Charit y spotlight

Congenital cy tomegalov ir us Leena O’Hara discusses congenital cytomegalovirus, and shares the stor y of Melanie Hiscutt and her daughter, Hope, who was born with congenital cytomegalovirus

Congenital cytomegalovirus (cCMV) is not a rare virus, but little awareness of it exists. It has been refer red to as an ‘intelligent’ or ‘stealth’ virus.

It has evolved to pass unnoticed and often unknown, until it is too late. The char ity CMV Action aims to shine a light on cCMV, to help reduce its potentially life-changing effects on newborn babies and children.

CMV is part of the herpes virus family and is incredibly common. Most people have had it without knowing or might have mistaken it for a mild cold or flu (NHS, 2023). However, if passed to an unborn baby, it can lead to cCMV, the most common infectious cause of birth defects (Dollard et al, 2007; Kenneson and Cannon, 2007).

As many as 1 in 200 newborn babies are born with cCMV (Kenneson and Cannon, 2007). The major ity will not have any symptoms but around 1 in 1000 babies born in the UK every year will be severely impacted (Dollard et al, 2007), equivalent to approximately 900 children every year. The potential long‑ter m health impacts include deafness, developmental delays and vision loss (Leruez-Ville et al, 2024). cCMV can also cause miscarr iage and stillbirth. It is more common than Down’s syndrome, spina bifida or cystic fibrosis (Dollard et al, 2007; Kenneson and Cannon, 2007; Townsend et al, 2011).

How can midwives help? CMV is spread through bodily fluids, particularly from young children. Pregnant women, especially those with young children or working in environments like nurser ies,

Leena O’Hara CMV Action Melanie Hiscutt Hope’s mother

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As a result of congenital cytomegalovirus, Mel’s daughter Hope was born with a number of serious conditions. She is now a happy, resilient child about to star t school are at greater r isk of exposure.The updated National Institute for Health and Care Excellence (2023) guidelines recommend that pregnant women are made aware of CMV at their first antenatal appointment (later, if appropr iate) and encouraged to take simple hygiene measures: ● Avoid shar ing food, dr inks, and utensils with young children ● Wash hands regularly, especially after changing nappies or wiping a child’s nose or mouth ● Avoid kissing young children on their face and give them kisses on their head or hugs instead. Although pregnant women are often asymptomatic, CMV can occasionally present with mild flu‑like symptoms, such as fever, sore throat, fatigue or swollen glands. If a midwife suspects a pregnant woman might have a CMV infection, they can refer her to be tested. If the tests confir m CMV, the pregnant woman could be given antiviral treatment (Leruez‑Ville et al, 2024).

Midwives should be vigilant for symptoms of cCMV in newborns, including jaundice, a rash, low birth weight or small head size (microcephaly). Advocating for testing in the first 3 weeks of life could make all the difference, as timing is cr itical. During this window, cCMV needs to be confir med and antiviral treatments started within the first 4 weeks. Early treatment can potentially reduce long-ter m complications (Leruez‑Ville et al, 2024) and impact the progression of hear ing loss.

Hear ing loss is often the silent legacy of cCMV. In the UK, 25% of preventable hear ing loss in childhood is a result of cCMV (Manicklal et al, 2013). Any baby who fails the newborn hear ing screen should automatically be tested for cCMV.

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https://doi.org/10.12968/bjom.2024.0098 | British Journal of Midwifer y, November 2024, Vol 32, No 11