prolonged
• Night sweats
• Tiredness, general feeling of illness, uneasiness
• Sore throat
• Swollen glands
• Joint pain
• Muscle pain
• Lack of appetite
• Weight loss.

Symptoms may normally go away after two weeks.

In Recurring CMV –   Symptoms of recurring CMV vary, depending which organs are affected. The most likely affected areas are the eyes, lungs or digestive system. Symptoms may include –

• An elevated body temperature – fever
• Diarrhea, gastrointestinal ulcerations, and gastrointestinal bleeding
• Panting – shortness of breath
• Pneumonia with hypoxemia – low blood oxygen
• Ulcers in the mouth; sometimes they can be fairly large and unpleasant
• Problems with vision, including floaters, blind spots and possibly blurred vision. In some cases symptoms may be more severe.
• Hepatitis – inflamed liver, often characterized by prolonged fever
• Encephalitis – brain inflammation, which may include behavioral changes, seizures, and even coma.

Congenital CMV –

• Hearing Loss
• Jaundice
• Pneumonia
• Purple Skin splotches or a rash (possibly both)
• Enlarged liver
• Enlarged spine
• Below-normal birth weight
• Seizures – uncontrolled electrical activity in the brain, which may cause a physical convulsion.
• Red spots under the skin

Rare symptoms may include –

• Autism
• Central vision loss, scarring of the retina, uveitis (swelling and irritation of the eye)
• Cognitive difficulties (including learning difficulties)
• Deafness (varying degrees)
• Epilepsy
• Impaired vision
• Problems with physical coordination
• Seizures
• Small head. 

Treatments

Healthy people who are infected with CMV but who have no symptoms usually do not require medical treatment.

Medications – Antiviral medicine may be needed to treat congenital CMV or active CMV in someone with a weakened immune system. The antiviral medications against CMV include the following:

• Ganciclovir (Cytovene) – Side effects include fever, rash, diarrhea, anemia, and low white blood cell and platelet counts.
• Valganciclovir (Valcyte)
• Foscarnet (Foscavir) – It is toxic to the kidneys and can cause seizures due to an imbalance of minerals and electrolytes.
• Cidofovir (Vistide)

Patients infected for the first time who experience symptoms may find that OTC (over-the-counter, no prescription required) painkilling medications, such as Tylenol (paracetamol), ibuprofen or aspirin (patient must be over 16 years of age for aspirin) will help relieve symptoms. Newborns may need to stay in hospital until their organ functions return to normal. Adults with weakened immune systems may also have to be hospitalized if there is extensive organ damage.

Alternative Medicine

• Minerals are important especially Zinc, Magnesium and Selenium. However taking Colloidal minerals is highly recommended as they generally supply good amounts of all necessary minerals.
• Lysine can help stop viruses replicating and is an excellent defense.
• Vitamin C is useful but needs to be taken in large amounts to be effective against a herpes type infection.
• All B vitamins are necessary to support the immune system as is Vitamin A and should be taken daily. Vitamin A often also needs reasonably high amounts to be effective against viruses. Often extra Vitamin B12 is necessary.
• Supplements containing Paris polyphylla, Dandelion, Woad, and Licorice appears safe and effective in reducing cytomegalovirus infection activity in pregnant women.
• Garlic extract has potent antiviral activity against human cytomegalovirus. Garlic contains a compound known as allitridin which has therapeutic activity comparable to the antiviral drug ganiciclovir in a mouse model of cytomegalovirus hepatitis.
• Supplements containing Jinye Baidu granule significantly increase the negative conversion rate of HCMV-IgM.
• Ascorbic acid reduces the infectivity of herpesviruses and paramyxoviruses.
• Astragalus may have a therapeutic role in combating cytomegalovirus infection.
• Geum japonicum, Syzygium aromaticum (Clove), and Terminalia chebula inhibit Cytomegalovirus infection.
• The brown seaweed known as Leathesia difformis contains fucoidan fractions with antiviral activity against cytomegalovirus and herpes simplex virus type 1 and 2.
• Various extracts of ginger inhibit Cytomegalovirus, HSV-1, and HIV virus.
• Artemisinin, a compound found within the herb wormwood, inhibits a broad range of viruses.
• Bamboo compounds have anti-cytomegalovirus activity.
• Calcium spirulan, an inhibitor of enveloped virus replication, from a blue-green alga Spirulina, exhibits activity against a variety of viruses.
• Flavonoids belonging to the kaempferol series exhibit antiviral activity against cytomegalovirus.
• Other very useful herbs for any viral infection are Echinacea, Astragalus, Phyllanthus and Reishi mushroom.

 

Refernence –

http://www.ncbi.nlm.nih.gov/pubmed/10611727

http://www.greenmedinfo.com/disease/cytomegalovirus-infections

http://www.aidsmeds.com/articles/CMV_6771.shtml

http://www.thebody.com/content/art6017.html

http://www.medicinenet.com/cytomegalovirus_cmv/page5.htm

http://kidshealth.org/parent/infections/bacterial_viral/cytomegalovirus.html#

http://www.mayoclinic.org/diseases-conditions/cmv/basics/treatment/con-20029514

http://www.nhs.uk/Conditions/Cytomegalovirus/Pages/Treatment.aspx