Cytomegalovirus Infections

Abstract

It has been 25 years now since the first strains of cytomegalovirus (CMV) were isolated. At that time, and for several years thereafter, the infection was recognized as the cause of a rare and severe congenital infection referred to as cytomegalic inclusion disease (CID). More recently the virus has been associated with a wide range of clinical abnormalities.1 It is the most common congenital infection of man and even inapparent infections are now known to have long term CNS sequelae.2,3 This review will focus on information that the child health clinician must be aware of in dealing with CMV infections acquired at different stages of development. EPIDEMIOLOGY It is probable that most individuals in every society are infected with a strain of CMV at some time in life. Much of the early seroepidemiologic data in the literature were based on the complement fixation test, a relatively insensitive method compared to the immunofluorescent and indirect hemagglutination tests for CMV antibody. The frequency of congenital infection ranges from 0.2% to 8.0% with an average in the United States of about 1%. The highest rate of infection is in infants born to teenaged mothers from lower socioeconomic groups. Not all the infants born excreting the virus are infected as a result of primary infection in the mother.