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What is CMV?
How is it spread?
Who is at risk from infection?
The health effects
CMV and pregnancy
How to prevent infection
CMV is a common viral infection that affects many people.
The first time that a person is infected with CMV is called a primary infection. After primary infection, the virus can live in the body in an inactive or dormant state. It can periodically become active again causing a reactivation of infection. This may occur when a person becomes ill or stressed. A previously infected person can also be infected with a different strain of CMV, and this is called a reinfection.
CMV is spread occupationally from person-to-person by contact with body substances, including urine and saliva. An infected person can pass the virus to another person even though they do not have symptoms.
CMV can also be transmitted from a mother to her unborn child during pregnancy. This is called congenital infection.
People who have occupational contact with young children are particularly at risk of CMV infection. Workers in child day care centres are at highest risk because of their frequent contact with children’s urine and saliva when changing nappies, assisting with toilet care and feeding infants.
Health care workers caring for infants and children, and patients, who have an impaired immune system, may also be at increased risk of infection.
CMV infection does not usually cause illness in healthy people, and people may be unaware that they have been infected. Occasionally it causes an illness with fever, sore throat and swollen glands. CMV infection can however cause serious illness in people who have an impaired immune system, and there can be adverse health effects for unborn children if they are infected during their mother’s pregnancy. These can include damage to the brain, liver, eyesight and hearing.
The most severe form of the disease generally occurs in infants born to mothers who have a primary infection during pregnancy. The risk to an infant from reactivation of infection or reinfection during pregnancy is generally lower.
A small number of babies who have been infected with CMV during pregnancy have symptoms at birth. Many of these infants will have lifelong disabilities of varying degrees. The majority of infants who have been infected with CMV during pregnancy do not have symptoms at birth. However, some of these children may develop disabilities later in childhood, such as hearing loss, learning difficulties and developmental delay.
Women working in the childcare industry who are pregnant, or expect to become pregnant, should discuss the risks of CMV with their doctor, and inform their employer so that their individual risk can be assessed and managed.
The doctor may suggest a blood test to determine if the woman has had a CMV infection in the past. This will assist in determining if a woman is at risk of a primary infection during her pregnancy. There is no vaccine to prevent CMV infection during pregnancy, however good hygiene practices, including hand hygiene, can reduce the risk.
In a landmark decision in NSW, a childcare worker and her severely disabled son were awarded $4.65 million. A Court of Appeal ruled that the child's disabilities resulted from the woman being infected with cytomegalovirus (CMV) at work (Hughes v SDN Children’s Services 2002).
There is currently no vaccine to prevent against infection with CMV. Good personal hygiene, including hand hygiene, is the most important way to prevent CMV infection, as CMV is readily killed with soap and detergent.
CMV infections are common among children in childcare settings, but most children will not have symptoms and their infection will be unknown. Children known to have CMV do not need to be excluded from child care because the virus may persist in their urine and saliva for months to years.
The occupational risks of CMV infection in childcare facilities should be managed using a risk management approach, as outlined in the Risk Management Code of Practice 2007.
The following control measures can be effective in preventing CMV infection:
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© The State of Queensland (Department of Justice and Attorney-General) 2009.