Managing primary CMV infection in pregnancy

Abstract

Vertical infection can occur antenatally throughthe placenta, during delivery through cervical secretions andblood and postnatally through breast milk. CMV is endemicand most adults will be infected during their lifetime. Adultseroprevalence in developed countries is around 50%, but indeveloping countries it may be as high as 90–100%. Primaryinfection in immunocompetent adults is usually asymptom-atic, and viral shedding continues for some months before theinfection is brought to its latent phase. In children, viral shed-ding may persist for years after a primary infection and tod-dlers in day care constitute an important infectious source. Incommon with other herpesviruses, CMV remains lifelong atspecific sites (mainly the salivary glands) and the viral repli-cation cycle can be reactivated. Secondary infection can occurdue to such reactivation of the residing virus or due to infec-tion with a different strain (reinfection).