It is not always possible to detect signs of a cytomegalovirus infection in a child’s body, since it does not have negative impact for the baby. This infectious agent is usually detected completely by accident during an examination. Cytomegalovirus is diagnosed in a child by a positive blood test for igg antibodies. Primary infection does not show any symptoms until a certain point. Cytomegalovirus (CMV) is activated against the background of decreased immunity, and the consequences of the disease can be very sad.
What is cytomegalovirus in a child?
CMV is the most common infectious agent among children. IN at different ages it occurs in more than half of babies worldwide. The specific causative agent of the infection is Human betaherpesvirus (human herpes virus). Of particular health risk is the penetration of CMV into children's body does not, because the pathology is mostly asymptomatic and does not require treatment. The danger arises if intrauterine infection of the fetus occurs or cytomegalovirus is detected in newborns, because infants still have low activity of the immune system.
Causes
Activated cytomegalovirus infection in children against the background of reduced immunity. The pathogen initially penetrates into digestive system, genital or respiratory organs through the mucous membranes of the nose or mouth. There are no changes in the introduction of infectious agents into children. Once in the body, the virus continues to exist there for life. CMV in children is in a latent phase until immunodeficiency appears. The cause of reduced immunity in a child can be:
- frequent colds (sore throat, acute respiratory viral infections, acute respiratory infections);
- chemotherapy;
- AIDS, HIV;
- long-term use of cytostatics and antibiotics.
How is it transmitted?
Only a virus carrier can become a source of infection for a child. Several options for transmitting cytomegalovirus to a child:
- Transplacental. The virus is transmitted by crossing the placenta from an infected mother to the fetus.
- Contact. With the help of saliva during kissing, the infection enters the respiratory system through the mucous membranes and larynx.
- Domestic. The route of transmission is through the common use of household items.
- Airborne. When someone who has the virus coughs or sneezes, or through saliva from close contact.
Symptoms of cytomegalovirus in children
Clinical manifestations of CMV are nonspecific. The first symptoms appear only after a decrease in immunity and are easily confused with other diseases:
- suppressed mononucleosis symptoms against the background of vitamin deficiency;
- fever that occurs for no apparent reason;
- pain syndrome in the limbs;
- signs of tonsillitis;
- swollen lymph nodes;
- increased body temperature up to 39 degrees;
- small rash all over the body.
In newborns
Cytomegalovirus manifests itself completely differently in children under one year of age. If a baby becomes infected through breast milk or during passage through the birth canal, then in 90% of cases the disease is asymptomatic. Clinical manifestations of congenital cytomegalovirus in a child:
- hemorrhagic or cavityless swelling, in 80% of cases minor hemorrhages;
- persistent jaundice in combination with an enlarged spleen and liver is observed in 75% of babies;
- the body weight of the newborn is much less than WHO indicators;
- pathology peripheral nerves(polyneuropathy);
- small skull size;
- microcephaly with areas of calcified tissue in the brain in 50% of babies;
- inflammation of the retina;
- pneumonia;
- hydrocephalus.
Kinds
There are several forms of the virus:
- Congenital. Jaundice and internal bleeding may develop. The disease can lead to damage to the nervous system even during a woman’s pregnancy. Congenital cytomegalovirus infection can cause miscarriage or ectopic fertilization.
- Spicy. More often, infection occurs through sexual contact, and a child becomes infected from an adult during a blood transfusion. The symptoms are similar to those of a cold with the addition of increased salivary glands.
- Generalized. Inflammatory foci form in the kidneys, spleen, and pancreas. Symptoms appear after a decrease in immunity and are often accompanied by a bacterial infection.
How dangerous is cytomegalovirus for a child?
Healthy children tolerate the infection normally. The pathology occurs without symptoms, or with the onset of a cold, but goes away after 2-3 days. In weakened children, CMV occurs with complications that appear either immediately or after illness. In the future, the virus may cause a child to have mental retardation, visual impairment, or liver damage.
Over time, infected children experience neurological abnormalities and hearing problems. If a positive blood test for igg antibodies is detected during an examination of a pregnant woman, then after infection of the fetus the virus exhibits a teratogenic effect: the child experiences a developmental disorder visceral organs, brain, organs of vision and hearing.
Antibodies to cytomegalovirus
The human body uses the same strategy to fight the disease - it produces antibodies that attack only viruses and do not affect healthy cells. Once battling an infectious agent, specific immunity remembers him forever. Antibodies are produced in the body not only after an encounter with a “familiar” virus, but also when a vaccine is administered. A blood test for CMV shows either negative or positive result for igg class antibodies. This means the presence or absence of cytomegalovirus in the body.
Diagnostics
Since the manifestations of CMV are nonspecific, diagnosing the pathology in a child is not an easy task. To confirm cytomegaly, the doctor after examination prescribes the following tests:
- blood for the presence of antibodies to the pathogen: the igm protein indicates an acute infection, and the igg protein indicates a latent or acute form illness;
- PCR of saliva and urine to detect cytomegalovirus DNA;
- general blood test to determine the number of leukocytes, platelets, red blood cells;
- biochemical blood test to identify increased indicators liver enzymes AST and ALT (the concentration of creatinine and urea increases with kidney damage);
- MRI or ultrasound of the brain to detect calcifications or areas of inflammation;
- Ultrasound abdominal cavity to detect an enlarged spleen or liver;
- chest x-ray to determine pneumonia.
Treatment
Depending on the form and severity of the disease, treatment of cytomegalovirus in children occurs. The latent form does not require any therapy. Children with an acute form of cytogelovirus need treatment. For severe manifest infections and intrauterine infection, complex therapy is carried out in a hospital. The treatment regimen for CMV includes:
- antiviral treatment (Foscarnet, Ganciclovir);
- interferons (Viferon, Altevir);
- immunoglobulin preparations (Cytotect, Rebinolin);
- antibiotics for secondary infections (Sumamed, Klacid);
- vitamin and mineral complexes (Immunokind, Pikovit);
- immunomodulators (Tactivin, Mercurid);
- for severe cytomegalovirus, corticosteroids (Prednisolone, Kenacort) are used.
Folk remedies
Herbal infusions and decoctions help strengthen the immune system and strengthen the body. In case of infection with cytomegalovirus ethnoscience offers the following recipes:
- It is necessary to mix the components in equal parts: succession grass, chamomile flowers, alder fruits, roots of Leuzea, licorice, kopeck. Pour 2 tbsp into a thermos. l. herbal mixture, pour 500 ml of boiling water, let it brew overnight. Drink the finished infusion 1/3 cup 3-4 times a day until the condition improves.
- You should mix equal parts of yarrow and thyme herbs, burnet roots, birch buds, and wild rosemary leaves. Then 2 tbsp. l. pour 2 cups of boiling water over the herbal mixture and leave in a thermos for 12 hours. In the morning, the infusion must be filtered and taken 100 ml 2 times a day daily for 3 weeks.
Consequences
You need to worry more about newborns and babies under 5 years old. After all, at this age children have a low immune status, so the virus can cause undesirable consequences for good health:
- with intrauterine infection, there is a risk that the baby will be born with problems with internal organs and heart defects;
- if the infection occurs late in pregnancy, pneumonia and jaundice occur after childbirth;
- When infected, periodic convulsions and swelling are observed at one year of age. salivary glands.
Prevention
To prevent infection with cytomegalovirus, it is necessary to strengthen the child’s immunity. Prevention consists of the following:
- taking antiviral drugs (Acyclovir, Foscarnet);
- balanced diet;
- regular walks in the fresh air;
- hardening;
- avoiding contact with infected people;
- strict adherence to personal hygiene rules.
Video
But they have no idea what this disease is until they encounter it themselves. What is cytomegalovirus, how does it become infected, how does it manifest itself, how to treat it, and, most importantly, what to do if CMV is detected in a child - the answers to these and many other questions are in our article.
Cytomegalovirus is a type of herpes type 5. Since it was discovered relatively recently, scientists cannot say with certainty that it has been fully studied. It is found in more than 40% of adults and 15% of children.
Until recently, it was believed that this disease could only be acquired through unprotected sexual contact with a carrier, but in our time other routes of transmission have been proven.
The insidious feature of this infection is that once it penetrates the body, it remains in it throughout life, but often occurs hidden and does not manifest itself in any way.
In many cases, the manifestations of the disease may be minor, but they pose a danger to children with weakened immune systems, as well as those with chronic diseases.
During pregnancy
Expectant mothers are at particular risk for cytomegalovirus. When identifying positive analysis there is an extremely high risk of infection of the fetus. But the most dangerous cases are primary infection during pregnancy, because The body lacks the necessary antibodies to fight this disease. Therefore, the infection can manifest itself in an acute form, threatening the health of both the mother and the unborn baby.
You can become infected during pregnancy through sexual contact. Less commonly, infection occurs through contact of a pregnant woman with a carrier of the virus who is in the active stage, as well as through household items, personal hygiene, and kissing.
Therefore, every woman should be tested for antibodies to CMV before pregnancy. In case of their absence, must be observed preventive measures to prevent the virus from entering the body of a pregnant woman. The doctor develops special tactics for managing such a pregnancy.
If detected early in expectant mother and carrying out preventive measures, you can significantly reduce the likelihood of its intrauterine transmission to the fetus.
Causes of cytomegalovirus in children
Infection of babies with cytomegalovirus can occur in utero from an infected mother, or in early childhood. The source of infection is a carrier of a virus with an acute or latent (hidden) form.
CMV infection in children can for a long time be asymptomatic, sometimes signs of a cold or flu appear, but with a longer course. However, you should not perceive cytomegalovirus as a harmless disease, since it can cause irreparable damage to the baby’s health, especially against the backdrop of a weakened immune system.
A child can get cytomegalovirus in several ways:
- Transplacental. It is transmitted to the fetus from an infected mother through the placenta.
- During delivery.
- In an infant, the infection enters the body through breast milk.
- By everyday means. An actively sick person can infect a healthy person, especially if the latter has a decrease in immunity due to illness or stress. In this case, infection occurs through airborne droplets, coughing and sneezing. It is also possible to get this virus in children's groups, through shared toys, which children are sure to taste one by one.
Identification of the flow pattern
congenital cytomegalovirus in children When CMV enters the body, it causes a primary infection. In some cases, it is not expressed by any symptoms, but sometimes it manifests itself acutely, with the occurrence of many complications.
The form of leakage in babies can be of three types:
- Congenital.
- Spicy.
- Generalized.
With congenital liver and spleen are enlarged in shape. Can lead to hemorrhages of internal organs and disruption of the central nervous system.
Acute the form is detected with an acquired virus, its symptoms are similar to colds, but, as a rule, it has a severe course with the addition of secondary infections. The severity of the course directly depends on the child’s immune status.
At generalized observed inflammatory processes in internal organs, pneumonia often occurs, various lesions brain, peripheral nervous system, in many cases aggravated by the addition of a secondary bacterial infection.
Also distinguished recurrent type leakage. He manifests himself in the form frequent colds, complicated by bronchitis and pneumonia, increase The lymph nodes throughout the body.
Very rarely observed atypical. It can cause damage to the reproductive system, interfere with blood clotting, and lead to hemolytic disease.
If it is congenital
Separately, the congenital form of CMV should be highlighted, since it is this that brings the most severe consequences to the health and development of the baby. From a carrier mother, the virus can enter the fetus at any stage of pregnancy. The nature of the lesions is directly related to the period at which the infection occurred. In the early stages of pregnancy (before 12 weeks), infection often leads to miscarriage.
The newborn is diagnosed with jaundice, convulsions, malformations of internal organs, incompetence respiratory system. In especially severe cases, damage to the central nervous system, hydro- or microcephaly, complete blindness and deafness are observed. As these children grow up, in addition to developmental delays, there are dysfunctions of the musculoskeletal system and mental development.
Symptoms
Manifestations of CMV in children are directly related to the child’s age and state of health.
Often, with the congenital form, there may be no obvious symptoms, but its consequences arise later in the form of visual impairment, neurological abnormalities, and delays in growth and development. Less commonly, the disease attacks a newborn immediately after birth. In this case, the salivary glands are affected, jaundice occurs, enlargement and inflammation of the internal organs, skin rash, decreased hearing and vision.
When an infant is infected from mother's milk, as well as in babies under one year of age, symptoms may appear in the form of a rash and pneumonia.
A child 3 years of age or older experiences fever, fatigue, respiratory symptoms. These conditions usually go away on their own within a few weeks. The older the baby, the easier it will be to cope with an exacerbation.
In general, symptoms do not appear immediately after infection because incubation period The illness can last up to three months. Symptoms of manifestation are often mistaken for a banal ARVI or influenza condition:
- Heat.
- Redness of the throat and pain when swallowing.
- Runny nose.
- General malaise, weakness, drowsiness.
- In some cases, the lymph nodes become enlarged.
- Sometimes a rash appears in the form of red dots all over the body.
In children with healthy immunity these symptoms go away after a couple of weeks. With a decrease in immunity, weakness and body temperature may remain elevated for a long time, up to several weeks or even months.
Based on severity, the disease is divided into three categories:
- light;
- moderate;
- heavy.
At easy In this form, symptoms may be mild or absent altogether. Recovery occurs on its own, even without special treatment.
At medium-heavy form, damage to internal organs is observed, in many cases reversible.
At severe form there are expressed functional disorders work of internal organs, as well as severe intoxication of the whole body.
Diagnosis and treatment of CMV
Cytomegalovirus is diagnosed in the laboratory in several ways:
- Cytological method. Biological fluids are taken for analysis - urine or saliva, and when stained, cytomegalic cells are revealed. One of the disadvantages of this method is its low information content (50%) and the need for multiple repetitions.
- PCR method. More informative compared to cytology. Capable of detecting both active and latent viruses.
- DNA probe method. Detects the presence of a virus from the mucus of the cervical canal.
- Serological method. With this type of study, antibodies to CMV are determined - immunoglobulins M and G (lgM and lgG). This type of diagnosis is highly informative and determines the presence of a primary infection from the onset of infection until 12 weeks after. The presence of IgG antibodies and high IgG titers indicate activation of the latent virus in the body.
- ELISA diagnostics (enzyme-linked immunosorbent assay). Most exact method diagnostics, but very expensive. It is able to detect CMV in children's blood even in the presence of other infections in the body.
If, as a result of an analysis for antibodies to CMV, a child is found to be IgG positive, this means that the child has previously encountered this type and has received immunity from it. Antibodies of the IgG type tend to accumulate in the blood and are present in a certain concentration throughout life. The doctor may retest in a few weeks.
An increase in antibody titers several times when compared with the first test result means that the virus is in an active stage of reproduction and treatment is required. If titers do not increase and there are no symptoms, treatment is not prescribed.
Antibodies of the lgM type are actively produced 5-7 weeks after the virus has captured the body, as well as during its next activation. The presence of lgM antibodies means that the infection occurred either recently, or the virus present in the body has passed into active stage. These antibodies may be present in a blood test for 6-12 months and disappear over time.
Treatment
in children it is long-lasting and complex. Unfortunately, it has not yet been developed these days specific remedy to suppress or complete cure this type of virus. Most commonly known antiviral drugs are not effective in treating CMV. Therefore, all measures are aimed at suppressing its activity, increasing protective functions the baby’s body and reducing the frequency of relapses.
In children with a congenital form of CMV, complex antiviral drugs. In addition, measures are being taken to minimize the harm caused by the virus and treat concomitant diseases depending on the severity of the lesions.
Therapy with human immunoglobulin preparations is also used, the administration of which is possible within a few hours after birth, due to their low toxicity.
CMV infection in children under one year of age is dangerous because their immunity is not yet developed enough to resist this disease, and the symptoms can be pronounced. Children with an acquired form of the virus in the latent stage, as a rule, do not require treatment.
The closest attention should be paid to those children whose immunity is reduced by other diseases. In this case, the disease can strike the internal organs, leading to their irreversible changes and malfunction in the future.
In other cases, symptomatic treatment is carried out:
- Taking antipyretics when the temperature rises.
- Bed rest.
- Drink plenty of fluids.
The condition of a sick child should be monitored by a doctor, since he is the one who is able to recognize the signs possible complications diseases.
Only the attending physician should prescribe medications for treatment and select the dosage of drugs depending on the age of the child and the severity of the disease. Self-administration of medications without control will lead to unpredictable consequences and complications, which, in turn, will complicate further treatment.
Prevention
Use contraceptive methods A healthy child’s immune system will not allow the virus to activate in the body, or the disease will proceed easily and without complications. Therefore, preventive measures are aimed at strengthening immune defense. Children should eat properly and balanced, harden themselves, and regularly spend time in the fresh air.
Taking multivitamin complexes gives good results, especially in winter. Decoctions of medicinal herbs - rosehip, St. John's wort, chamomile - have a positive effect on the immune system. Regular consumption of them in the form of tea will help to strengthen the children's body.
During epidemics of influenza and ARVI, you should limit the child’s communication with peers for some time, and also pay increased attention to his personal hygiene: regularly wash your hands with soap, when coming from the street, after playing and before eating. Be sure to carry out wet cleaning of the apartment and ventilation.
Sometimes, after an immunological examination of the child, to prevent complications, the doctor may prescribe immunostimulants in the form medicines. This can reduce the symptoms of the virus and transfer the disease to an inactive stage.
It is important for parents to remember that if their baby experiences long-term, frequently recurring colds, you should definitely show your baby to a doctor, conduct an examination and never self-medicate. Timely preventive and treatment measures will help transform it into an inactive form and make it non-hazardous to the health and development of your child.
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Most parents do not know what kind of scourge this is - cytomegalovirus infection. Although, with a high degree of probability, they themselves have already been ill with this “sore”, and will forever remain its carriers. Why is cytomegalovirus infection dangerous for children? And how to treat cytomegalovirus in a child?
Newborns and children with weakened immune systems suffer the most from cytomegalovirus infection and its consequences.
Cytomegalovirus infection in children: what does herpes have to do with it?
Speaking about cytomegalovirus infection in children, we return to the topic. In essence, cytomegalovirus is a type of herpes virus, and mention of it is found in medical records no less often than mention of the herpes simplex virus.
Medical scientists are convinced: all people on Earth (with the possible exception of those who live their lives, like Robinson, in absolute isolation from other people) are infected with cytomegalovirus. The only difference is that most of the population becomes infected with it in childhood, and the rest - already in mature age, but no later than 40-45 years.
Like the herpes simplex virus, cytomegalovirus also penetrates the child’s cells during the first infection and remains there for life, for the most part remaining in a “dormant” inactive state. And if a person leads a healthy lifestyle from early childhood, avoids stressful situations, monitors his diet and health (at first, of course, at the suggestion of his reasonable parents), thereby maintaining his immunity in constant “combat readiness,” then the cytomegalovirus in his body can “sleep” indefinitely...
How does cytomegalovirus infection occur?
Cytomegalovirus is transmitted from person to person through contact. And since it is contained in any secretions human body(in saliva, sweat, blood, sputum, feces, urine, semen and breast milk) - there are a great many chances of becoming infected. But all of them are acquired in nature and are not considered dangerous to the child’s health.
In both adults and children (usually already several months of age or older), infection with acquired cytomegalovirus occurs practically asymptomatically. And it does not pose any serious damage to health.
However, children can become infected not only in the first years or in the first months of life. But a little earlier! And in this case, the infection can turn into a tragedy...
We mentioned that cytomegalovirus in children can be acquired- and in this case it poses virtually no danger to the baby’s health. But cytomegalovirus can also be present in children congenital(when a child is infected in the womb, at the time of birth, or in the first days after birth). And in this case, cytomegalovirus infection can cause irreparable harm to the child’s health.
For which children is cytomegalovirus most dangerous?
- unborn children who become infected during intrauterine development through the placenta;
- newborn children whose immune system is still weak and unstable;
- children of any age with severely weakened immunity or with its complete absence (for example, against the background of AIDS).
With congenital infection with cytomegalovirus, there is a real risk of damage to the child - with a high degree of probability, malformations of the baby may occur, serious disorders in his nervous system, in the digestive system, in the cardiovascular and musculoskeletal systems, and irreversible damage to the organs of hearing and vision is also possible .
Moreover, a baby can “catch” cytomegalovirus, which is dangerous for a baby, not only during intrauterine development, but also during childbirth (by contact with secretions in birth canal), as well as immediately after birth - when feeding with mother's breast milk.
Diagnosis of cytomegalovirus infection in children occurs through laboratory analysis, which can be carried out in several ways. In Russia today the most common method is the so-called ELISA method - enzyme-linked immunosorbent assay. Moreover, it is important to find out not only the presence of the virus in the body, but also to determine its form - whether it is congenital or acquired.
When a cytomegalovirus infection develops in children during the neonatal period, then in this case its symptoms are usually similar to those - the lymphoid tissue suffers, which can be expressed in enlarged lymph nodes, inflammation of the tonsils, an increase in the size of the liver and spleen, and difficulty breathing. Also among the symptoms of congenital cytomegalovirus infection are often found:
- impaired swallowing and sucking reflexes.
And if the baby has difficulty breathing through his nose, the following will naturally be added to the symptoms:
- loss of appetite and weight loss;
- lack of restful sleep;
- crying and worry.
At different stages of pregnancy, the expectant mother undergoes a lot of tests. Including cytomegalovirus. If before the start of the “interesting situation” or in the first weeks of pregnancy, the analysis showed the presence of mature antibodies to cytomegalovirus, this woman can calmly rejoice, without fear of anything.
She herself is protected, and will be able to protect her child from this infection. The most dangerous
situation: if a woman does not have antibodies to cytomegalovirus at the beginning of pregnancy. The likelihood of encountering it within 9 months is extremely
great, but for her this meeting will be absolutely safe, but for her
it may pose the greatest risks to the future baby...
And despite the fact that congenital infection of the baby occurs even before birth (or during childbirth, or immediately after birth), the symptoms of cytomegalovirus infection may not appear immediately, but even 1-2 months after birth.
Cytomegalovirus infection in children acquires its most severe forms during intrauterine infection. Alas, even in this case, the disease may be asymptomatic - and then not only parents, but even doctors may not immediately suspect that the baby has a serious illness that threatens serious consequences.
Possible complications of asymptomatic development of cytomegalovirus in infants
Perhaps this is one of the most terrible and dangerous situations in the life of a baby and his parents - when the baby develops serious illness, but no symptoms are observed. Unfortunately, sometimes cytomegalovirus infection develops in precisely this scenario in young children.
In this case, the consequences can be very sad. For example:
- About 20% of children with active cytomegalovirus, but an asymptomatic form of the disease, several months after infection demonstrate severe convulsions, disturbances in motor activity, changes in the skeleton of the skull, clearly insufficient body weight.
- And after 4-5 years, approximately half of these children show obvious disorders of speech and mental development, and also experience serious problems at work of cardio-vascular system. Some children begin to rapidly lose their vision.
How does cytomegalovirus progress in children older than the neonatal period?
If the infection is acquired and the infection itself occurs when the baby has already passed the neonatal stage, the child, as a rule, easily copes with the disease: the infection is almost always asymptomatic, and only in some cases can it resemble.
Symptoms may include:
- lethargy and drowsiness;
- enlarged lymph nodes (especially in the neck);
- muscle and joint pain;
- chills and slight increase temperature.
Usually, acute period The acquired form of cytomegalovirus infection in children lasts from 2 weeks to 2 months. But most often it goes unnoticed. In some cases, the disease requires medical supervision, but almost always goes away on its own, without any specific treatment. However, let us remind you: this applies specifically to the acquired form of the disease - when the baby became infected long after birth, having managed to accumulate a certain supply of the body’s immune defense by the time of infection.
Only in the rarest cases does the acquired form of cytomegalovirus cause any serious complications. And in the vast majority of cases, the disease passes without a trace.
But if your child, 2-3 months after the diagnosis of cytomegalovirus infection, still exhibits obvious signs of mononucleosis (enlarged lymph nodes, adenoids and inflamed tonsils, constant lethargy and fatigue, sometimes - increased salivation and a whitish coating on the oral mucosa), it is imperative to consult a doctor.
Treatment tactics for cytomegalovirus in children
Drug treatment for cytomegalovirus infection in children is carried out only in cases of congenital infection, as well as severe forms ah illness.
As in the case of the herpes simplex virus, treatment of cytomegalovirus infection in children does not imply total ridding of the body from viruses - this is simply impossible. Treatment comes down to “quenching” the activity of the virus and avoiding possible negative consequences. Most often, antiherpetic drugs such as cytovene or ganciclovir are used to treat cytomegalovirus infection.
As is the case with others herpetic infections, drug therapy in no case can it be prescribed independently - any medicines against herpes (including against cytomegalovirus) must be used strictly as prescribed by a doctor, and not by a neighbor, an erudite relative or online bloggers!
In a word - about the most important
Among the sea of information, it will be useful for parents to “fish out” and remember several particularly important facts about cytomegalovirus infection:
- 1 The cytomegalovirus itself, being present in human cells in an inactive state, remains invulnerable to any drugs - it is impossible to kill or “drive” it out of the body. A person (most often a child), who becomes infected with cytomegalovirus, remains a carrier for life.
- 2 For adults and children over 1 month of age, cytomegalovirus infection in the vast majority of cases does not threaten any harm to health - it is asymptomatic and without consequences.
- 3 Infection with cytomegalovirus is truly dangerous for people (and children) with weakened immunity or obvious immunodeficiency, as well as for newborn babies (who could have become infected in utero or during childbirth), as well as for pregnant women. And only for those expectant mothers who become infected with cytomegalovirus for the first time during pregnancy.
- 4 It is possible to detect cytomegalovirus infection only with the help of special tests, which are extremely rare - after all, in most cases the disease is asymptomatic. Consequently, a huge number of people do not even suspect that they themselves, or their children, have had CMV infection.
- 5 In patients with immunodeficiency, as well as newborn babies, the infection often takes on a generalized form, the symptomatic picture of which has its own characteristics - the course of the disease is very similar to mononucleosis: the tonsils become inflamed, the lymph nodes increase in size, the temperature can rise to 39 ° C, and signs of sore throat may appear and pneumonia, etc. Symptoms of jaundice may occur due to liver damage. At the first suspicion of mononucleosis, it is necessary to do a cytomegalovirus test.
- 6 Congenital cytomegalovirus infection is the most dangerous. But it does not affect all newborn babies, but only about 10% of them. The rest recover asymptomatically and without negative consequences.
- 7 The course of cytomegalovirus infection in newborn babies is symptomatically similar not only to mononucleosis, but also to other infections - for example, herpes simplex, rubella and toxoplasmosis. Therefore, as a rule, when symptoms of one of these diseases appear, an analysis is done immediately for everything.
- 8 The earlier the analysis is carried out and the presence of infection is detected, the greater the chances of fast recovery without consequences. If treatment is started in the first 7-9 days after infection, almost all of the catastrophic consequences of cytomegalovirus infection can be avoided. The most common type of analysis for cytomegalovirus is an ELISA test (enzyme-linked immunosorbent assay).
According to WHO, mortality from the generalized form of cytomegalovirus infection worldwide currently ranks second in the viral diseases sector after mortality. However, you always have all the means at your disposal: information, diagnostic and treatment options to protect your children or yourself from any negative consequences of “communication” with cytomegalovirus...
Once viruses enter a baby’s body, they do not manifest themselves immediately. They are waiting for the right moment. A factor in the development of infection is a decrease in resistance - the body's resistance. Cytomegalovirus infection acts in a similar way. The virus is usually discovered by chance during a blood test.
The child receives CMV from the outside or becomes infected before birth, through the placenta. The congenital type of the disease is more difficult to tolerate and has a lot of complications, as a result of which work is disrupted different organs and systems. Treatment of the disease depends on the method of infection.
Why do children get cytomegalovirus?
CMV belongs to the DNA virus – Cytomegalovirus, which belongs to the herpesvirus family. It penetrates into all human organs, but is mainly isolated from the salivary glands, where it actively multiplies and integrates its DNA into the cell nucleus. Because of foreign element salivary gland cells increase in size. This is where the name of the virus came from (translated from Latin as “giant cells”).
At good immunity the child has cytomegalovirus “ IgG positive” is in an inactive state. This means that the child is only a carrier of the infection, but is not sick himself. When the body’s resistance decreases, the virus begins to actively multiply, the body secretes specific antibodies and certain symptoms appear.
Additional factors that reduce the body's resistance are digestive problems and heavy loads on a fragile child's body, leading to increased fatigue. With a weakened immune system, the body becomes an easy target for infectious agents.
Factors that reduce immunity are:
- rehabilitation of the body after a protracted illness (for example, influenza);
- allergic reactions;
- birth injuries;
- vitamin deficiency;
- improper use of medications;
- bad ecology;
- short period of breastfeeding for newborns.
Types and symptoms of the disease
Congenital infection
With intrauterine infection, clinical signs appear in children after birth. TO symptoms of CMV infections include:
- Yellowness of the skin. Indicates hepatitis. Blood tests reveal elevated bilirubin.
- As a result of hepatitis, the liver and spleen may become enlarged, as they are the first to respond to an infectious agent in the body.
- High body temperature.
- Muscle weakness.
- There is a rash on the skin, and bleeding ulcers are possible.
- Signs of general intoxication of the body.
- Enlarged lymph nodes (we recommend reading:).
One of the symptoms of cytomegalovirus infection is enlarged lymph nodes - Swollen larynx, possibly enlarged tonsils.
- Deterioration of breathing.
- Skin cyanosis (cyanosis).
- Sucking and swallowing reflexes are impaired.
- Digestive disorders, accompanied by vomiting and diarrhea.
- Loss of vision or hearing.
- Possible pneumonia.
- Underweight.
Congenital cytomegalovirus infection in children can cause mental retardation. Sometimes a virus leads to fatal outcome. The mortality rate of infected newborns reaches 30%. Also, due to infection, vision deteriorates to the point of blindness. If children with congenital cytomegalovirus do not show clinical symptoms, then 10-15% of these children will subsequently have hearing impairment.
Acquired infection
You can only get cytomegalovirus from a patient or a carrier of the virus. Clinical symptoms Diseases appear when the body's resistance decreases. Often the disease resembles a common ARVI, as it is accompanied by signs of inflammation of the upper respiratory tract, cough and pain when swallowing. Nasal congestion and increased body temperature are also possible. As an additional clinical sign A rash may appear all over the body in the form of red spots.
The lymphatic system responds to the proliferation of an infectious agent by enlarging the lymph nodes in the neck and under lower jaw. They are painless, the skin over them looks unchanged.
If the baby complains of pain in the tummy, this is a symptom of an enlarged liver and spleen. Nearby lymph nodes - inguinal and axillary - may also enlarge. Yellowness of the whites of the eyes and skin indicates liver damage.
The sick baby becomes lethargic and drowsy. All signs of tonsillitis begin to develop. Children complain of pain in muscles and joints. Complications may include pneumonia or hepatitis. This picture is accompanied by neurological abnormalities in behavior.
How is CMV transmitted and who is the carrier?
In external environment cytomegalovirus in children comes with biological fluids: saliva, discharge from the genital openings. Children become infected in the following ways:
- In utero. If the expectant mother becomes infected during pregnancy, the cytomegalovirus infection penetrates into the fetus through the placenta through the blood from the mother.
- With breast milk, if the nursing mother is acutely ill or became infected during breastfeeding.
- By airborne droplets when communicating with infected people or carriers of infection.
- Contact. A child can get the virus from the mother while moving through the birth canal.
If a nursing woman is infected with cytomegalovirus, it will be transmitted to the baby through breast milk For the virus to enter the body, you may not even have contact with a sick person. Biological secretions also pose a great threat to the baby's health. The infection can be transmitted on dishes, personal hygiene items, door handles, etc. Contact transmission does not pose a threat to the life and health of the baby.
A carrier of infection is a person who has no visible signs of the disease. However, it is dangerous for other people with reduced resistance. The infection is in a latent state in the body and waits for the right moment when the child’s immunity decreases. Then the virus begins to actively multiply and infect the child’s body.
How is the disease detected?
To make a diagnosis, it is not enough just to conduct an examination. The attending physician prescribes a number of tests:
- A serological blood test that identifies specific antibodies. Selection IgM antibodies means that the infection has become acute (the latent type is characterized by the IgG protein).
- PCR will help detect the virus in saliva, urine and other biological fluids.
- General blood analysis. It will show a decrease in the number of red blood cells, platelets and leukocytes (we recommend reading:).
- Biochemistry of blood. ALT and AST levels will be elevated, and an increase in creatinine and urea will indicate kidney damage.
- Microscopic analysis of urine sediment for the presence of giant cells.
To accurately confirm the presence of the disease, it is necessary to carry out a series of biological tests Cytomegalovirus IgG positive indicates chronic course diseases. TO additional methods diagnostics include:
- X-rays for complications in the lungs will show pneumonia;
- An abdominal ultrasound will show an enlarged spleen and liver;
- An MRI of the brain will reveal areas of inflammation.
An examination by an ophthalmologist is also possible. It reveals changes in the structures of the eye during fundus examination during generalized infection.
Is cytomegalovirus infection dangerous for children?
The infection is very dangerous for children who have it in infancy or were infected in utero. In 20% of cases, in those children whose infection is not accompanied by specific symptoms, the functioning of the nervous system is disrupted - anxiety, convulsions, and involuntary muscle contractions appear. Such children quickly lose weight, and skin rashes are possible.
The consequences of cytomegalovirus can appear in a child at 2 and 4 years old, as well as after several years in the form of delayed speech and mental development, diseases of the cardiovascular system, dysfunction of the ear and visual apparatus, up to complete loss of vision and partial loss of hearing. In older children, against the background of infection, the body's resistance sharply decreases. This provokes the development of bacterial microflora and causes other diseases, such as pneumonia or bronchitis.
Against the background of cytomegalovirus infection, a child may develop bronchitis or pneumonia How to cure the disease?
It is impossible to completely get rid of the virus, you can only bring it into an inactive state, so therapy is aimed at eliminating the activity of the virus and reducing the consequences of infection of the body by pathogenic bacteria. used in pediatrics:
- Ganciclovir. Active against many viruses, including CMV. Active substance The drug is integrated into the DNA of the virus and inhibits its synthesis.
- Acyclovir. Successfully fights all herpes viruses, including chickenpox. The principle of action is similar to antibiotics - slowing down and interrupting the chain of viral DNA reproduction.
Duration of treatment antiviral agents is 2-3 weeks. When clinical manifestations are completely stopped, and test results show an inactive state of the virus, therapy is stopped.
Another group of drugs used in the complex treatment of cytomegalovirus are immunostimulants:
- Isoprinosine (we recommend reading:). Stimulator of the body's immune forces. Suppresses the reproduction of RNA viruses. Activates the work that destroys abnormal cells, which is why it is used even in oncology. In the treatment of cytomegalovirus, it is often prescribed in parallel with Acyclovir to complement the action of the latter.
- Viferon. A drug based on artificially synthesized human interferon. Effective against herpes viruses. Available in the form rectal suppositories and ointments and is used in cases where oral medications are contraindicated due to complications on the liver and digestive system.
As an addition to medication treatment, there are folk remedies. However official medicine believes that they are useless in the fight against cytomegalovirus, so doctors do not recommend these recipes.
Preventive measures to prevent consequences
To avoid infection, you need to limit contact with sick people. It is necessary to instill in the child the rules of hygiene and explain the need for thorough hand washing. If a mother infected with cytomegalovirus gives birth to healthy child, you should completely stop breastfeeding.
In order for a child’s immunity to be resistant to infections, it must be strengthened with a balanced diet containing all the essential vitamins and microelements. Children with reduced resistance are given nonspecific immunoglobulin, which contains antibodies to the virus.
You need to strengthen your immune system in other well-known ways: in a healthy way life, hardening, active recreation. Physical exercise must be feasible - sport for the sake of results is as harmful as a sedentary lifestyle.
The fight against the disease is carried out by an infectious disease doctor, who should show the child if a virus is suspected. For various complications, it is also necessary to consult a neurologist, gastroenterologist, ENT specialist, ophthalmologist, nephrologist, pulmonologist. Complex treatment depends on the type of complications.
In conclusion, we can say that you should not let the situation take its course and self-medicate. This will aggravate the disease and give a lot of complications that will affect the development of the child. It is also important to be tested for cytomegalovirus carriage during pregnancy and undergo appropriate therapy.
Cytomegalovirus is one of the most common infectious agents in the human population, and is found in more than half of children worldwide at one age or another.
The penetration of the virus into a child’s body usually does not pose a particular danger, since most often it is asymptomatic and does not require treatment. However, the danger arises when infected during gestation, the first weeks after birth, or a significant decrease in the activity of the baby’s immune system...
Penetration of the virus into the child’s body
The mechanism of virus introduction and the age of the child play a special role in the development of cytomegalovirus infection.
There are the following ways of penetration of cytomegalovirus into the child’s body:
- antenatal (through the placenta during intrauterine development);
- intrapartum (during childbirth);
- postnatal (after birth).
The most severe consequences for the health of the child occur when infected through the placenta. In this case, the virus is in the amniotic fluid and enters in large quantities into the child’s digestive system and lungs, from where it penetrates almost all organs and tissues.
When an expectant mother is initially infected during pregnancy, the probability of the virus entering the amniotic fluid reaches 50%.
Sometimes during pregnancy there is a decrease in the overall resistance of the body, against the background of which an exacerbation is possible. hidden infection. However, the mother’s body already has specific antibodies that reduce the risk of infection of the fetus to 2%, and also protect the unborn child’s body from development severe complications.
If the mother has antibodies to the virus without any signs of disease, the risk of developing a congenital infection in the child is practically absent.
Primary infection or activation of a chronic infection in the mother in the 1st and 2nd trimesters of pregnancy poses the greatest threat to the health of the developing fetus, and sometimes leads to miscarriage. During this period, the fetus does not produce its own antibodies, and maternal antibodies are not enough for effective protection. In the third trimester, the fetus develops its own antibodies of classes M and G, so the risk of complications is minimal.
Infection during childbirth plays a minor role in the transmission of cytomegalovirus: the probability does not exceed 5% when a child is born to a mother with an active infection.
In the postnatal period, babies can become infected from their parents through kissing and other close contact. When feeding infected mothers with milk, the virus is transmitted to the child in 30-70% of cases.
Most often, infection occurs between the ages of 2 and 5-6 years. During this period, the child usually attends preschool institutions, where there is a high probability of transmission of the pathogen from staff and from other children. In carriers, the virus can be present in the blood, saliva, urine, and other secretions and can be transmitted through close contact, sneezing, poor hygiene, or sharing toys. The incidence of infection in preschool institutions is 25-80%. From infected human body The virus can be actively released for about two years.
Cytomegalovirus infection in children aged 2 to 6 years is most often asymptomatic and does not lead to any negative consequences. After 5-6 years, the activity of the immune system in children becomes stable, and the potential risk of developing severe cytomegaly decreases to almost zero.
Cytomegalovirus infection in newborns
There are congenital and acquired forms of CMV infection.
The congenital form occurs during intrauterine infection of the fetus and has a more severe course. Despite the high frequency of transmission of the virus from a sick mother to the fetus, only about 10% of children are born with congenital infection. Of these, more than 90% have no signs of the disease.
Symptoms of congenital infection include prematurity, jaundice, drowsiness, and difficulty swallowing and sucking. Enlargement of the spleen and liver, convulsions, strabismus, blindness, deafness, microcephaly, hydrocephalus are often observed. Sometimes abnormalities in the development of the cardiovascular, digestive and musculoskeletal systems are detected.
The absence of these symptoms in a newborn with suspected congenital CMV infection does not indicate the health of the child. There may be a late manifestation of the disease in the first 10 years of life in the form of mental retardation, impaired tooth formation, decreased visual acuity and hearing.
Acquired infection develops when infected during childbirth and in the first weeks of life. Symptoms of the disease appear 1-2 months after birth. There is a mental retardation and physical development, decreased or increased physical activity, convulsions, swelling of the salivary glands, blurred vision, subcutaneous hemorrhages. Pneumonia, pancreatitis, diabetes, and hepatitis may develop. However, in most cases, acquired infection is asymptomatic and becomes latent.
Normal course of the disease in children
As a rule, the child’s body copes quite effectively with cytomegalovirus without any external manifestations. In some cases, mononucleosis-like syndrome occurs. Its main symptoms are similar to ARVI: fatigue, pain in muscles and joints, headache, chills, fever, runny nose. Sometimes there is an enlargement of the lymph nodes, increased salivation, a whitish coating on the gums and tongue.
The disease lasts from two weeks to two months. The duration of symptoms may serve as an indirect indication of CMV infection. Hospitalization and specific treatment not required.
Sometimes encountered complications
Lack of control over the course of infection in external healthy child with suspected congenital infection can lead to delayed onset of complications.
Approximately 17% of asymptomatic infants infected with cytomegalovirus develop seizures several months after birth. movement disorders, abnormal dimensions of the skull (micro- or hydrocephalus), insufficient body weight. At the age of 5-7 years, 10% of children develop disorders of the nervous system, speech impairment, mental retardation, and underdevelopment of the cardiovascular system. About 20% of children at this age rapidly lose their vision.
Acquired infection most often does not cause severe complications. However, if you observe symptoms of a mononucleosis-like disease for more than two months, you should consult a doctor.
Forms of CMV infection and their features
The first entry of CMV into the body causes a primary infection. With normal activity of the immune system, it is asymptomatic, with reduced immune status– acutely, with signs of mononucleosis-like syndrome. Liver damage and pneumonia may also be recorded.
With a weakened immune system, recurrent infections develop. It manifests itself in the form of frequent bronchitis, pneumonia, multiple inflammation of the lymph nodes, chronic fatigue and general weakness. Inflammation of the adrenal glands, kidneys, pancreas, and spleen may develop. In severe relapses, the fundus, retina, intestines, nervous system, joints. Bacterial infections are often observed.
The atypical course of cytomegalovirus infection is rare and may manifest itself in small skin rashes, damage to the reproductive system, paralysis, hemolytic anemia, dropsy of the abdomen, decreased blood clotting, enlarged ventricles of the brain or the formation of cysts in them.
How to identify cytomegalovirus in a child: diagnostic methods
Diagnosis of CMV infection is possible using several methods:
- cultural: isolation of the virus in human cell culture. The method is the most accurate and allows you to determine the activity of the virus, but takes about 14 days;
- Cytoscopic: detection of characteristic owl-eye giant cells in urine or saliva. The method is not informative enough;
- Enzyme-linked immunosorbent assay (ELISA): detection of immunoglobulin M (IgM) in the blood indicates primary infection. If immunoglobulin G (IgG) is detected, re-examination is carried out at intervals of at least two weeks. An increase in antibody titers indicates activation of the infection. It is possible to obtain false positive results;
- Polymerase chain reaction (PCR): a fast and accurate method that reveals the DNA of the virus and how quickly it multiplies in the body.
The most common is enzyme immunoassay. When using it, it is necessary to determine several types of antibodies at once, which makes it quite expensive. However, this allows the stage of infection to be determined. The accuracy of the method is about 95%.
The PCR method is not available to every laboratory due to its high cost, but if possible, preference should be given to it due to its high accuracy (99.9%).
A short video about how enzyme immunoassay is done
Features of infection control
With asymptomatic CMV and mononucleosis-like syndrome, treatment is not required. In the second case, drinking plenty of fluids is recommended to reduce signs of intoxication.
Treatment is necessary when severe symptoms congenital infection or complications. The list and dosage of medications is determined by the doctor, taking into account the severity of the disease, age and body weight of the child. Antiviral drugs are used for treatment: Ganciclovir, Viferon, Foscarnet, Panavir, Cidofovir. As well as immunoglobulin preparations - Megalotect and Cytotect.
Self-treatment is strictly contraindicated due to the high likelihood of developing severe side effects.
A few words about prevention
Facilities specific prevention there are no cytomegalovirus infections. The vaccine is under development.
To protect the child from possible consequences infection, it is necessary, first of all, to take pregnancy planning seriously. The expectant mother should be tested for the presence of specific antibodies. If there is no immunity to the virus, a pregnant woman must use separate utensils, avoid frequent contact with small children, and carefully observe personal hygiene rules. During pregnancy, it is necessary to be tested twice for the presence of antibodies to the virus for the timely detection of a primary infection or relapse of a chronic one.
In the first months after birth, the child should be protected from close contact with adults and children under 6 years of age, and kissing the newborn should be avoided. 2-3 months after birth, the child’s immune system is already able to protect him from the development of severe forms of infection, so in the future it is only enough to provide the baby with adequate care. After 6 years, the formation of the immune system is completed. From this age, the body of a normally growing child is able to effectively cope with cytomegalovirus without developing clinical manifestations.
In the future, it is enough to instill in the baby the necessary hygiene skills, provide a balanced diet and harden the body.
