Cytomegalovirus secondary prevention

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Template:Cytomegalovirus Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Secondary Prevention

Recommendations for pregnant women with regard to CMV infection:

  • Laboratory testing for antibody to CMV can be performed to determine if a women has already had CMV infection.
  • Women who develop a mononucleosis-like illness during pregnancy should be evaluated for CMV infection and counseled about the possible risks to the unborn child.
  • Recovery of CMV from the cervix or urine of women at or before the time of delivery does not warrant a cesarean section.
  • The demonstrated benefits of breast-feeding outweigh the minimal risk of acquiring CMV from the breast-feeding mother.
  • There is no need to either screen for CMV or exclude CMV-excreting children from schools or institutions because the virus is frequently found in many healthy children and adults.

Recommendation for individuals providing care for infants and children:

  • Routine laboratory testing for CMV antibody in female workers is not specifically recommended due to its high occurrence, but can be performed to determine their immune status.

Patients without CMV infection who are given organ transplants from CMV-infected donors should be given prophylactic treatment with valganciclovir (ideally) or ganciclovir and require regular serological monitoring to detect a rising CMV titre, which should be treated early to prevent a potentially life-threatening infection becoming established.

CMV assays are part of the standard screening for non-directed blood donation (donations not specified for a particular patient) in the U.S. CMV-negative donations are then earmarked for transfusion to infants or immunocompromised patients. Some blood donation centers maintain lists of donors whose blood is CMV negative due to special demands.

References

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