Materiały źródłowe

• #1 Cytomegalovirus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459185/

  Cytomegalovirus (CMV) is a wide-spread virus, with manifestations ranging from asymptomatic to severe end-organ dysfunction in immunocompromised patients with congenital CMV disease. […] CMV infects between 60% to 70% of adults in industrialized countries and close to 100% in emerging countries. […] Approximately 59% of the population older than six years old has been exposed to CMV, with an increase in the populations seroprevalence with increasing age. Infection can occur as a primary infection, reinfection, or reactivation. Transmission of CMV can occur in numerous ways: via blood products (transfusions, organ transplantation), breastfeeding, viral shedding in close-contact settings, perinatally, and sexual transmission. Reactivation is seen in patients who become immunocompromised and is associated with elevated morbidity and mortality. […] CMV is a double-stranded DNA virus and is a member of the herpesviruses. Like other herpesviruses, after recovery of the initial infection, CMV remains dormant within the host. Viral reactivation occurs during the compromise of the immune system with immunosuppression.

• #1 Cytomegalovirus (CMV): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/215702-overview

  CMV seroprevalence in immunocompetent adults varies from 40-100% globally. […] At least 50-60% of the US population has been exposed to CMV, with a prevalence of more than 90% in high-risk groups (eg, male homosexuals), and outside of the US prevalence can be more than 90%. […] The incidence of CMV seropositivity rises with age and in a US-based study was reported to increase from 36% in children aged 6-11 years to 91% in individuals older than 80 years. […] Individuals at an increased risk for CMV infection include individuals who attend or work at daycare centers, patients who undergo blood transfusions, persons who have multiple sex partners, and recipients of CMV mismatched organ or bone marrow transplants. […] CMV is transmitted from person to person via close contact with an individual who is excreting the virus.

• #1 About Cytomegalovirus | Cytomegalovirus (CMV) and Congenital CMV Infection | CDC

  https://www.cdc.gov/cytomegalovirus/about/index.html

  Cytomegalovirus (pronounced sy-toe-MEG-a-low-vy-rus or CMV) is a common virus found in people of all ages. […] In the United States, nearly 1 in 3 children is already infected with CMV by age 5. Over half of adults have been infected with CMV by age 40. […] Anyone can get CMV. Some people are at higher risk for complications from CMV, like those who are pregnant or have weakened immune systems. […] About 1 in 200 babies is born with congenital CMV infection. About 1 in 5 babies with congenital CMV infection will have birth defects or other long-term health problems. […] The virus can stay in a child’s body fluids for months after the infection. People who are often around young children are more likely to get infected. […] CDC aims to reduce the burden of congenital CMV. We work closely with national experts to conduct research and increase awareness of CMV among the public and healthcare providers. […] CMV is the most common infectious cause of birth defects in the United States. It can spread through body fluids like saliva and urine, especially by children.

• #1 A systematic literature review of the global seroprevalence of cytomegalovirus: possible implications for treatment, screening, and vaccine development | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13971-7

  Cytomegalovirus (CMV) is a common pathogen that affects individuals of all ages and establishes lifelong latency. […] Knowledge of the current epidemiologic burden of CMV is necessary to understand the need for treatment and prevention. […] A systematic literature review (SLR) was conducted to describe the most recent epidemiologic burden of CMV globally. […] Among adult men, CMV immunoglobulin G (IgG) seroprevalence ranged from 39.3% (France) to 48.0% (United States). […] Among women of reproductive age in Europe, Japan, LATAM, and North America, CMV IgG seroprevalence was 45.6-95.7%, 60.2%, 58.3-94.5%, and 24.6-81.0%, respectively. […] Seroprevalence increased with age and was lower in developed than developing countries, but data were limited. […] Certain populations and regions are at a substantially higher risk of CMV infection.

• #1 A systematic literature review of the global seroprevalence of cytomegalovirus: possible implications for treatment, screening, and vaccine development | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13971-7

  The extensive epidemiologic burden of CMV calls for increased efforts in the research and development of vaccines and treatments. […] In the United States, it is estimated that the virus will infect approximately 30% of children by 5 years of age and more than 50% of adults by 40 years of age. […] Generally, CMV seroprevalence is higher among women, those in older age groups, persons of lower socioeconomic status, and in developing countries. […] Among women of reproductive age in particular, global CMV seroprevalence ranges from 45 to 100%. […] Given that CMV infection is common globally yet has a variable clinical course and a potential for long-term sequelae, a greater understanding of CMV epidemiologic data worldwide is needed, which can support the development of CMV vaccines and justify vaccine introduction into immunization schedules.

• #1 Changes in the Epidemiology of Cytomegalovirus | SpringerLink

  https://link.springer.com/chapter/10.1007/978-1-4684-5853-4_10

  Human cytomegalovirus (CMV) is highly species-specific, and humans are believed to be its only reservoir. Seroepidemiologic surveys have found CMV infection in every population that has been tested, including remote Indian tribes in the Amazon basin that lacked evidence of past measles or influenza infections. CMV infection is endemic and without seasonal variation. Climate does not affect the prevalence of infection, and there are no known vectors in the natural transmission cycle. The prevalence of CMV infection increases with age, but according to geographic, ethnic, and socioeconomic backgrounds, the patterns of acquisition of this infection vary widely among populations. As illustrated in figure 1, in general, CMV is acquired earlier in life in developing countries and among the lower socioeconomic strata of developed countries. Differences between populations can be particularly striking during childhood, with rates of seropositivity of 46-yr-olds varying from less than 10% in Great Britain and certain populations in the United States to nearly 100% in Africa and the South Pacific. Presumably, these significant differences are the reflection of factors that account for increased exposure to CMV, such as crowding, breast-feeding, sexual practices, and certain rearing practices. Transmission occurs by direct or indirect person-to-person contact. Sources of the virus include urine, oropharyngeal secretions, cervical and vaginal secretions, semen, milk, tears, and blood. CMV is not very contagious, and the spread of infection requires close or intimate contact with infected secretions. Restriction-enzyme analyses of CMV DNA have been used to demonstrate person-to-person spread of the virus in situations where close contact occurs, such as breast-feeding, sexual activity, day care, and interaction between parents or care takers and infected toddlers. Under special circumstances fomites may also play a role, since CMV has been shown to retain infectivity for hours on plastic surfaces and has been isolated from randomly selected toys and surfaces in day-care centers.

• #1 Pediatric Cytomegalovirus Infection: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/963090-overview

  Epidemiology […] Every mammal appears to be infected with its own species-specific cytomegalovirus (CMV), and no evidence suggests that infections cross species. Hence, humans are the only natural host for human CMV infection. Although most adults eventually become infected with CMV, the epidemiology of this infection is complex, and the age at which an individual acquires CMV greatly depends on geographic location, socioeconomic status, cultural factors, and child-rearing practices. […] In developing countries, most children acquire CMV infection early in life, with adult seroprevalence approaching 100% by early adulthood. In contrast, in developed countries, the seroprevalence of CMV approximates 50% in young adults of middle-upper socioeconomic status. This observation has important implications for congenital CMV epidemiology because women of childbearing age who are CMV seronegative are at major risk of giving birth to infants with symptomatic congenital infection if primary infection is acquired during pregnancy. […] Transmission of CMV infection may occur throughout life, chiefly via contact with infected secretions. In the developed world, CMV is the most common congenital viral infection. An overall rate of congenital CMV transmission of approximately 1% (ranging from 0.252%, depending on the population studied) has been estimated in newborn infants in the developed world in most reviews. This translates to about 80,000 congenital CMV infections per year in the United States and Europe. In the United States, congenital CMV infection occurs in 3-6 of every 1000 infants born each year. […] A meta-analysis of published studies concluded that the overall birth prevalence of congenital CMV infection was 0.64%, but noted that rates varied considerably among different study populations. Nonwhite race, low socioeconomic status, premature birth, and neonatal intensive care unit admittance were risk factors for congenital CMV infection; and birth prevalence increased with maternal CMV seroprevalence. […] There has been insufficient attention given to congenital CMV infection in the developing world, but the limited data available suggest that CMV may also represent a significant public health concern in these populations. A multicenter study comparing newborn screening by oropharyngeal culture versus polymerase chain reaction (PCR) based detection of viral DNA in the newborn dried blood spot identified an overall prevalence of 0.45% in the 7 sites surveyed. […] Most congenital CMV infections occur in infants born to mothers with preexisting immunity, and these infections are clinically asymptomatic at birth; however, long-term sequelae, including deafness, can occur. […] The route of congenital infection is presumed to be transplacental. The transplacental transmission rate after maternal primary infection is about 32%. CMV may also be transmitted perinatally, both by aspiration of cervicovaginal secretions in the birth canal and by breastfeeding. More than 50% of infants fed with breast milk that contains infectious virus become infected with CMV. […] Infants who are not infected congenitally or perinatally with CMV are at high risk to acquire infection in daycare centers. According to some studies, the prevalence of CMV infection in children who attend daycare, particularly children younger than 2 years, approximates 80%. […] The virus may be readily transmitted to susceptible children via saliva, urine, and fomites; these children, in turn, may transmit infection to their parents. Horizontal transmission of infection in daycare centers appears to play a major role in the epidemiology of many CMV infections in young parents. […] In adulthood, sexual activity is probably the most important route of acquisition of CMV, although the observation that virus is present in saliva, cervicovaginal secretions, and semen obscures which route or routes of transmission are primarily responsible for establishment of infection. Saliva alone appears to be sufficient for transmission of CMV, and this route of transmission may be responsible for those cases of heterophile-negative mononucleosis, which are attributable to CMV. Kissing appears to be a way in which CMV is transmitted from toddlers to seronegative parents. Work by the Centers for Disease Control and Prevention (CDC) has emphasized the need for greater public awareness of these risks and for educational interventions for young women of childbearing age. […] Other important routes of transmission include blood transfusion and solid organ transplantation. Before screening of blood products, transfusion-associated CMV was an important cause of morbidity and mortality in premature infants; however, the routine use in many neonatal intensive care units of CMV-negative blood products has largely eliminated this problem. Posttransfusion CMV is still a risk in CMV-seronegative trauma and in surgery patients, often manifesting as hepatitis.

• #1 Congenital cytomegalovirus infection – Wikipedia

  https://en.wikipedia.org/wiki/Congenital_cytomegalovirus_infection

  Worldwide, approximately 1 in 100 to 500 babies are born with congenital CMV. Approximately 1 in 3000 will show symptoms and 1 in 7000 will die. Congenital HCMV infection occurs when the mother has a primary infection (or reactivation) during pregnancy. Due to the lower seroprevalence of HCMV in industrialized countries and higher socioeconomic groups, congenital infections are actually less common in poorer communities, where more women of child-bearing age are already seropositive. In industrialized countries up to 8% of HCMV seronegative mothers contract primary HCMV infection during pregnancy, of which roughly 50% will transmit to the fetus. Between 10 and 15% of infected fetuses are then born with symptoms, which may include pneumonia, gastrointestinal, retinal and neurological disease. 10-15% of asymptomatic babies will develop long term neurological effects. SNHL is found in 35% of children with CMV, cognitive deficits have been found in 66% of children with CMV, and death occurs in 4% of children. HCMV infection occurs in roughly 1% of all neonates with those who are not congenitally infected contracting the infection possibly through breast milk. Other sources of neonatal infection are bodily fluids which are known to contain high titres in shedding individuals: saliva and urine seem common routes of transmission.

• #1 Update on congenital cytomegalovirus infection: Prenatal prevention, newborn diagnosis, and management | Canadian Paediatric Society

  https://cps.ca/documents/position/update-on-congenital-cytomegalovirus-infection-prenatal-prevention-newborn-diagnosis-and-management

  Cytomegalovirus (CMV) is the most common cause of congenital infection, affecting 0.5% to 1% of live births in North America and Europe, and up to 6% of live births in developing countries. […] CMV is the leading (up to 25%) cause of non-genetic childhood sensorineural hearing loss (SNHL). […] The estimated prevalence of long-term neurological sequelae ranges from 5% to 15% in asymptomatic congenital CMV (cCMV) cases, to 36% to 90% in survivors of symptomatic cCMV. […] Recent advances in drug therapy for this infection have renewed focus on prevention, diagnosis, and treatment. […] Universal infant screening for cCMV is being considered in some countries, and in Canada, has already commenced in Ontario. […] Expectant mothers with primary infection or non-primary (reinfection with different viral strains or reactivation of the primary strain) CMV are at risk of transmitting CMV vertically (transplacentally) to their unborn fetuses.

• #1 Cytomegalovirus (CMV) and Congenital CMV Infection

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/cmv.html

  Cytomegalovirus (CMV) is a common virus that infects people of all ages. […] About one out of every 200 babies are born with congenital CMV infection. […] Women can pass CMV to their baby during pregnancy. […] Congenital CMV infection can be diagnosed by testing a newborn babys saliva, urine, or blood. […] Medicines, called antivirals, may decrease the risk of health problems and hearing loss in some infected babies who show signs of congenital CMV infection at birth.

• #1 Cytomegalovirus (CMV)

  https://www.health.ny.gov/diseases/communicable/cytomegalovirus/fact_sheet.htm

  CMV is a common virus that infects 50 to 80 percent of people at some time during their lives but rarely causes obvious illness. […] Anyone can become infected with CMV. Almost all people have been exposed to CMV by the time they reach adulthood. […] 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, semen and to a lesser extent in other body fluids. […] Approximately 8 out of every 1,000 babies born in the United States will have CMV infection, of which 1 to 2 may have significant illness involving nervous system damage or developmental disabilities. […] The risk of CMV infection in hospital workers is not greater than it is in others in the community and is probably low because of careful hand washing practices. […] Good handwashing is the best preventive measure. Plastic disposable gloves should be worn when handling linen or underclothes soiled with feces or urine.

• #1 Cytomegalovirus | Utah Epidemiology

  https://epi.utah.gov/cytomegalovirus/

  Human cytomegalovirus (CMV) is a is a common virus that infects people of all ages. CMV is spread from person to person by contact with urine, saliva, breast milk, blood, semen, and possibly other body fluids. The virus can spread from an infected mother to her fetus or newborn baby. CMV can also be spread by blood transfusion and organ transplants. […] CMV infection before birth is known as “congenital CMV”. When this happens, the virus gets transmitted to the unborn infant and can cause permanent health problems with the brain, eyes, and/or inner ears.

• #1 Cytomegalovirus (CMV) Infection – Epidemiology Forecast to 2032

  https://www.researchandmarkets.com/reports/4330795/cytomegalovirus-cmv-infection-epidemiology?srsltid=AfmBOooNPb0qnWE0bQxFf2FJVNk5RxHeM-BJzHiVAcbuso-IicsVFuxA

  This „Cytomegalovirus (CMV) Infection – Epidemiology Forecast to 2032” report delivers an in-depth understanding of the disease, historical and forecasted Cytomegalovirus (CMV) Infection epidemiology in the 7MM, i.e., the United States, EU5 (Germany, Spain, Italy, France, and the United Kingdom), and Japan. […] The Cytomegalovirus (CMV) Infection epidemiology report gives a thorough understanding of the Cytomegalovirus (CMV) Infection by including details such as disease definition, symptoms, causes, pathophysiology, and diagnosis. […] The Cytomegalovirus (CMV) Infection epidemiology division provides insights about historical and current patient pool and forecasted trend for every seven major countries. […] The Cytomegalovirus (CMV) Infection epidemiology segment covers the epidemiology data in the US, EU5 countries (Germany, Spain, Italy, France, and the UK), and Japan from 2019 to 2032.

• #1 CMV – Health Protection Surveillance Centre

  https://www.hpsc.ie/a-z/hepatitis/bloodbornevirus/cmv/

  Cytomegalovirus (CMV) is a common viral infection with approximately 60% of European people being infected by adulthood. […] CMV infection is transmitted from person to person via contact with infected body fluids (urine, saliva, blood, faeces, semen, breast milk, tears). […] CMV is a notifiable disease.

• #1 Factsheet – Health Protection Surveillance Centre

  https://www.hpsc.ie/a-z/hepatitis/bloodbornevirus/cmv/factsheet/

  Cytomegalovirus infection (congenital) is a notifiable disease. […] Each year, approximately one in 150 children in the United States and the UK is born with or develops disabilities as a result of CMV infection. […] Currently there is no recommended treatment for CMV infection. […] Further useful information is available on the HSE website.

• #1 Congenital Cytomegalovirus Surveillance – MN Dept. of Health

  https://www.health.state.mn.us/people/newbornscreening/program/cmv/surveillance.html

  Because Minnesota is the first state to offer universal newborn screening for congenital cytomegalovirus (CMV) the Minnesota Department of Health is taking special care to monitor the impact. […] Surveillance for cCMV is statewide, population-level, laboratory and case-based, capturing information on newborns who were born in and reside in Minnesota. […] The primary goals for surveillance are: Describe the epidemiology of cCMV in Minnesota. […] Congenital CMV is part of the reportable disease rule in Minnesota.

• #1 Cytomegalovirus (CMV) Infection- Epidemiology Insights-2023- EU5

  https://www.prnewswire.com/news-releases/cytomegalovirus-cmv-infection–epidemiology-insights-2023–eu5-300399252.html

  LONDON, Jan. 30, 2017 /PRNewswire/ — DelveInsight’s „Cytomegalovirus (CMV) Infection- Epidemiology Insights-2023-EU5” Reports provides an overview of the disease and the historical and forecasted epidemiological data for the Cytomegalovirus (CMV) Infection in EU5 (France, Germany, Italy, Spain and United Kingdom) for 2013-2023. […] According to DelveInsight, the total number of Diagnosed Cytomegalovirus (CMV) infection cases in France is expected to increase at a CAGR of 0.06% to 20,871 cases by 2023. In case of Germany it is expected to increase at a CAGR of 0.067% to 21,619 cases by 2023. In United Kingdom, the total number of Diagnosed Cytomegalovirus (CMV) infection cases is expected to increase at a CAGR of 0.061% to 14,417 cases by 2023 and in Spain is expected to increase at a CAGR of 0.029% to 12,810 cases in 2023. For Italy, it is expected to increase at a CAGR of 0.031% to 13,358 cases in 2023. CMV infection is most prevalent in Italy and least prevalent in Spain of the EU5. […] The Report covers the detailed historical and forecasted epidemiological data covering European from 2013-2023.

• #1 Fifteen-Year Surveillance of LTR Receiving Pre-Emptive Therapy for CMV Infection: Prevention of CMV Disease and Incidence of CLAD

  https://www.mdpi.com/2076-2607/10/12/2339

  Fifteen-Year Surveillance of LTR Receiving Pre-Emptive Therapy for CMV Infection: Prevention of CMV Disease and Incidence of CLAD […] The efficacy of pre-emptive therapy in the prevention of cytomegalovirus (CMV) disease and the potential association of CMV infection with the occurrence of chronic lung allograft dysfunction (CLAD) was evaluated in 129 lung transplant recipients receiving pre-emptive therapy based on pp65-antigenemia or CMV-DNA in the blood and in the bronchoalveolar lavage. […] Cytomegalovirus (CMV) infection is the most frequent viral complication in LT recipients. […] In the absence of any prophylaxis, the frequency of CMV infection and disease is highly variable among studies, ranging from 38% to 75%. […] The cumulative incidence of CLAD was 38% at 5 years and 54% at 10 years.

• #1 Cytomegalovirus infection – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/cytomegalovirus-infection/

  Infection with cytomegalovirus (CMV or human herpes virus 5) is generally asymptomatic in immunocompetent individuals but can cause mild, mononucleosis-like symptoms. […] Epidemiological data refers to the US, unless otherwise specified. […] Prevalence of CMV infection in the general population: 40-100%. […] Seroprevalence increases with age with more than 90% in individuals 80 years. […] Screening is performed before solid organ and hematopoietic stem cell transplant. […] Despite the risk for congenital CMV infection, routine screening for CMV during pregnancy is not recommended. […] For individuals who are immunocompromised, additional CMV precautions depend on the nature of immunocompromise. […] Recommended before HSCT or solid organ transplant. […] Not routinely recommended for pregnant individuals or those planning pregnancy.

• #1 Cytomegalovirus (CMV) in Pregnancy | ACOG

  https://www.acog.org/clinical-information/physician-faqs/cytomegalovirus-in-pregnancy

  With primary maternal CMV infection, the overall risk of transmission to the fetus is approximately 30-40%. […] Routine serologic screening of pregnant individuals for CMV is not recommended. […] Most adult CMV infections are asymptomatic, which makes recognition of primary infection difficult. […] After detection of maternal infection or suspected fetal infection based on ultrasound findings, CMV can be detected in the amniotic fluid of infected fetuses by either culture or PCR. […] Currently, no therapies are approved by the U.S. Food and Drug Administration (FDA) for the treatment of maternal or fetal CMV infection. […] Some have suggested that pregnant individuals should be instructed on the importance of personal hygiene and safe-handling techniques. […] In some states, routine screening of all newborns has been instituted.

• #1 Update on congenital cytomegalovirus infection: Prenatal prevention, newborn diagnosis, and management | Canadian Paediatric Society

  https://cps.ca/documents/position/update-on-congenital-cytomegalovirus-infection-prenatal-prevention-newborn-diagnosis-and-management

  Rates of transmission are 10- to 15-fold higher in primary compared with non-primary maternal infection. […] Although administering CMV-specific hyperimmune globulin and antiviral therapy to pregnant women with primary infection may provide benefit, robust evidence to support these interventions is lacking. […] Developing an effective pre-pregnancy vaccine would likely be the best preventive strategy, but this option is not yet available. […] Newborns who fail their newborn hearing screen (NBHS) are also being tested for CMV. […] Although universal screening would (ideally) optimize detection of cCMV, consensus is needed concerning the optimal specimen to use for early newborn screening. […] When testing has confirmed cCMV, symptomatic infants require ophthalmological and hearing evaluation as well as head imaging.

• #1 RealTime CMV Assay

  https://www.uspharmacist.com/article/realtime-cmv-assay

  Cytomegalovirus (CMV) is a member of the herpesvirus family. CMV is a common virus that is usually harmless to people with healthy immune systems. After an initial infection, the virus remains latent in the body and can reactivate at any time. For those with a normal immune system, infection with the virus is usually asymptomatic. When symptoms occur, they may appear cold-like; the virus may cause mononucleosis or hepatitis. The CMV may cause serious issues in those with a compromised immune system and can cause a congenital CMV infection in infants. […] According to the CDC, nearly one in three children is infected with CMV by the age of 5 years, and over half of adults have been infected by the age of 40 years, with most being asymptomatic. […] Transmission of the virus is similar to that of the other herpesviruses by contact with bodily fluids. It can be transmitted sexually, during birth, through breast milk, through contact with saliva, or through organ transplants and blood infusions.

• #1 RealTime CMV Assay

  https://www.uspharmacist.com/article/realtime-cmv-assay

  Diagnosis is confirmed when CMV antibodies are detected through serology tests. […] The RealTime CMV assay has demonstrated effectiveness for use in clinical and laboratory evaluations. Although currently it is only used in the management of patients with hematopoietic stem cell transplants, it is becoming a routine test in the laboratory.

• #1 The Current Status of Cytomegalovirus (CMV) Prevalence in the MENA Region: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6963600/

  The incidence rate of cCMV in the MENA region seems to be higher than in other populations. […] Nevertheless, there is substantial variability in the definitions of symptomatic and asymptomatic cCMV infection, study designs, and the methods of determining CMV infection. […] The studies on transplant and transfusion recipients reported the incidence of CMV with uncertainty about the disease. […] The low number of published articles, the low number of reporting countries, the inconsistency in measurement and detection protocols, as well as the variability in endpoint evaluation of the clinical illness, are all factors that limited the ability to generalize the information across the region. Thus, there is an incessant need to conduct well-designed studies under the umbrella of the WHO to estimate the burden of CMV disease on transplant recipients in the MENA region and to standardized both the prophylactic and preemptive treatment and predict the subsequent morbidity and mortality.

• #1 Cytomegalovirus (CMV) in Pregnancy | ACOG

  https://www.acog.org/clinical-information/physician-faqs/cytomegalovirus-in-pregnancy

  Cytomegalovirus (CMV) is a ubiquitous double-stranded DNA herpesvirus that is transmitted by sexual contact or direct contact with infected blood, urine, or saliva. […] In the United States, nearly one in three children is already infected with CMV by age 5. More than one-half of adults have been infected with CMV by age 40. […] Cytomegalovirus is the most common congenital infection, occurring in 0.2-2.2% of all neonates. […] Cytomegalovirus infection can occur during pregnancy. The incidence of primary CMV infection among previously seronegative pregnant people in the United States ranges from 0.3% to 4%. […] Vertical transmission of CMV may occur because of transplacental infection after primary or secondary infection, exposure to contaminated genital tract secretions at delivery, or breastfeeding.

• #1 Surveillance of congenital cytomegalovirus in the UK and ireland | Archives of Disease in Childhood

  https://adc.bmj.com/content/96/Suppl_1/A46.1

  W Wielkiej Brytanii szacuje się, że 34 na 1000 noworodków rodzi się z wrodzoną infekcją wirusem cytomegalii (CMV); 10-15% dotkniętych noworodków zgłasza objawy związane z CMV, 40-58% z nich rozwija długoterminowe następstwa. […] Aktywna populacyjna surveillance noworodków urodzonych w latach 2001-2002 z potwierdzoną lub podejrzewaną wrodzoną infekcją CMV została przeprowadzona przez Brytyjską Jednostkę Nadzoru Pediatrycznego. […] Liczba potwierdzonych przypadków zdiagnozowanej wrodzonej infekcji CMV zgłoszonej w tym badaniu była niższa niż oczekiwano, co podkreśla potrzebę wczesnych i odpowiednich badań, gdy podejrzewa się wrodzoną infekcję.

• #1 Seroepidemiology of Cytomegalovirus Infection in Pregnant Women in the Central Mexican City of Aguascalientes | Alvarado-Esquivel | Journal of Clinical Medicine Research

  https://www.jocmr.org/index.php/JOCMR/article/view/3358

  Infection with cytomegalovirus (CMV) during pregnancy may lead to congenital disease. Very little is known about the seroepidemiology of CMV infection in pregnant women in Mexico. We sought to determine the seroprevalence and correlates of CMV infection in pregnant women in Aguascalientes City, Mexico. […] Anti-CMV IgG antibodies were detected in 259 (89.6%) of the 289 pregnant women studied. None of the 289 pregnant women were positive for anti-CMV IgM antibodies. Seroprevalence of CMV infection was significantly lower (P = 0.03) in pregnant women with reflex impairment (5/8: 62.5%) than in those without this clinical feature (246/272: 90.4%). Seroprevalence of CMV infection was significantly higher (P = 0.03) in pregnant women with 2 – 9 pregnancies (140/150: 93.3%) than in those with only one pregnancy (119/139: 86.2%). […] We found a high endemicity of CMV infection in pregnant women in Aguascalientes City, Mexico. Factors associated with CMV infection found in this study may be useful for an optimal planning of preventive measures against CMV exposure in pregnant women.

• #1

  https://journals.lww.com/transplantjournal/fulltext/2022/09001/424_1__epidemiology_of_cytomegalovirus_infection.701.aspx

  Cytomegalovirus (CMV) is a highly prevalent herpes virus with a seroprevalence higher in South America, Africa, and Asia than in Europe and North America. In hematopoietic stem cell transplant recipients (HSCT), CMV infection is a common opportunistic infection and a major cause of morbidity and mortality. To better understand the epidemiology of CMV infection and disease post-HSCT in selected countries outside of Europe and North America, a systematic review was conducted. […] In 43 of 54 studies reporting on incidence of CMV infection, within 1 year post-HSCT, estimates were uniformly distributed between 24.8% and 61.2%. Lower estimates were reported in autologous HSCT recipients (5.3%), and younger patients at the time of transplantation (9.3% in adults with a median age of 25 years and 18.6% in patients aged 20 years). Higher estimates (range: 69.4% to 88.2%) were found in 8 studies from China and South Korea, most with a follow-up period 1 year. Incidence of CMV disease following HSCT was below 20%, with estimates uniformly distributed between 0% and 15.7% in allogeneic HSCT.

• #1

  https://journals.lww.com/transplantjournal/fulltext/2022/09001/424_7__epidemiology_of_cytomegalovirus_infection.707.aspx

  Cytomegalovirus (CMV), a highly prevalent herpes virus worldwide, can lead to a wide range of serious direct and indirect effects in solid organ transplant (SOT) recipients. As the seroprevalence of CMV varies across countries, a systematic review was undertaken to describe the epidemiology of CMV infection and disease in SOT recipients in selected countries outside of North America and Europe. […] Reported incidence estimates of CMV infection varied greatly, ranging from 5.2% to 79.0%, according to type of organ transplanted and country. For CMV disease, incidence estimates within one-year post-SOT ranged from 0% to 19%, in 21 of 23 studies, regardless of prevention strategy used or distribution of CMV serostatus in donor and recipients. […] Heterogeneity in the incidence of CMV infection across organ types and countries outside of North America and Europe was found, despite most studies reporting on adult kidney recipients. High rates of CMV infection, CMV recurrence and CMV disease are likely to impact graft and patient outcomes post-transplantation and may contribute to greater disease burden post-SOT.

• #1 Cytomegalovirus (CMV) | Causes, Symptoms, and Treatment

  https://patient.info/doctor/cytomegalovirus

  Cytomegalovirus epidemiology […] Worldwide estimates of CMV infection prevalence vary from 50% to over 70% of all adults. […] Infection may be passed via body fluids – eg, kissing, sexual intercourse and blood transfusion, or by tissue donation. […] Most HIV-infected individuals are seropositive for CMV. HIV infection accelerates the development of CMV-dependent immunological abnormalities.

• #1 Cytomegalovirus Disease: Adult and Adolescent OIs | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/cytomegalovirus

  Cytomegalovirus (CMV) is a double-stranded DNA virus in the herpesvirus family that can cause disseminated or localized end-organ disease in people with HIV with advanced immunosuppression. Most clinical disease occurs in individuals previously infected with CMV experiencing reactivation of latent infection. Infection with a novel strain also may occur. […] End-organ disease caused by CMV occurs in patients with HIV and advanced immunosuppression, typically those with CD4+ T lymphocyte cell (CD4) counts 50 cells/mm3 who are not receiving, adherent to, or responding to antiretroviral therapy (ART). Among those treated with ART who have achieved virologic control, a new diagnosis of CMV end-organ disease is exceedingly rare. […] Before potent ART, an estimated 30% of patients with AIDS experienced CMV retinitis, the most common CMV end-organ disease in such patients. The incidence of new cases of CMV end-organ disease has declined by 95% with the advent of potent ART.

• #1 Prevalence, incidence, and risk factors associated with cytomegalovirus infection in healthcare and childcare worker: a systematic review and meta-analysis | Systematic Reviews | Full Text

  https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-022-02004-4

  Cytomegalovirus (CMV) is transmitted by direct contact with body fluids from infected individuals. Transmission of CMV in households, particularly those with young children, contributes significantly to CMV infection in the general population. However, little is known about the contribution of occupational healthcare or childcare exposure to risk of CMV infection. […] To determine CMV seroprevalence, incidence of primary infection, and associated risk factors in healthcare and childcare workers. […] Pooled CMV seroprevalence was 59.3% among childcare workers and 49.5% among healthcare workers, and pooled incidences of primary CMV infection per 100 person-years were respectively 7.4 and 3.1. […] Childcare workers, but not healthcare workers, have an increased risk of prevalent and incident CMV infection, a risk that is further increased with the presence of at least one child living at home.

• #1 Prevalence, incidence, and risk factors associated with cytomegalovirus infection in healthcare and childcare worker: a systematic review and meta-analysis | Systematic Reviews | Full Text

  https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-022-02004-4

  The overall pooled incidence of primary CMV infection among healthcare and childcare workers was 4.6 per 100 person-years. […] The odds of CMV seropositivity were significantly higher among childcare workers, but not healthcare workers, when compared to their respective controls. […] In both healthcare and childcare workers, having one or more children residing at home doubled the risk of CMV seropositivity. […] This meta-analysis provides updated estimates of indicators of CMV infection in healthcare and childcare workers. Prevalence and incidence of CMV infection was more common in childcare than in healthcare workers, which we believe is due to better adherence to infection prevention measures in the healthcare environment.

• #1 Cytomegalovirus | Infection Control | CDC

  https://www.cdc.gov/infection-control/hcp/healthcare-personnel-epidemiology-control/cytomegalovirus.html

  Cytomegalovirus (CMV) infection is common, with over half of adults infected by age 40 years. […] Transmission of CMV between healthcare personnel (HCP) and patients in healthcare settings is possible, but has not been well documented. […] However, HCP have not been demonstrated to be at greater risk for acquiring CMV than the general population. […] Hence, occupational transmission of CMV in healthcare settings may be very rare. […] Using infection prevention and control practices as recommended by CDC prevents transmission of CMV in healthcare settings. […] Testing HCP for CMV infection is not typically performed by Occupational Health Services (OHS) nor indicated for most HCP, regardless of symptoms or potential exposure. […] Post-exposure prophylaxis (PEP) is not administered after exposure to CMV.

• #1 Update on congenital cytomegalovirus infection: Prenatal prevention, newborn diagnosis, and management | Canadian Paediatric Society

  https://cps.ca/documents/position/update-on-congenital-cytomegalovirus-infection-prenatal-prevention-newborn-diagnosis-and-management

  For asymptomatic or minimally symptomatic infants, a head ultrasound (HUS) is usually sufficient. […] All moderate to severe CMV cases should be referred promptly for infectious disease consultation. […] There is no evidence to support antiviral therapy for asymptomatic CMV disease without SNHL at the present time. […] Late-onset, progressive SNHL has a median onset of 27 months of age, but has been reported to develop as late as 44 months of age. […] cCMV is the leading cause of non-genetic SNHL and a significant cause of neurodevelopmental and neurosensory morbidity. […] Early laboratory identification of infants with cCMV (within the first 21 days after birth) is essential to determine disease severity and initiate antiviral therapy in moderate to severe cases.

• #1 The Current Status of Cytomegalovirus (CMV) Prevalence in the MENA Region: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6963600/

  Furthermore, there was a lack of CMV epidemiological studies from several countries in the region (Algeria, Bahrain, Djibouti, Lebanon, Libya, Morocco, Palestine, Qatar, Syria, the UAE, and Yemen), rendering the actual incidence of CMV across the region undetermined. […] The high risk of CMV infection and transmission through organ transplantation is universal. The prevalence across the globe ranges from 45% in developed countries to near 100% in developing countries. […] Even though the risk is high for transplant patients in the MENA region, only a few studies suggested screening for CMV in donors. […] Overall, these findings demonstrate a high rate of prevalence of CMV infections in the MENA region, and as such, posing serious implications for the blood transfusion practices if proper screening measures are not implemented.

• #1 Seroepidemiology of Cytomegalovirus Infection in Pregnant Women in the Central Mexican City of Aguascalientes | Alvarado-Esquivel | Journal of Clinical Medicine Research

  https://www.jocmr.org/index.php/JOCMR/article/view/3358/2095

  Cytomegalovirus (CMV) infection during pregnancy may lead to congenital disease. Very little is known about the seroepidemiology of CMV infection in pregnant women in Mexico. We sought to determine the seroprevalence and correlates of CMV infection in pregnant women in Aguascalientes City, Mexico. Anti-CMV IgG antibodies were detected in 259 (89.6%) of the 289 pregnant women studied. None of the 289 pregnant women were positive for anti-CMV IgM antibodies. We found a high endemicity of CMV infection in pregnant women in Aguascalientes City, Mexico. Factors associated with CMV infection found in this study may be useful for an optimal planning of preventive measures against CMV exposure in pregnant women. The seroepidemiology of CMV infection in Mexico has been scantily studied. We reported the seroepidemiology of CMV infection in pregnant women in the northern Mexican state of Durango. In the present study, we sought to determine the seroprevalence and correlates of CMV infection in pregnant women in the central Mexican city of Aguascalientes. We found an 89.6% seroprevalence in pregnant women in Aguascalientes City. This seroprevalence is higher than the 65.6% seroprevalence found in pregnant women in Durango City. The seroprevalence of CMV infection in women in Aguascalientes is comparable with a 92.6% seroprevalence of CMV infection reported in healthy women at reproductive age in Cuernavaca City in central Mexico, and an 89.2% seroprevalence found in a national survey in subjects aged 1 – 70 years old in Mexico. In an international context, the seroprevalence found in pregnant women in Aguascalientes is as high as the 88.5-100% seroprevalences reported in pregnant women in Ethiopia, China, Cuba, Iran, Brazil, Palestine, Turkey, and Nigeria. On the other hand, the seroprevalence found in pregnant women in Aguascalientes is higher than the 42.3-66% seroprevalences reported in pregnant women in Germany, France, Poland, Japan, and Norway. Therefore, comparison of the seroprevalence found in our study with those reported in other countries suggests that seroprevalence of CMV infection in pregnant women in Aguascalientes City could be placed in a high position of endemicity. However, interpretation of this comparison of seroprevalences should be cautious since different laboratory methods for detection of anti-CMV IgG antibodies were used among the studies.

• #1 Cytomegalovirus (CMV) infection – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cmv/symptoms-causes/syc-20355358

  Complications of CMV infection vary, depending on your overall health and when you were infected. […] An infant whose mother first became infected with CMV during pregnancy is more likely to experience complications. Complications for the baby can include hearing loss, intellectual disability, vision problems, seizures, lack of coordination, and weakness or problems using muscles. […] Careful hygiene is the best prevention against CMV. You can take these precautions: Wash your hands often. Use soap and water for 15 to 20 seconds, especially if you have contact with young children or their diapers, saliva or other oral secretions. […] Experimental vaccines are being tested for women of childbearing age. These vaccines may be useful in preventing CMV infection in mothers and infants, and reducing the chance that babies born to women who are infected while pregnant will develop disabilities.

• #1 The Current Status of Cytomegalovirus (CMV) Prevalence in the MENA Region: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6963600/

  Human cytomegalovirus (CMV) is a highly prevalent herpesvirus worldwide. According to the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), CMV infects people of all ages, and by the age of five, approximately one-third of children in the United States are infected. […] The objective of this study is to systematically review published literature on CMV in the MENA region to estimate its incidence in the region and describe its epidemiological and clinical significance. […] The CMV IgG seroprevalence ranged from 8.7-99.2% (SD = 38.95%). CMV incidence in these countries ranged between 1.22% and 77% in transplant and transfusion recipients, with an increase in incidence with advanced age. […] However, the incidence rate was unclear for congenital CMV due to the variability of the reporting. This review highlights the need for more robust and well-designed studies to better estimate CMV incidence in the MENA region, standardize diagnostic criteria, and consider prophylactic and pre-emptive treatments to limit the morbidity and mortality of the disease.

• #1 Cytomegalovirus infectionExternal LinkExternal Link

  https://www.health.vic.gov.au/infectious-diseases/cytomegalovirus-infection

  Primary cytomegalovirus (CMV) infection may cause a mononucleosis syndrome clinically indistinguishable from Epstein–Barr virus infection. […] CMV is the most important cause of congenital viral infections in Australia. Some infected infants develop health problems. […] Although infection with CMV is very common around the world, symptomatic disease is rare. The risk of severe or complicated CMV infection is increased in some groups, including: developing infants during pregnancy and people with immunosuppression, such as organ transplant recipients, people infected with human immunodeficiency virus (HIV) and those being treated for cancer. […] Serosurveys of adult populations worldwide have shown widespread evidence of previous CMV infection; seropositivity rates range from 40 per cent in highly developed countries to 100 per cent in developing countries. […] The incidence peaks during the perinatal period, with a secondary peak among young adults in areas where perinatal infection is less common.

• #1 Competetive landscape analysis in Cytomegalovirus (CMV) Infection

  https://synapse.patsnap.com/article/competetive-landscape-analysis-in-cytomegalovirus-cmv-infection

  Cytomegalovirus (CMV) is a ubiquitous beta-herpesvirus that infects a significant proportion of the adult population worldwide, with seropositivity rates ranging from 40% to as high as 100% in different populations. […] The epidemiology of CMV demonstrates a marked disparity in infection outcomes: while most healthy individuals do not suffer clinical consequences, immunosuppressed groups experience high morbidity and mortality due to both direct CMV disease and its indirect complications (such as increased susceptibility to other opportunistic infections, graft rejection, and cardiovascular diseases). […] Furthermore, in specific geographical regions and among populations with varied socioeconomic backgrounds, the epidemiological characteristics of CMV infection differ, which influences both clinical presentations and the demand for effective therapies.

• #1 A systematic literature review of the global seroprevalence of cytomegalovirus: possible implications for treatment, screening, and vaccine development | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13971-7

  Overall, additional insight into the epidemiologic burden of CMV across different risk factors is needed, which can help guide targeted strategies for those populations at greatest risk for infection and disease. […] Only 4 studies evaluating CMV shedding were identified in our review, which indicated shedding prevalence ranged from 11.0 to 51.9% in newborns to children aged 10 years. […] However, prior findings have indicated that shedding of CMV is more prevalent among younger age groups, particularly those 2 years of age. […] Thus, comprehensive CMV epidemiologic studies are imperative toward furthering our understanding of CMV and associated disease, which in turn can guide public health strategies to reduce disease burden in vulnerable populations through screening, treatment, and vaccine development.

• #2 Epidemiology, clinical manifestations, and treatment of cytomegalovirus infection in immunocompetent adults – UpToDate

  https://www.uptodate.com/contents/epidemiology-clinical-manifestations-and-treatment-of-cytomegalovirus-infection-in-immunocompetent-adults

  Epidemiology, clinical manifestations, and treatment of cytomegalovirus infection in immunocompetent adults […] The spectrum of human illness caused by cytomegalovirus (CMV) is diverse and mostly dependent on the host. CMV infections in immunocompromised patients cause substantial morbidity and mortality, especially among transplant recipients and those infected with the human immunodeficiency virus (HIV). Infection in the immunocompetent host is generally asymptomatic or may present as a mononucleosis syndrome. However, occasionally, primary CMV infection can lead to severe organ-specific complications with significant morbidity and mortality. […] Infection of pregnant women, even if asymptomatic, is occasionally associated with the syndrome of congenital CMV in newborns. […] The manifestations and treatment of CMV infection in immunocompetent adults will be reviewed here. The diagnosis of CMV infections in immunocompetent and immunocompromised patients is discussed separately. CMV infection in neonates, children, and immunocompromised hosts is also presented separately.

• #2 Cytomegalovirus infection – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/cytomegalovirus-infection/

  Infection with cytomegalovirus (CMV or human herpes virus 5) is generally asymptomatic in immunocompetent individuals but can cause mild, mononucleosis-like symptoms. […] Epidemiological data refers to the US, unless otherwise specified. […] Prevalence of CMV infection in the general population: 40-100%. […] Seroprevalence increases with age with more than 90% in individuals 80 years. […] Screening is performed before solid organ and hematopoietic stem cell transplant. […] Despite the risk for congenital CMV infection, routine screening for CMV during pregnancy is not recommended. […] For individuals who are immunocompromised, additional CMV precautions depend on the nature of immunocompromise. […] Recommended before HSCT or solid organ transplant. […] Not routinely recommended for pregnant individuals or those planning pregnancy.

• #2 A systematic literature review of the global seroprevalence of cytomegalovirus: possible implications for treatment, screening, and vaccine development | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13971-7

  The extensive epidemiologic burden of CMV calls for increased efforts in the research and development of vaccines and treatments. […] In the United States, it is estimated that the virus will infect approximately 30% of children by 5 years of age and more than 50% of adults by 40 years of age. […] Generally, CMV seroprevalence is higher among women, those in older age groups, persons of lower socioeconomic status, and in developing countries. […] Among women of reproductive age in particular, global CMV seroprevalence ranges from 45 to 100%. […] Given that CMV infection is common globally yet has a variable clinical course and a potential for long-term sequelae, a greater understanding of CMV epidemiologic data worldwide is needed, which can support the development of CMV vaccines and justify vaccine introduction into immunization schedules.

• #2 Changes in the Epidemiology of Cytomegalovirus | SpringerLink

  https://link.springer.com/chapter/10.1007/978-1-4684-5853-4_10

  Human cytomegalovirus (CMV) is highly species-specific, and humans are believed to be its only reservoir. Seroepidemiologic surveys have found CMV infection in every population that has been tested, including remote Indian tribes in the Amazon basin that lacked evidence of past measles or influenza infections. CMV infection is endemic and without seasonal variation. Climate does not affect the prevalence of infection, and there are no known vectors in the natural transmission cycle. The prevalence of CMV infection increases with age, but according to geographic, ethnic, and socioeconomic backgrounds, the patterns of acquisition of this infection vary widely among populations. As illustrated in figure 1, in general, CMV is acquired earlier in life in developing countries and among the lower socioeconomic strata of developed countries. Differences between populations can be particularly striking during childhood, with rates of seropositivity of 46-yr-olds varying from less than 10% in Great Britain and certain populations in the United States to nearly 100% in Africa and the South Pacific. Presumably, these significant differences are the reflection of factors that account for increased exposure to CMV, such as crowding, breast-feeding, sexual practices, and certain rearing practices. Transmission occurs by direct or indirect person-to-person contact. Sources of the virus include urine, oropharyngeal secretions, cervical and vaginal secretions, semen, milk, tears, and blood. CMV is not very contagious, and the spread of infection requires close or intimate contact with infected secretions. Restriction-enzyme analyses of CMV DNA have been used to demonstrate person-to-person spread of the virus in situations where close contact occurs, such as breast-feeding, sexual activity, day care, and interaction between parents or care takers and infected toddlers. Under special circumstances fomites may also play a role, since CMV has been shown to retain infectivity for hours on plastic surfaces and has been isolated from randomly selected toys and surfaces in day-care centers.

• #2 Pediatric Cytomegalovirus Infection: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/963090-overview

  Epidemiology […] Every mammal appears to be infected with its own species-specific cytomegalovirus (CMV), and no evidence suggests that infections cross species. Hence, humans are the only natural host for human CMV infection. Although most adults eventually become infected with CMV, the epidemiology of this infection is complex, and the age at which an individual acquires CMV greatly depends on geographic location, socioeconomic status, cultural factors, and child-rearing practices. […] In developing countries, most children acquire CMV infection early in life, with adult seroprevalence approaching 100% by early adulthood. In contrast, in developed countries, the seroprevalence of CMV approximates 50% in young adults of middle-upper socioeconomic status. This observation has important implications for congenital CMV epidemiology because women of childbearing age who are CMV seronegative are at major risk of giving birth to infants with symptomatic congenital infection if primary infection is acquired during pregnancy. […] Transmission of CMV infection may occur throughout life, chiefly via contact with infected secretions. In the developed world, CMV is the most common congenital viral infection. An overall rate of congenital CMV transmission of approximately 1% (ranging from 0.252%, depending on the population studied) has been estimated in newborn infants in the developed world in most reviews. This translates to about 80,000 congenital CMV infections per year in the United States and Europe. In the United States, congenital CMV infection occurs in 3-6 of every 1000 infants born each year. […] A meta-analysis of published studies concluded that the overall birth prevalence of congenital CMV infection was 0.64%, but noted that rates varied considerably among different study populations. Nonwhite race, low socioeconomic status, premature birth, and neonatal intensive care unit admittance were risk factors for congenital CMV infection; and birth prevalence increased with maternal CMV seroprevalence. […] There has been insufficient attention given to congenital CMV infection in the developing world, but the limited data available suggest that CMV may also represent a significant public health concern in these populations. A multicenter study comparing newborn screening by oropharyngeal culture versus polymerase chain reaction (PCR) based detection of viral DNA in the newborn dried blood spot identified an overall prevalence of 0.45% in the 7 sites surveyed. […] Most congenital CMV infections occur in infants born to mothers with preexisting immunity, and these infections are clinically asymptomatic at birth; however, long-term sequelae, including deafness, can occur. […] The route of congenital infection is presumed to be transplacental. The transplacental transmission rate after maternal primary infection is about 32%. CMV may also be transmitted perinatally, both by aspiration of cervicovaginal secretions in the birth canal and by breastfeeding. More than 50% of infants fed with breast milk that contains infectious virus become infected with CMV. […] Infants who are not infected congenitally or perinatally with CMV are at high risk to acquire infection in daycare centers. According to some studies, the prevalence of CMV infection in children who attend daycare, particularly children younger than 2 years, approximates 80%. […] The virus may be readily transmitted to susceptible children via saliva, urine, and fomites; these children, in turn, may transmit infection to their parents. Horizontal transmission of infection in daycare centers appears to play a major role in the epidemiology of many CMV infections in young parents. […] In adulthood, sexual activity is probably the most important route of acquisition of CMV, although the observation that virus is present in saliva, cervicovaginal secretions, and semen obscures which route or routes of transmission are primarily responsible for establishment of infection. Saliva alone appears to be sufficient for transmission of CMV, and this route of transmission may be responsible for those cases of heterophile-negative mononucleosis, which are attributable to CMV. Kissing appears to be a way in which CMV is transmitted from toddlers to seronegative parents. Work by the Centers for Disease Control and Prevention (CDC) has emphasized the need for greater public awareness of these risks and for educational interventions for young women of childbearing age. […] Other important routes of transmission include blood transfusion and solid organ transplantation. Before screening of blood products, transfusion-associated CMV was an important cause of morbidity and mortality in premature infants; however, the routine use in many neonatal intensive care units of CMV-negative blood products has largely eliminated this problem. Posttransfusion CMV is still a risk in CMV-seronegative trauma and in surgery patients, often manifesting as hepatitis.

• #2 About Cytomegalovirus | Cytomegalovirus (CMV) and Congenital CMV Infection | CDC

  https://www.cdc.gov/cytomegalovirus/about/index.html

  Cytomegalovirus (pronounced sy-toe-MEG-a-low-vy-rus or CMV) is a common virus found in people of all ages. […] In the United States, nearly 1 in 3 children is already infected with CMV by age 5. Over half of adults have been infected with CMV by age 40. […] Anyone can get CMV. Some people are at higher risk for complications from CMV, like those who are pregnant or have weakened immune systems. […] About 1 in 200 babies is born with congenital CMV infection. About 1 in 5 babies with congenital CMV infection will have birth defects or other long-term health problems. […] The virus can stay in a child’s body fluids for months after the infection. People who are often around young children are more likely to get infected. […] CDC aims to reduce the burden of congenital CMV. We work closely with national experts to conduct research and increase awareness of CMV among the public and healthcare providers. […] CMV is the most common infectious cause of birth defects in the United States. It can spread through body fluids like saliva and urine, especially by children.

• #2 Cytomegalovirus (CMV)

  https://www.health.ny.gov/diseases/communicable/cytomegalovirus/fact_sheet.htm

  CMV is a common virus that infects 50 to 80 percent of people at some time during their lives but rarely causes obvious illness. […] Anyone can become infected with CMV. Almost all people have been exposed to CMV by the time they reach adulthood. […] 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, semen and to a lesser extent in other body fluids. […] Approximately 8 out of every 1,000 babies born in the United States will have CMV infection, of which 1 to 2 may have significant illness involving nervous system damage or developmental disabilities. […] The risk of CMV infection in hospital workers is not greater than it is in others in the community and is probably low because of careful hand washing practices. […] Good handwashing is the best preventive measure. Plastic disposable gloves should be worn when handling linen or underclothes soiled with feces or urine.

• #2 Cytomegalovirus (CMV) Infection – Epidemiology Forecast to 2032

  https://www.researchandmarkets.com/reports/4330795/cytomegalovirus-cmv-infection-epidemiology?srsltid=AfmBOooNPb0qnWE0bQxFf2FJVNk5RxHeM-BJzHiVAcbuso-IicsVFuxA

  The Cytomegalovirus (CMV) Infection epidemiology covered in the report provides historical as well as forecasted Cytomegalovirus (CMV) Infection epidemiology scenario in the 7MM covering the United States, EU5 countries (Germany, Spain, Italy, France, and the United Kingdom), and Japan from 2019 to 2032. […] The report provides insight into the historical and forecasted patient pool of Cytomegalovirus (CMV) Infection in seven major markets covering the United States, EU5 (Germany, Spain, France, Italy, UK), and Japan. […] The report assesses the disease risk and burden and highlights the unmet needs of Cytomegalovirus (CMV) Infection. […] 11-year Forecast of Cytomegalovirus (CMV) Infection epidemiology. […] What are the key findings pertaining to the Cytomegalovirus (CMV) Infection epidemiology across 7MM and which country will have the highest number of patients during the forecast period (2019-2032)? […] What is the disease risk, burden and unmet needs of Cytomegalovirus (CMV) Infection?

• #2 Factsheet – Health Protection Surveillance Centre

  https://www.hpsc.ie/a-z/hepatitis/bloodbornevirus/cmv/factsheet/

  Cytomegalovirus infection (congenital) is a notifiable disease. […] Each year, approximately one in 150 children in the United States and the UK is born with or develops disabilities as a result of CMV infection. […] Currently there is no recommended treatment for CMV infection. […] Further useful information is available on the HSE website.

• #2 Congenital Cytomegalovirus Surveillance – MN Dept. of Health

  https://www.health.state.mn.us/people/newbornscreening/program/cmv/surveillance.html

  Because Minnesota is the first state to offer universal newborn screening for congenital cytomegalovirus (CMV) the Minnesota Department of Health is taking special care to monitor the impact. […] Surveillance for cCMV is statewide, population-level, laboratory and case-based, capturing information on newborns who were born in and reside in Minnesota. […] The primary goals for surveillance are: Describe the epidemiology of cCMV in Minnesota. […] Congenital CMV is part of the reportable disease rule in Minnesota.

• #2 Cytomegalovirus (CMV) Infection – Epidemiology Forecast to 2032

  https://www.researchandmarkets.com/reports/4330795/cytomegalovirus-cmv-infection-epidemiology?srsltid=AfmBOooNPb0qnWE0bQxFf2FJVNk5RxHeM-BJzHiVAcbuso-IicsVFuxA

  This „Cytomegalovirus (CMV) Infection – Epidemiology Forecast to 2032” report delivers an in-depth understanding of the disease, historical and forecasted Cytomegalovirus (CMV) Infection epidemiology in the 7MM, i.e., the United States, EU5 (Germany, Spain, Italy, France, and the United Kingdom), and Japan. […] The Cytomegalovirus (CMV) Infection epidemiology report gives a thorough understanding of the Cytomegalovirus (CMV) Infection by including details such as disease definition, symptoms, causes, pathophysiology, and diagnosis. […] The Cytomegalovirus (CMV) Infection epidemiology division provides insights about historical and current patient pool and forecasted trend for every seven major countries. […] The Cytomegalovirus (CMV) Infection epidemiology segment covers the epidemiology data in the US, EU5 countries (Germany, Spain, Italy, France, and the UK), and Japan from 2019 to 2032.

• #2 Update on congenital cytomegalovirus infection: Prenatal prevention, newborn diagnosis, and management | Canadian Paediatric Society

  https://cps.ca/documents/position/update-on-congenital-cytomegalovirus-infection-prenatal-prevention-newborn-diagnosis-and-management

  Cytomegalovirus (CMV) is the most common cause of congenital infection, affecting 0.5% to 1% of live births in North America and Europe, and up to 6% of live births in developing countries. […] CMV is the leading (up to 25%) cause of non-genetic childhood sensorineural hearing loss (SNHL). […] The estimated prevalence of long-term neurological sequelae ranges from 5% to 15% in asymptomatic congenital CMV (cCMV) cases, to 36% to 90% in survivors of symptomatic cCMV. […] Recent advances in drug therapy for this infection have renewed focus on prevention, diagnosis, and treatment. […] Universal infant screening for cCMV is being considered in some countries, and in Canada, has already commenced in Ontario. […] Expectant mothers with primary infection or non-primary (reinfection with different viral strains or reactivation of the primary strain) CMV are at risk of transmitting CMV vertically (transplacentally) to their unborn fetuses.

• #2 RealTime CMV Assay

  https://www.uspharmacist.com/article/realtime-cmv-assay

  Cytomegalovirus (CMV) is a member of the herpesvirus family. CMV is a common virus that is usually harmless to people with healthy immune systems. After an initial infection, the virus remains latent in the body and can reactivate at any time. For those with a normal immune system, infection with the virus is usually asymptomatic. When symptoms occur, they may appear cold-like; the virus may cause mononucleosis or hepatitis. The CMV may cause serious issues in those with a compromised immune system and can cause a congenital CMV infection in infants. […] According to the CDC, nearly one in three children is infected with CMV by the age of 5 years, and over half of adults have been infected by the age of 40 years, with most being asymptomatic. […] Transmission of the virus is similar to that of the other herpesviruses by contact with bodily fluids. It can be transmitted sexually, during birth, through breast milk, through contact with saliva, or through organ transplants and blood infusions.

• #2 Cytomegalovirus (CMV) and Congenital CMV Infection

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/cmv.html

  Cytomegalovirus (CMV) is a common virus that infects people of all ages. […] About one out of every 200 babies are born with congenital CMV infection. […] Women can pass CMV to their baby during pregnancy. […] Congenital CMV infection can be diagnosed by testing a newborn babys saliva, urine, or blood. […] Medicines, called antivirals, may decrease the risk of health problems and hearing loss in some infected babies who show signs of congenital CMV infection at birth.

• #2 Cytomegalovirus (CMV) in Pregnancy | ACOG

  https://www.acog.org/clinical-information/physician-faqs/cytomegalovirus-in-pregnancy

  With primary maternal CMV infection, the overall risk of transmission to the fetus is approximately 30-40%. […] Routine serologic screening of pregnant individuals for CMV is not recommended. […] Most adult CMV infections are asymptomatic, which makes recognition of primary infection difficult. […] After detection of maternal infection or suspected fetal infection based on ultrasound findings, CMV can be detected in the amniotic fluid of infected fetuses by either culture or PCR. […] Currently, no therapies are approved by the U.S. Food and Drug Administration (FDA) for the treatment of maternal or fetal CMV infection. […] Some have suggested that pregnant individuals should be instructed on the importance of personal hygiene and safe-handling techniques. […] In some states, routine screening of all newborns has been instituted.

• #2 The Current Status of Cytomegalovirus (CMV) Prevalence in the MENA Region: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6963600/

  The incidence rate of cCMV in the MENA region seems to be higher than in other populations. […] Nevertheless, there is substantial variability in the definitions of symptomatic and asymptomatic cCMV infection, study designs, and the methods of determining CMV infection. […] The studies on transplant and transfusion recipients reported the incidence of CMV with uncertainty about the disease. […] The low number of published articles, the low number of reporting countries, the inconsistency in measurement and detection protocols, as well as the variability in endpoint evaluation of the clinical illness, are all factors that limited the ability to generalize the information across the region. Thus, there is an incessant need to conduct well-designed studies under the umbrella of the WHO to estimate the burden of CMV disease on transplant recipients in the MENA region and to standardized both the prophylactic and preemptive treatment and predict the subsequent morbidity and mortality.

• #2

  https://journals.lww.com/transplantjournal/fulltext/2022/09001/424_1__epidemiology_of_cytomegalovirus_infection.701.aspx

  Cytomegalovirus (CMV) is a highly prevalent herpes virus with a seroprevalence higher in South America, Africa, and Asia than in Europe and North America. In hematopoietic stem cell transplant recipients (HSCT), CMV infection is a common opportunistic infection and a major cause of morbidity and mortality. To better understand the epidemiology of CMV infection and disease post-HSCT in selected countries outside of Europe and North America, a systematic review was conducted. […] In 43 of 54 studies reporting on incidence of CMV infection, within 1 year post-HSCT, estimates were uniformly distributed between 24.8% and 61.2%. Lower estimates were reported in autologous HSCT recipients (5.3%), and younger patients at the time of transplantation (9.3% in adults with a median age of 25 years and 18.6% in patients aged 20 years). Higher estimates (range: 69.4% to 88.2%) were found in 8 studies from China and South Korea, most with a follow-up period 1 year. Incidence of CMV disease following HSCT was below 20%, with estimates uniformly distributed between 0% and 15.7% in allogeneic HSCT.

• #2

  https://journals.lww.com/transplantjournal/fulltext/2022/09001/424_7__epidemiology_of_cytomegalovirus_infection.707.aspx

  Cytomegalovirus (CMV), a highly prevalent herpes virus worldwide, can lead to a wide range of serious direct and indirect effects in solid organ transplant (SOT) recipients. As the seroprevalence of CMV varies across countries, a systematic review was undertaken to describe the epidemiology of CMV infection and disease in SOT recipients in selected countries outside of North America and Europe. […] Reported incidence estimates of CMV infection varied greatly, ranging from 5.2% to 79.0%, according to type of organ transplanted and country. For CMV disease, incidence estimates within one-year post-SOT ranged from 0% to 19%, in 21 of 23 studies, regardless of prevention strategy used or distribution of CMV serostatus in donor and recipients. […] Heterogeneity in the incidence of CMV infection across organ types and countries outside of North America and Europe was found, despite most studies reporting on adult kidney recipients. High rates of CMV infection, CMV recurrence and CMV disease are likely to impact graft and patient outcomes post-transplantation and may contribute to greater disease burden post-SOT.

• #2 Cytomegalovirus (CMV) | Causes, Symptoms, and Treatment

  https://patient.info/doctor/cytomegalovirus

  Cytomegalovirus epidemiology […] Worldwide estimates of CMV infection prevalence vary from 50% to over 70% of all adults. […] Infection may be passed via body fluids – eg, kissing, sexual intercourse and blood transfusion, or by tissue donation. […] Most HIV-infected individuals are seropositive for CMV. HIV infection accelerates the development of CMV-dependent immunological abnormalities.

• #2 Cytomegalovirus Disease: Adult and Adolescent OIs | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/cytomegalovirus

  Cytomegalovirus (CMV) is a double-stranded DNA virus in the herpesvirus family that can cause disseminated or localized end-organ disease in people with HIV with advanced immunosuppression. Most clinical disease occurs in individuals previously infected with CMV experiencing reactivation of latent infection. Infection with a novel strain also may occur. […] End-organ disease caused by CMV occurs in patients with HIV and advanced immunosuppression, typically those with CD4+ T lymphocyte cell (CD4) counts 50 cells/mm3 who are not receiving, adherent to, or responding to antiretroviral therapy (ART). Among those treated with ART who have achieved virologic control, a new diagnosis of CMV end-organ disease is exceedingly rare. […] Before potent ART, an estimated 30% of patients with AIDS experienced CMV retinitis, the most common CMV end-organ disease in such patients. The incidence of new cases of CMV end-organ disease has declined by 95% with the advent of potent ART.

• #2 Prevalence, incidence, and risk factors associated with cytomegalovirus infection in healthcare and childcare worker: a systematic review and meta-analysis | Systematic Reviews | Full Text

  https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-022-02004-4

  Cytomegalovirus (CMV) is transmitted by direct contact with body fluids from infected individuals. Transmission of CMV in households, particularly those with young children, contributes significantly to CMV infection in the general population. However, little is known about the contribution of occupational healthcare or childcare exposure to risk of CMV infection. […] To determine CMV seroprevalence, incidence of primary infection, and associated risk factors in healthcare and childcare workers. […] Pooled CMV seroprevalence was 59.3% among childcare workers and 49.5% among healthcare workers, and pooled incidences of primary CMV infection per 100 person-years were respectively 7.4 and 3.1. […] Childcare workers, but not healthcare workers, have an increased risk of prevalent and incident CMV infection, a risk that is further increased with the presence of at least one child living at home.

• #2 Prevalence, incidence, and risk factors associated with cytomegalovirus infection in healthcare and childcare worker: a systematic review and meta-analysis | Systematic Reviews | Full Text

  https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-022-02004-4

  The overall pooled incidence of primary CMV infection among healthcare and childcare workers was 4.6 per 100 person-years. […] The odds of CMV seropositivity were significantly higher among childcare workers, but not healthcare workers, when compared to their respective controls. […] In both healthcare and childcare workers, having one or more children residing at home doubled the risk of CMV seropositivity. […] This meta-analysis provides updated estimates of indicators of CMV infection in healthcare and childcare workers. Prevalence and incidence of CMV infection was more common in childcare than in healthcare workers, which we believe is due to better adherence to infection prevention measures in the healthcare environment.

• #2 Cytomegalovirus | Infection Control | CDC

  https://www.cdc.gov/infection-control/hcp/healthcare-personnel-epidemiology-control/cytomegalovirus.html

  Cytomegalovirus (CMV) infection is common, with over half of adults infected by age 40 years. […] Transmission of CMV between healthcare personnel (HCP) and patients in healthcare settings is possible, but has not been well documented. […] However, HCP have not been demonstrated to be at greater risk for acquiring CMV than the general population. […] Hence, occupational transmission of CMV in healthcare settings may be very rare. […] Using infection prevention and control practices as recommended by CDC prevents transmission of CMV in healthcare settings. […] Testing HCP for CMV infection is not typically performed by Occupational Health Services (OHS) nor indicated for most HCP, regardless of symptoms or potential exposure. […] Post-exposure prophylaxis (PEP) is not administered after exposure to CMV.

• #2 The Current Status of Cytomegalovirus (CMV) Prevalence in the MENA Region: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6963600/

  Furthermore, there was a lack of CMV epidemiological studies from several countries in the region (Algeria, Bahrain, Djibouti, Lebanon, Libya, Morocco, Palestine, Qatar, Syria, the UAE, and Yemen), rendering the actual incidence of CMV across the region undetermined. […] The high risk of CMV infection and transmission through organ transplantation is universal. The prevalence across the globe ranges from 45% in developed countries to near 100% in developing countries. […] Even though the risk is high for transplant patients in the MENA region, only a few studies suggested screening for CMV in donors. […] Overall, these findings demonstrate a high rate of prevalence of CMV infections in the MENA region, and as such, posing serious implications for the blood transfusion practices if proper screening measures are not implemented.

• #2 Update on congenital cytomegalovirus infection: Prenatal prevention, newborn diagnosis, and management | Canadian Paediatric Society

  https://cps.ca/documents/position/update-on-congenital-cytomegalovirus-infection-prenatal-prevention-newborn-diagnosis-and-management

  Rates of transmission are 10- to 15-fold higher in primary compared with non-primary maternal infection. […] Although administering CMV-specific hyperimmune globulin and antiviral therapy to pregnant women with primary infection may provide benefit, robust evidence to support these interventions is lacking. […] Developing an effective pre-pregnancy vaccine would likely be the best preventive strategy, but this option is not yet available. […] Newborns who fail their newborn hearing screen (NBHS) are also being tested for CMV. […] Although universal screening would (ideally) optimize detection of cCMV, consensus is needed concerning the optimal specimen to use for early newborn screening. […] When testing has confirmed cCMV, symptomatic infants require ophthalmological and hearing evaluation as well as head imaging.

• #2 Cytomegalovirus (CMV) infection – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cmv/symptoms-causes/syc-20355358

  Complications of CMV infection vary, depending on your overall health and when you were infected. […] An infant whose mother first became infected with CMV during pregnancy is more likely to experience complications. Complications for the baby can include hearing loss, intellectual disability, vision problems, seizures, lack of coordination, and weakness or problems using muscles. […] Careful hygiene is the best prevention against CMV. You can take these precautions: Wash your hands often. Use soap and water for 15 to 20 seconds, especially if you have contact with young children or their diapers, saliva or other oral secretions. […] Experimental vaccines are being tested for women of childbearing age. These vaccines may be useful in preventing CMV infection in mothers and infants, and reducing the chance that babies born to women who are infected while pregnant will develop disabilities.

• #2 Update on congenital cytomegalovirus infection: Prenatal prevention, newborn diagnosis, and management | Canadian Paediatric Society

  https://cps.ca/documents/position/update-on-congenital-cytomegalovirus-infection-prenatal-prevention-newborn-diagnosis-and-management

  For asymptomatic or minimally symptomatic infants, a head ultrasound (HUS) is usually sufficient. […] All moderate to severe CMV cases should be referred promptly for infectious disease consultation. […] There is no evidence to support antiviral therapy for asymptomatic CMV disease without SNHL at the present time. […] Late-onset, progressive SNHL has a median onset of 27 months of age, but has been reported to develop as late as 44 months of age. […] cCMV is the leading cause of non-genetic SNHL and a significant cause of neurodevelopmental and neurosensory morbidity. […] Early laboratory identification of infants with cCMV (within the first 21 days after birth) is essential to determine disease severity and initiate antiviral therapy in moderate to severe cases.

• #2 A systematic literature review of the global seroprevalence of cytomegalovirus: possible implications for treatment, screening, and vaccine development | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13971-7

  Cytomegalovirus (CMV) is a common pathogen that affects individuals of all ages and establishes lifelong latency. […] Knowledge of the current epidemiologic burden of CMV is necessary to understand the need for treatment and prevention. […] A systematic literature review (SLR) was conducted to describe the most recent epidemiologic burden of CMV globally. […] Among adult men, CMV immunoglobulin G (IgG) seroprevalence ranged from 39.3% (France) to 48.0% (United States). […] Among women of reproductive age in Europe, Japan, LATAM, and North America, CMV IgG seroprevalence was 45.6-95.7%, 60.2%, 58.3-94.5%, and 24.6-81.0%, respectively. […] Seroprevalence increased with age and was lower in developed than developing countries, but data were limited. […] Certain populations and regions are at a substantially higher risk of CMV infection.

• #2 A systematic literature review of the global seroprevalence of cytomegalovirus: possible implications for treatment, screening, and vaccine development | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13971-7

  Overall, additional insight into the epidemiologic burden of CMV across different risk factors is needed, which can help guide targeted strategies for those populations at greatest risk for infection and disease. […] Only 4 studies evaluating CMV shedding were identified in our review, which indicated shedding prevalence ranged from 11.0 to 51.9% in newborns to children aged 10 years. […] However, prior findings have indicated that shedding of CMV is more prevalent among younger age groups, particularly those 2 years of age. […] Thus, comprehensive CMV epidemiologic studies are imperative toward furthering our understanding of CMV and associated disease, which in turn can guide public health strategies to reduce disease burden in vulnerable populations through screening, treatment, and vaccine development.

• #3 Cytomegalovirus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459185/

  Cytomegalovirus (CMV) is a wide-spread virus, with manifestations ranging from asymptomatic to severe end-organ dysfunction in immunocompromised patients with congenital CMV disease. […] CMV infects between 60% to 70% of adults in industrialized countries and close to 100% in emerging countries. […] Approximately 59% of the population older than six years old has been exposed to CMV, with an increase in the populations seroprevalence with increasing age. Infection can occur as a primary infection, reinfection, or reactivation. Transmission of CMV can occur in numerous ways: via blood products (transfusions, organ transplantation), breastfeeding, viral shedding in close-contact settings, perinatally, and sexual transmission. Reactivation is seen in patients who become immunocompromised and is associated with elevated morbidity and mortality. […] CMV is a double-stranded DNA virus and is a member of the herpesviruses. Like other herpesviruses, after recovery of the initial infection, CMV remains dormant within the host. Viral reactivation occurs during the compromise of the immune system with immunosuppression.

• #3 Pediatric Cytomegalovirus Infection: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/963090-overview

  Epidemiology […] Every mammal appears to be infected with its own species-specific cytomegalovirus (CMV), and no evidence suggests that infections cross species. Hence, humans are the only natural host for human CMV infection. Although most adults eventually become infected with CMV, the epidemiology of this infection is complex, and the age at which an individual acquires CMV greatly depends on geographic location, socioeconomic status, cultural factors, and child-rearing practices. […] In developing countries, most children acquire CMV infection early in life, with adult seroprevalence approaching 100% by early adulthood. In contrast, in developed countries, the seroprevalence of CMV approximates 50% in young adults of middle-upper socioeconomic status. This observation has important implications for congenital CMV epidemiology because women of childbearing age who are CMV seronegative are at major risk of giving birth to infants with symptomatic congenital infection if primary infection is acquired during pregnancy. […] Transmission of CMV infection may occur throughout life, chiefly via contact with infected secretions. In the developed world, CMV is the most common congenital viral infection. An overall rate of congenital CMV transmission of approximately 1% (ranging from 0.252%, depending on the population studied) has been estimated in newborn infants in the developed world in most reviews. This translates to about 80,000 congenital CMV infections per year in the United States and Europe. In the United States, congenital CMV infection occurs in 3-6 of every 1000 infants born each year. […] A meta-analysis of published studies concluded that the overall birth prevalence of congenital CMV infection was 0.64%, but noted that rates varied considerably among different study populations. Nonwhite race, low socioeconomic status, premature birth, and neonatal intensive care unit admittance were risk factors for congenital CMV infection; and birth prevalence increased with maternal CMV seroprevalence. […] There has been insufficient attention given to congenital CMV infection in the developing world, but the limited data available suggest that CMV may also represent a significant public health concern in these populations. A multicenter study comparing newborn screening by oropharyngeal culture versus polymerase chain reaction (PCR) based detection of viral DNA in the newborn dried blood spot identified an overall prevalence of 0.45% in the 7 sites surveyed. […] Most congenital CMV infections occur in infants born to mothers with preexisting immunity, and these infections are clinically asymptomatic at birth; however, long-term sequelae, including deafness, can occur. […] The route of congenital infection is presumed to be transplacental. The transplacental transmission rate after maternal primary infection is about 32%. CMV may also be transmitted perinatally, both by aspiration of cervicovaginal secretions in the birth canal and by breastfeeding. More than 50% of infants fed with breast milk that contains infectious virus become infected with CMV. […] Infants who are not infected congenitally or perinatally with CMV are at high risk to acquire infection in daycare centers. According to some studies, the prevalence of CMV infection in children who attend daycare, particularly children younger than 2 years, approximates 80%. […] The virus may be readily transmitted to susceptible children via saliva, urine, and fomites; these children, in turn, may transmit infection to their parents. Horizontal transmission of infection in daycare centers appears to play a major role in the epidemiology of many CMV infections in young parents. […] In adulthood, sexual activity is probably the most important route of acquisition of CMV, although the observation that virus is present in saliva, cervicovaginal secretions, and semen obscures which route or routes of transmission are primarily responsible for establishment of infection. Saliva alone appears to be sufficient for transmission of CMV, and this route of transmission may be responsible for those cases of heterophile-negative mononucleosis, which are attributable to CMV. Kissing appears to be a way in which CMV is transmitted from toddlers to seronegative parents. Work by the Centers for Disease Control and Prevention (CDC) has emphasized the need for greater public awareness of these risks and for educational interventions for young women of childbearing age. […] Other important routes of transmission include blood transfusion and solid organ transplantation. Before screening of blood products, transfusion-associated CMV was an important cause of morbidity and mortality in premature infants; however, the routine use in many neonatal intensive care units of CMV-negative blood products has largely eliminated this problem. Posttransfusion CMV is still a risk in CMV-seronegative trauma and in surgery patients, often manifesting as hepatitis.

• #3 Cytomegalovirus (CMV) Infection – Epidemiology Forecast to 2032

  https://www.researchandmarkets.com/reports/4330795/cytomegalovirus-cmv-infection-epidemiology?srsltid=AfmBOooNPb0qnWE0bQxFf2FJVNk5RxHeM-BJzHiVAcbuso-IicsVFuxA

  The Cytomegalovirus (CMV) Infection epidemiology covered in the report provides historical as well as forecasted Cytomegalovirus (CMV) Infection epidemiology scenario in the 7MM covering the United States, EU5 countries (Germany, Spain, Italy, France, and the United Kingdom), and Japan from 2019 to 2032. […] The report provides insight into the historical and forecasted patient pool of Cytomegalovirus (CMV) Infection in seven major markets covering the United States, EU5 (Germany, Spain, France, Italy, UK), and Japan. […] The report assesses the disease risk and burden and highlights the unmet needs of Cytomegalovirus (CMV) Infection. […] 11-year Forecast of Cytomegalovirus (CMV) Infection epidemiology. […] What are the key findings pertaining to the Cytomegalovirus (CMV) Infection epidemiology across 7MM and which country will have the highest number of patients during the forecast period (2019-2032)? […] What is the disease risk, burden and unmet needs of Cytomegalovirus (CMV) Infection?

• #3 About Cytomegalovirus | Cytomegalovirus (CMV) and Congenital CMV Infection | CDC

  https://www.cdc.gov/cytomegalovirus/about/index.html

  Cytomegalovirus (pronounced sy-toe-MEG-a-low-vy-rus or CMV) is a common virus found in people of all ages. […] In the United States, nearly 1 in 3 children is already infected with CMV by age 5. Over half of adults have been infected with CMV by age 40. […] Anyone can get CMV. Some people are at higher risk for complications from CMV, like those who are pregnant or have weakened immune systems. […] About 1 in 200 babies is born with congenital CMV infection. About 1 in 5 babies with congenital CMV infection will have birth defects or other long-term health problems. […] The virus can stay in a child’s body fluids for months after the infection. People who are often around young children are more likely to get infected. […] CDC aims to reduce the burden of congenital CMV. We work closely with national experts to conduct research and increase awareness of CMV among the public and healthcare providers. […] CMV is the most common infectious cause of birth defects in the United States. It can spread through body fluids like saliva and urine, especially by children.

• #3 A systematic literature review of the global seroprevalence of cytomegalovirus: possible implications for treatment, screening, and vaccine development | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-13971-7

  The extensive epidemiologic burden of CMV calls for increased efforts in the research and development of vaccines and treatments. […] In the United States, it is estimated that the virus will infect approximately 30% of children by 5 years of age and more than 50% of adults by 40 years of age. […] Generally, CMV seroprevalence is higher among women, those in older age groups, persons of lower socioeconomic status, and in developing countries. […] Among women of reproductive age in particular, global CMV seroprevalence ranges from 45 to 100%. […] Given that CMV infection is common globally yet has a variable clinical course and a potential for long-term sequelae, a greater understanding of CMV epidemiologic data worldwide is needed, which can support the development of CMV vaccines and justify vaccine introduction into immunization schedules.

• #3

  https://journals.lww.com/transplantjournal/fulltext/2022/09001/424_1__epidemiology_of_cytomegalovirus_infection.701.aspx

  Cytomegalovirus (CMV) is a highly prevalent herpes virus with a seroprevalence higher in South America, Africa, and Asia than in Europe and North America. In hematopoietic stem cell transplant recipients (HSCT), CMV infection is a common opportunistic infection and a major cause of morbidity and mortality. To better understand the epidemiology of CMV infection and disease post-HSCT in selected countries outside of Europe and North America, a systematic review was conducted. […] In 43 of 54 studies reporting on incidence of CMV infection, within 1 year post-HSCT, estimates were uniformly distributed between 24.8% and 61.2%. Lower estimates were reported in autologous HSCT recipients (5.3%), and younger patients at the time of transplantation (9.3% in adults with a median age of 25 years and 18.6% in patients aged 20 years). Higher estimates (range: 69.4% to 88.2%) were found in 8 studies from China and South Korea, most with a follow-up period 1 year. Incidence of CMV disease following HSCT was below 20%, with estimates uniformly distributed between 0% and 15.7% in allogeneic HSCT.

• #3 Cytomegalovirus Disease: Adult and Adolescent OIs | NIH

  https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-opportunistic-infections/cytomegalovirus

  Cytomegalovirus (CMV) is a double-stranded DNA virus in the herpesvirus family that can cause disseminated or localized end-organ disease in people with HIV with advanced immunosuppression. Most clinical disease occurs in individuals previously infected with CMV experiencing reactivation of latent infection. Infection with a novel strain also may occur. […] End-organ disease caused by CMV occurs in patients with HIV and advanced immunosuppression, typically those with CD4+ T lymphocyte cell (CD4) counts 50 cells/mm3 who are not receiving, adherent to, or responding to antiretroviral therapy (ART). Among those treated with ART who have achieved virologic control, a new diagnosis of CMV end-organ disease is exceedingly rare. […] Before potent ART, an estimated 30% of patients with AIDS experienced CMV retinitis, the most common CMV end-organ disease in such patients. The incidence of new cases of CMV end-organ disease has declined by 95% with the advent of potent ART.

• #3 Factsheet – Health Protection Surveillance Centre

  https://www.hpsc.ie/a-z/hepatitis/bloodbornevirus/cmv/factsheet/

  Cytomegalovirus infection (congenital) is a notifiable disease. […] Each year, approximately one in 150 children in the United States and the UK is born with or develops disabilities as a result of CMV infection. […] Currently there is no recommended treatment for CMV infection. […] Further useful information is available on the HSE website.

• #3 Update on congenital cytomegalovirus infection: Prenatal prevention, newborn diagnosis, and management | Canadian Paediatric Society

  https://cps.ca/documents/position/update-on-congenital-cytomegalovirus-infection-prenatal-prevention-newborn-diagnosis-and-management

  Cytomegalovirus (CMV) is the most common cause of congenital infection, affecting 0.5% to 1% of live births in North America and Europe, and up to 6% of live births in developing countries. […] CMV is the leading (up to 25%) cause of non-genetic childhood sensorineural hearing loss (SNHL). […] The estimated prevalence of long-term neurological sequelae ranges from 5% to 15% in asymptomatic congenital CMV (cCMV) cases, to 36% to 90% in survivors of symptomatic cCMV. […] Recent advances in drug therapy for this infection have renewed focus on prevention, diagnosis, and treatment. […] Universal infant screening for cCMV is being considered in some countries, and in Canada, has already commenced in Ontario. […] Expectant mothers with primary infection or non-primary (reinfection with different viral strains or reactivation of the primary strain) CMV are at risk of transmitting CMV vertically (transplacentally) to their unborn fetuses.

• #3 The Current Status of Cytomegalovirus (CMV) Prevalence in the MENA Region: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6963600/

  The incidence rate of cCMV in the MENA region seems to be higher than in other populations. […] Nevertheless, there is substantial variability in the definitions of symptomatic and asymptomatic cCMV infection, study designs, and the methods of determining CMV infection. […] The studies on transplant and transfusion recipients reported the incidence of CMV with uncertainty about the disease. […] The low number of published articles, the low number of reporting countries, the inconsistency in measurement and detection protocols, as well as the variability in endpoint evaluation of the clinical illness, are all factors that limited the ability to generalize the information across the region. Thus, there is an incessant need to conduct well-designed studies under the umbrella of the WHO to estimate the burden of CMV disease on transplant recipients in the MENA region and to standardized both the prophylactic and preemptive treatment and predict the subsequent morbidity and mortality.

• #3 Cytomegalovirus | Infection Control | CDC

  https://www.cdc.gov/infection-control/hcp/healthcare-personnel-epidemiology-control/cytomegalovirus.html

  Cytomegalovirus (CMV) infection is common, with over half of adults infected by age 40 years. […] Transmission of CMV between healthcare personnel (HCP) and patients in healthcare settings is possible, but has not been well documented. […] However, HCP have not been demonstrated to be at greater risk for acquiring CMV than the general population. […] Hence, occupational transmission of CMV in healthcare settings may be very rare. […] Using infection prevention and control practices as recommended by CDC prevents transmission of CMV in healthcare settings. […] Testing HCP for CMV infection is not typically performed by Occupational Health Services (OHS) nor indicated for most HCP, regardless of symptoms or potential exposure. […] Post-exposure prophylaxis (PEP) is not administered after exposure to CMV.

• #3 Update on congenital cytomegalovirus infection: Prenatal prevention, newborn diagnosis, and management | Canadian Paediatric Society

  https://cps.ca/documents/position/update-on-congenital-cytomegalovirus-infection-prenatal-prevention-newborn-diagnosis-and-management

  Rates of transmission are 10- to 15-fold higher in primary compared with non-primary maternal infection. […] Although administering CMV-specific hyperimmune globulin and antiviral therapy to pregnant women with primary infection may provide benefit, robust evidence to support these interventions is lacking. […] Developing an effective pre-pregnancy vaccine would likely be the best preventive strategy, but this option is not yet available. […] Newborns who fail their newborn hearing screen (NBHS) are also being tested for CMV. […] Although universal screening would (ideally) optimize detection of cCMV, consensus is needed concerning the optimal specimen to use for early newborn screening. […] When testing has confirmed cCMV, symptomatic infants require ophthalmological and hearing evaluation as well as head imaging.

• #3 Cytomegalovirus (CMV) and Congenital CMV Infection

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/cmv.html

  Cytomegalovirus (CMV) is a common virus that infects people of all ages. […] About one out of every 200 babies are born with congenital CMV infection. […] Women can pass CMV to their baby during pregnancy. […] Congenital CMV infection can be diagnosed by testing a newborn babys saliva, urine, or blood. […] Medicines, called antivirals, may decrease the risk of health problems and hearing loss in some infected babies who show signs of congenital CMV infection at birth.

• #4 Cytomegalovirus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459185/

  Cytomegalovirus (CMV) is a wide-spread virus, with manifestations ranging from asymptomatic to severe end-organ dysfunction in immunocompromised patients with congenital CMV disease. […] CMV infects between 60% to 70% of adults in industrialized countries and close to 100% in emerging countries. […] Approximately 59% of the population older than six years old has been exposed to CMV, with an increase in the populations seroprevalence with increasing age. Infection can occur as a primary infection, reinfection, or reactivation. Transmission of CMV can occur in numerous ways: via blood products (transfusions, organ transplantation), breastfeeding, viral shedding in close-contact settings, perinatally, and sexual transmission. Reactivation is seen in patients who become immunocompromised and is associated with elevated morbidity and mortality. […] CMV is a double-stranded DNA virus and is a member of the herpesviruses. Like other herpesviruses, after recovery of the initial infection, CMV remains dormant within the host. Viral reactivation occurs during the compromise of the immune system with immunosuppression.

• #4 Pediatric Cytomegalovirus Infection: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/963090-overview

  Epidemiology […] Every mammal appears to be infected with its own species-specific cytomegalovirus (CMV), and no evidence suggests that infections cross species. Hence, humans are the only natural host for human CMV infection. Although most adults eventually become infected with CMV, the epidemiology of this infection is complex, and the age at which an individual acquires CMV greatly depends on geographic location, socioeconomic status, cultural factors, and child-rearing practices. […] In developing countries, most children acquire CMV infection early in life, with adult seroprevalence approaching 100% by early adulthood. In contrast, in developed countries, the seroprevalence of CMV approximates 50% in young adults of middle-upper socioeconomic status. This observation has important implications for congenital CMV epidemiology because women of childbearing age who are CMV seronegative are at major risk of giving birth to infants with symptomatic congenital infection if primary infection is acquired during pregnancy. […] Transmission of CMV infection may occur throughout life, chiefly via contact with infected secretions. In the developed world, CMV is the most common congenital viral infection. An overall rate of congenital CMV transmission of approximately 1% (ranging from 0.252%, depending on the population studied) has been estimated in newborn infants in the developed world in most reviews. This translates to about 80,000 congenital CMV infections per year in the United States and Europe. In the United States, congenital CMV infection occurs in 3-6 of every 1000 infants born each year. […] A meta-analysis of published studies concluded that the overall birth prevalence of congenital CMV infection was 0.64%, but noted that rates varied considerably among different study populations. Nonwhite race, low socioeconomic status, premature birth, and neonatal intensive care unit admittance were risk factors for congenital CMV infection; and birth prevalence increased with maternal CMV seroprevalence. […] There has been insufficient attention given to congenital CMV infection in the developing world, but the limited data available suggest that CMV may also represent a significant public health concern in these populations. A multicenter study comparing newborn screening by oropharyngeal culture versus polymerase chain reaction (PCR) based detection of viral DNA in the newborn dried blood spot identified an overall prevalence of 0.45% in the 7 sites surveyed. […] Most congenital CMV infections occur in infants born to mothers with preexisting immunity, and these infections are clinically asymptomatic at birth; however, long-term sequelae, including deafness, can occur. […] The route of congenital infection is presumed to be transplacental. The transplacental transmission rate after maternal primary infection is about 32%. CMV may also be transmitted perinatally, both by aspiration of cervicovaginal secretions in the birth canal and by breastfeeding. More than 50% of infants fed with breast milk that contains infectious virus become infected with CMV. […] Infants who are not infected congenitally or perinatally with CMV are at high risk to acquire infection in daycare centers. According to some studies, the prevalence of CMV infection in children who attend daycare, particularly children younger than 2 years, approximates 80%. […] The virus may be readily transmitted to susceptible children via saliva, urine, and fomites; these children, in turn, may transmit infection to their parents. Horizontal transmission of infection in daycare centers appears to play a major role in the epidemiology of many CMV infections in young parents. […] In adulthood, sexual activity is probably the most important route of acquisition of CMV, although the observation that virus is present in saliva, cervicovaginal secretions, and semen obscures which route or routes of transmission are primarily responsible for establishment of infection. Saliva alone appears to be sufficient for transmission of CMV, and this route of transmission may be responsible for those cases of heterophile-negative mononucleosis, which are attributable to CMV. Kissing appears to be a way in which CMV is transmitted from toddlers to seronegative parents. Work by the Centers for Disease Control and Prevention (CDC) has emphasized the need for greater public awareness of these risks and for educational interventions for young women of childbearing age. […] Other important routes of transmission include blood transfusion and solid organ transplantation. Before screening of blood products, transfusion-associated CMV was an important cause of morbidity and mortality in premature infants; however, the routine use in many neonatal intensive care units of CMV-negative blood products has largely eliminated this problem. Posttransfusion CMV is still a risk in CMV-seronegative trauma and in surgery patients, often manifesting as hepatitis.

• #4 About Cytomegalovirus | Cytomegalovirus (CMV) and Congenital CMV Infection | CDC

  https://www.cdc.gov/cytomegalovirus/about/index.html

  Cytomegalovirus (pronounced sy-toe-MEG-a-low-vy-rus or CMV) is a common virus found in people of all ages. […] In the United States, nearly 1 in 3 children is already infected with CMV by age 5. Over half of adults have been infected with CMV by age 40. […] Anyone can get CMV. Some people are at higher risk for complications from CMV, like those who are pregnant or have weakened immune systems. […] About 1 in 200 babies is born with congenital CMV infection. About 1 in 5 babies with congenital CMV infection will have birth defects or other long-term health problems. […] The virus can stay in a child’s body fluids for months after the infection. People who are often around young children are more likely to get infected. […] CDC aims to reduce the burden of congenital CMV. We work closely with national experts to conduct research and increase awareness of CMV among the public and healthcare providers. […] CMV is the most common infectious cause of birth defects in the United States. It can spread through body fluids like saliva and urine, especially by children.

• #4 Update on congenital cytomegalovirus infection: Prenatal prevention, newborn diagnosis, and management | Canadian Paediatric Society

  https://cps.ca/documents/position/update-on-congenital-cytomegalovirus-infection-prenatal-prevention-newborn-diagnosis-and-management

  Cytomegalovirus (CMV) is the most common cause of congenital infection, affecting 0.5% to 1% of live births in North America and Europe, and up to 6% of live births in developing countries. […] CMV is the leading (up to 25%) cause of non-genetic childhood sensorineural hearing loss (SNHL). […] The estimated prevalence of long-term neurological sequelae ranges from 5% to 15% in asymptomatic congenital CMV (cCMV) cases, to 36% to 90% in survivors of symptomatic cCMV. […] Recent advances in drug therapy for this infection have renewed focus on prevention, diagnosis, and treatment. […] Universal infant screening for cCMV is being considered in some countries, and in Canada, has already commenced in Ontario. […] Expectant mothers with primary infection or non-primary (reinfection with different viral strains or reactivation of the primary strain) CMV are at risk of transmitting CMV vertically (transplacentally) to their unborn fetuses.

• #4 The Current Status of Cytomegalovirus (CMV) Prevalence in the MENA Region: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6963600/

  The incidence rate of cCMV in the MENA region seems to be higher than in other populations. […] Nevertheless, there is substantial variability in the definitions of symptomatic and asymptomatic cCMV infection, study designs, and the methods of determining CMV infection. […] The studies on transplant and transfusion recipients reported the incidence of CMV with uncertainty about the disease. […] The low number of published articles, the low number of reporting countries, the inconsistency in measurement and detection protocols, as well as the variability in endpoint evaluation of the clinical illness, are all factors that limited the ability to generalize the information across the region. Thus, there is an incessant need to conduct well-designed studies under the umbrella of the WHO to estimate the burden of CMV disease on transplant recipients in the MENA region and to standardized both the prophylactic and preemptive treatment and predict the subsequent morbidity and mortality.

• #5 Human cytomegalovirus – Wikipedia

  https://en.wikipedia.org/wiki/Human_cytomegalovirus

  HCMV is found in all geographic locations and all socioeconomic groups, and infects between 60% and 70% of adults in the first world and almost 100% in the third world. […] Seroprevalence is age-dependent: 58.9% of individuals aged 6 and older are infected with CMV while 90.8% of individuals aged 80 and older are positive for HCMV. […] HCMV infection is more widespread in developing countries and in communities with lower socioeconomic status and represents the most significant viral cause of birth defects in industrialized countries. […] In the United States, CMV infection rises with age from about 60% of people infected by 6 years of age leveling off at about 85-90% of the population by ages 75-80.

• #5 Cytomegalovirus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459185/

  Cytomegalovirus (CMV) is a wide-spread virus, with manifestations ranging from asymptomatic to severe end-organ dysfunction in immunocompromised patients with congenital CMV disease. […] CMV infects between 60% to 70% of adults in industrialized countries and close to 100% in emerging countries. […] Approximately 59% of the population older than six years old has been exposed to CMV, with an increase in the populations seroprevalence with increasing age. Infection can occur as a primary infection, reinfection, or reactivation. Transmission of CMV can occur in numerous ways: via blood products (transfusions, organ transplantation), breastfeeding, viral shedding in close-contact settings, perinatally, and sexual transmission. Reactivation is seen in patients who become immunocompromised and is associated with elevated morbidity and mortality. […] CMV is a double-stranded DNA virus and is a member of the herpesviruses. Like other herpesviruses, after recovery of the initial infection, CMV remains dormant within the host. Viral reactivation occurs during the compromise of the immune system with immunosuppression.

• #5 Pediatric Cytomegalovirus Infection: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/963090-overview

  Epidemiology […] Every mammal appears to be infected with its own species-specific cytomegalovirus (CMV), and no evidence suggests that infections cross species. Hence, humans are the only natural host for human CMV infection. Although most adults eventually become infected with CMV, the epidemiology of this infection is complex, and the age at which an individual acquires CMV greatly depends on geographic location, socioeconomic status, cultural factors, and child-rearing practices. […] In developing countries, most children acquire CMV infection early in life, with adult seroprevalence approaching 100% by early adulthood. In contrast, in developed countries, the seroprevalence of CMV approximates 50% in young adults of middle-upper socioeconomic status. This observation has important implications for congenital CMV epidemiology because women of childbearing age who are CMV seronegative are at major risk of giving birth to infants with symptomatic congenital infection if primary infection is acquired during pregnancy. […] Transmission of CMV infection may occur throughout life, chiefly via contact with infected secretions. In the developed world, CMV is the most common congenital viral infection. An overall rate of congenital CMV transmission of approximately 1% (ranging from 0.252%, depending on the population studied) has been estimated in newborn infants in the developed world in most reviews. This translates to about 80,000 congenital CMV infections per year in the United States and Europe. In the United States, congenital CMV infection occurs in 3-6 of every 1000 infants born each year. […] A meta-analysis of published studies concluded that the overall birth prevalence of congenital CMV infection was 0.64%, but noted that rates varied considerably among different study populations. Nonwhite race, low socioeconomic status, premature birth, and neonatal intensive care unit admittance were risk factors for congenital CMV infection; and birth prevalence increased with maternal CMV seroprevalence. […] There has been insufficient attention given to congenital CMV infection in the developing world, but the limited data available suggest that CMV may also represent a significant public health concern in these populations. A multicenter study comparing newborn screening by oropharyngeal culture versus polymerase chain reaction (PCR) based detection of viral DNA in the newborn dried blood spot identified an overall prevalence of 0.45% in the 7 sites surveyed. […] Most congenital CMV infections occur in infants born to mothers with preexisting immunity, and these infections are clinically asymptomatic at birth; however, long-term sequelae, including deafness, can occur. […] The route of congenital infection is presumed to be transplacental. The transplacental transmission rate after maternal primary infection is about 32%. CMV may also be transmitted perinatally, both by aspiration of cervicovaginal secretions in the birth canal and by breastfeeding. More than 50% of infants fed with breast milk that contains infectious virus become infected with CMV. […] Infants who are not infected congenitally or perinatally with CMV are at high risk to acquire infection in daycare centers. According to some studies, the prevalence of CMV infection in children who attend daycare, particularly children younger than 2 years, approximates 80%. […] The virus may be readily transmitted to susceptible children via saliva, urine, and fomites; these children, in turn, may transmit infection to their parents. Horizontal transmission of infection in daycare centers appears to play a major role in the epidemiology of many CMV infections in young parents. […] In adulthood, sexual activity is probably the most important route of acquisition of CMV, although the observation that virus is present in saliva, cervicovaginal secretions, and semen obscures which route or routes of transmission are primarily responsible for establishment of infection. Saliva alone appears to be sufficient for transmission of CMV, and this route of transmission may be responsible for those cases of heterophile-negative mononucleosis, which are attributable to CMV. Kissing appears to be a way in which CMV is transmitted from toddlers to seronegative parents. Work by the Centers for Disease Control and Prevention (CDC) has emphasized the need for greater public awareness of these risks and for educational interventions for young women of childbearing age. […] Other important routes of transmission include blood transfusion and solid organ transplantation. Before screening of blood products, transfusion-associated CMV was an important cause of morbidity and mortality in premature infants; however, the routine use in many neonatal intensive care units of CMV-negative blood products has largely eliminated this problem. Posttransfusion CMV is still a risk in CMV-seronegative trauma and in surgery patients, often manifesting as hepatitis.

• #5 The Current Status of Cytomegalovirus (CMV) Prevalence in the MENA Region: A Systematic Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6963600/

  The incidence rate of cCMV in the MENA region seems to be higher than in other populations. […] Nevertheless, there is substantial variability in the definitions of symptomatic and asymptomatic cCMV infection, study designs, and the methods of determining CMV infection. […] The studies on transplant and transfusion recipients reported the incidence of CMV with uncertainty about the disease. […] The low number of published articles, the low number of reporting countries, the inconsistency in measurement and detection protocols, as well as the variability in endpoint evaluation of the clinical illness, are all factors that limited the ability to generalize the information across the region. Thus, there is an incessant need to conduct well-designed studies under the umbrella of the WHO to estimate the burden of CMV disease on transplant recipients in the MENA region and to standardized both the prophylactic and preemptive treatment and predict the subsequent morbidity and mortality.

• #5 About Cytomegalovirus | Cytomegalovirus (CMV) and Congenital CMV Infection | CDC

  https://www.cdc.gov/cytomegalovirus/about/index.html

  Cytomegalovirus (pronounced sy-toe-MEG-a-low-vy-rus or CMV) is a common virus found in people of all ages. […] In the United States, nearly 1 in 3 children is already infected with CMV by age 5. Over half of adults have been infected with CMV by age 40. […] Anyone can get CMV. Some people are at higher risk for complications from CMV, like those who are pregnant or have weakened immune systems. […] About 1 in 200 babies is born with congenital CMV infection. About 1 in 5 babies with congenital CMV infection will have birth defects or other long-term health problems. […] The virus can stay in a child’s body fluids for months after the infection. People who are often around young children are more likely to get infected. […] CDC aims to reduce the burden of congenital CMV. We work closely with national experts to conduct research and increase awareness of CMV among the public and healthcare providers. […] CMV is the most common infectious cause of birth defects in the United States. It can spread through body fluids like saliva and urine, especially by children.

• #6 Cytomegalovirus (CMV): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/215702-overview

  CMV seroprevalence in immunocompetent adults varies from 40-100% globally. […] At least 50-60% of the US population has been exposed to CMV, with a prevalence of more than 90% in high-risk groups (eg, male homosexuals), and outside of the US prevalence can be more than 90%. […] The incidence of CMV seropositivity rises with age and in a US-based study was reported to increase from 36% in children aged 6-11 years to 91% in individuals older than 80 years. […] Individuals at an increased risk for CMV infection include individuals who attend or work at daycare centers, patients who undergo blood transfusions, persons who have multiple sex partners, and recipients of CMV mismatched organ or bone marrow transplants. […] CMV is transmitted from person to person via close contact with an individual who is excreting the virus.

• #6 Pediatric Cytomegalovirus Infection: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/963090-overview

  Epidemiology […] Every mammal appears to be infected with its own species-specific cytomegalovirus (CMV), and no evidence suggests that infections cross species. Hence, humans are the only natural host for human CMV infection. Although most adults eventually become infected with CMV, the epidemiology of this infection is complex, and the age at which an individual acquires CMV greatly depends on geographic location, socioeconomic status, cultural factors, and child-rearing practices. […] In developing countries, most children acquire CMV infection early in life, with adult seroprevalence approaching 100% by early adulthood. In contrast, in developed countries, the seroprevalence of CMV approximates 50% in young adults of middle-upper socioeconomic status. This observation has important implications for congenital CMV epidemiology because women of childbearing age who are CMV seronegative are at major risk of giving birth to infants with symptomatic congenital infection if primary infection is acquired during pregnancy. […] Transmission of CMV infection may occur throughout life, chiefly via contact with infected secretions. In the developed world, CMV is the most common congenital viral infection. An overall rate of congenital CMV transmission of approximately 1% (ranging from 0.252%, depending on the population studied) has been estimated in newborn infants in the developed world in most reviews. This translates to about 80,000 congenital CMV infections per year in the United States and Europe. In the United States, congenital CMV infection occurs in 3-6 of every 1000 infants born each year. […] A meta-analysis of published studies concluded that the overall birth prevalence of congenital CMV infection was 0.64%, but noted that rates varied considerably among different study populations. Nonwhite race, low socioeconomic status, premature birth, and neonatal intensive care unit admittance were risk factors for congenital CMV infection; and birth prevalence increased with maternal CMV seroprevalence. […] There has been insufficient attention given to congenital CMV infection in the developing world, but the limited data available suggest that CMV may also represent a significant public health concern in these populations. A multicenter study comparing newborn screening by oropharyngeal culture versus polymerase chain reaction (PCR) based detection of viral DNA in the newborn dried blood spot identified an overall prevalence of 0.45% in the 7 sites surveyed. […] Most congenital CMV infections occur in infants born to mothers with preexisting immunity, and these infections are clinically asymptomatic at birth; however, long-term sequelae, including deafness, can occur. […] The route of congenital infection is presumed to be transplacental. The transplacental transmission rate after maternal primary infection is about 32%. CMV may also be transmitted perinatally, both by aspiration of cervicovaginal secretions in the birth canal and by breastfeeding. More than 50% of infants fed with breast milk that contains infectious virus become infected with CMV. […] Infants who are not infected congenitally or perinatally with CMV are at high risk to acquire infection in daycare centers. According to some studies, the prevalence of CMV infection in children who attend daycare, particularly children younger than 2 years, approximates 80%. […] The virus may be readily transmitted to susceptible children via saliva, urine, and fomites; these children, in turn, may transmit infection to their parents. Horizontal transmission of infection in daycare centers appears to play a major role in the epidemiology of many CMV infections in young parents. […] In adulthood, sexual activity is probably the most important route of acquisition of CMV, although the observation that virus is present in saliva, cervicovaginal secretions, and semen obscures which route or routes of transmission are primarily responsible for establishment of infection. Saliva alone appears to be sufficient for transmission of CMV, and this route of transmission may be responsible for those cases of heterophile-negative mononucleosis, which are attributable to CMV. Kissing appears to be a way in which CMV is transmitted from toddlers to seronegative parents. Work by the Centers for Disease Control and Prevention (CDC) has emphasized the need for greater public awareness of these risks and for educational interventions for young women of childbearing age. […] Other important routes of transmission include blood transfusion and solid organ transplantation. Before screening of blood products, transfusion-associated CMV was an important cause of morbidity and mortality in premature infants; however, the routine use in many neonatal intensive care units of CMV-negative blood products has largely eliminated this problem. Posttransfusion CMV is still a risk in CMV-seronegative trauma and in surgery patients, often manifesting as hepatitis.

• #7 Cytomegalovirus (CMV): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/215702-overview

  CMV seroprevalence in immunocompetent adults varies from 40-100% globally. […] At least 50-60% of the US population has been exposed to CMV, with a prevalence of more than 90% in high-risk groups (eg, male homosexuals), and outside of the US prevalence can be more than 90%. […] The incidence of CMV seropositivity rises with age and in a US-based study was reported to increase from 36% in children aged 6-11 years to 91% in individuals older than 80 years. […] Individuals at an increased risk for CMV infection include individuals who attend or work at daycare centers, patients who undergo blood transfusions, persons who have multiple sex partners, and recipients of CMV mismatched organ or bone marrow transplants. […] CMV is transmitted from person to person via close contact with an individual who is excreting the virus.

• #7 Pediatric Cytomegalovirus Infection: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/963090-overview

  Epidemiology […] Every mammal appears to be infected with its own species-specific cytomegalovirus (CMV), and no evidence suggests that infections cross species. Hence, humans are the only natural host for human CMV infection. Although most adults eventually become infected with CMV, the epidemiology of this infection is complex, and the age at which an individual acquires CMV greatly depends on geographic location, socioeconomic status, cultural factors, and child-rearing practices. […] In developing countries, most children acquire CMV infection early in life, with adult seroprevalence approaching 100% by early adulthood. In contrast, in developed countries, the seroprevalence of CMV approximates 50% in young adults of middle-upper socioeconomic status. This observation has important implications for congenital CMV epidemiology because women of childbearing age who are CMV seronegative are at major risk of giving birth to infants with symptomatic congenital infection if primary infection is acquired during pregnancy. […] Transmission of CMV infection may occur throughout life, chiefly via contact with infected secretions. In the developed world, CMV is the most common congenital viral infection. An overall rate of congenital CMV transmission of approximately 1% (ranging from 0.252%, depending on the population studied) has been estimated in newborn infants in the developed world in most reviews. This translates to about 80,000 congenital CMV infections per year in the United States and Europe. In the United States, congenital CMV infection occurs in 3-6 of every 1000 infants born each year. […] A meta-analysis of published studies concluded that the overall birth prevalence of congenital CMV infection was 0.64%, but noted that rates varied considerably among different study populations. Nonwhite race, low socioeconomic status, premature birth, and neonatal intensive care unit admittance were risk factors for congenital CMV infection; and birth prevalence increased with maternal CMV seroprevalence. […] There has been insufficient attention given to congenital CMV infection in the developing world, but the limited data available suggest that CMV may also represent a significant public health concern in these populations. A multicenter study comparing newborn screening by oropharyngeal culture versus polymerase chain reaction (PCR) based detection of viral DNA in the newborn dried blood spot identified an overall prevalence of 0.45% in the 7 sites surveyed. […] Most congenital CMV infections occur in infants born to mothers with preexisting immunity, and these infections are clinically asymptomatic at birth; however, long-term sequelae, including deafness, can occur. […] The route of congenital infection is presumed to be transplacental. The transplacental transmission rate after maternal primary infection is about 32%. CMV may also be transmitted perinatally, both by aspiration of cervicovaginal secretions in the birth canal and by breastfeeding. More than 50% of infants fed with breast milk that contains infectious virus become infected with CMV. […] Infants who are not infected congenitally or perinatally with CMV are at high risk to acquire infection in daycare centers. According to some studies, the prevalence of CMV infection in children who attend daycare, particularly children younger than 2 years, approximates 80%. […] The virus may be readily transmitted to susceptible children via saliva, urine, and fomites; these children, in turn, may transmit infection to their parents. Horizontal transmission of infection in daycare centers appears to play a major role in the epidemiology of many CMV infections in young parents. […] In adulthood, sexual activity is probably the most important route of acquisition of CMV, although the observation that virus is present in saliva, cervicovaginal secretions, and semen obscures which route or routes of transmission are primarily responsible for establishment of infection. Saliva alone appears to be sufficient for transmission of CMV, and this route of transmission may be responsible for those cases of heterophile-negative mononucleosis, which are attributable to CMV. Kissing appears to be a way in which CMV is transmitted from toddlers to seronegative parents. Work by the Centers for Disease Control and Prevention (CDC) has emphasized the need for greater public awareness of these risks and for educational interventions for young women of childbearing age. […] Other important routes of transmission include blood transfusion and solid organ transplantation. Before screening of blood products, transfusion-associated CMV was an important cause of morbidity and mortality in premature infants; however, the routine use in many neonatal intensive care units of CMV-negative blood products has largely eliminated this problem. Posttransfusion CMV is still a risk in CMV-seronegative trauma and in surgery patients, often manifesting as hepatitis.

• #8 Cytomegalovirus (CMV): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/215702-overview

  CMV seroprevalence in immunocompetent adults varies from 40-100% globally. […] At least 50-60% of the US population has been exposed to CMV, with a prevalence of more than 90% in high-risk groups (eg, male homosexuals), and outside of the US prevalence can be more than 90%. […] The incidence of CMV seropositivity rises with age and in a US-based study was reported to increase from 36% in children aged 6-11 years to 91% in individuals older than 80 years. […] Individuals at an increased risk for CMV infection include individuals who attend or work at daycare centers, patients who undergo blood transfusions, persons who have multiple sex partners, and recipients of CMV mismatched organ or bone marrow transplants. […] CMV is transmitted from person to person via close contact with an individual who is excreting the virus.

• #8 Pediatric Cytomegalovirus Infection: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/963090-overview

  Epidemiology […] Every mammal appears to be infected with its own species-specific cytomegalovirus (CMV), and no evidence suggests that infections cross species. Hence, humans are the only natural host for human CMV infection. Although most adults eventually become infected with CMV, the epidemiology of this infection is complex, and the age at which an individual acquires CMV greatly depends on geographic location, socioeconomic status, cultural factors, and child-rearing practices. […] In developing countries, most children acquire CMV infection early in life, with adult seroprevalence approaching 100% by early adulthood. In contrast, in developed countries, the seroprevalence of CMV approximates 50% in young adults of middle-upper socioeconomic status. This observation has important implications for congenital CMV epidemiology because women of childbearing age who are CMV seronegative are at major risk of giving birth to infants with symptomatic congenital infection if primary infection is acquired during pregnancy. […] Transmission of CMV infection may occur throughout life, chiefly via contact with infected secretions. In the developed world, CMV is the most common congenital viral infection. An overall rate of congenital CMV transmission of approximately 1% (ranging from 0.252%, depending on the population studied) has been estimated in newborn infants in the developed world in most reviews. This translates to about 80,000 congenital CMV infections per year in the United States and Europe. In the United States, congenital CMV infection occurs in 3-6 of every 1000 infants born each year. […] A meta-analysis of published studies concluded that the overall birth prevalence of congenital CMV infection was 0.64%, but noted that rates varied considerably among different study populations. Nonwhite race, low socioeconomic status, premature birth, and neonatal intensive care unit admittance were risk factors for congenital CMV infection; and birth prevalence increased with maternal CMV seroprevalence. […] There has been insufficient attention given to congenital CMV infection in the developing world, but the limited data available suggest that CMV may also represent a significant public health concern in these populations. A multicenter study comparing newborn screening by oropharyngeal culture versus polymerase chain reaction (PCR) based detection of viral DNA in the newborn dried blood spot identified an overall prevalence of 0.45% in the 7 sites surveyed. […] Most congenital CMV infections occur in infants born to mothers with preexisting immunity, and these infections are clinically asymptomatic at birth; however, long-term sequelae, including deafness, can occur. […] The route of congenital infection is presumed to be transplacental. The transplacental transmission rate after maternal primary infection is about 32%. CMV may also be transmitted perinatally, both by aspiration of cervicovaginal secretions in the birth canal and by breastfeeding. More than 50% of infants fed with breast milk that contains infectious virus become infected with CMV. […] Infants who are not infected congenitally or perinatally with CMV are at high risk to acquire infection in daycare centers. According to some studies, the prevalence of CMV infection in children who attend daycare, particularly children younger than 2 years, approximates 80%. […] The virus may be readily transmitted to susceptible children via saliva, urine, and fomites; these children, in turn, may transmit infection to their parents. Horizontal transmission of infection in daycare centers appears to play a major role in the epidemiology of many CMV infections in young parents. […] In adulthood, sexual activity is probably the most important route of acquisition of CMV, although the observation that virus is present in saliva, cervicovaginal secretions, and semen obscures which route or routes of transmission are primarily responsible for establishment of infection. Saliva alone appears to be sufficient for transmission of CMV, and this route of transmission may be responsible for those cases of heterophile-negative mononucleosis, which are attributable to CMV. Kissing appears to be a way in which CMV is transmitted from toddlers to seronegative parents. Work by the Centers for Disease Control and Prevention (CDC) has emphasized the need for greater public awareness of these risks and for educational interventions for young women of childbearing age. […] Other important routes of transmission include blood transfusion and solid organ transplantation. Before screening of blood products, transfusion-associated CMV was an important cause of morbidity and mortality in premature infants; however, the routine use in many neonatal intensive care units of CMV-negative blood products has largely eliminated this problem. Posttransfusion CMV is still a risk in CMV-seronegative trauma and in surgery patients, often manifesting as hepatitis.

• #9 Cytomegalovirus (CMV): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/215702-overview

  CMV seroprevalence in immunocompetent adults varies from 40-100% globally. […] At least 50-60% of the US population has been exposed to CMV, with a prevalence of more than 90% in high-risk groups (eg, male homosexuals), and outside of the US prevalence can be more than 90%. […] The incidence of CMV seropositivity rises with age and in a US-based study was reported to increase from 36% in children aged 6-11 years to 91% in individuals older than 80 years. […] Individuals at an increased risk for CMV infection include individuals who attend or work at daycare centers, patients who undergo blood transfusions, persons who have multiple sex partners, and recipients of CMV mismatched organ or bone marrow transplants. […] CMV is transmitted from person to person via close contact with an individual who is excreting the virus.

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