Newborns infected with CMV in the womb (congenital CMV), babies who become infected during birth or shortly after birth (perinatal CMV) — such as through breast-feeding — and people with weakened immune systems are more at risk of developing signs and symptoms than are healthy adults.
Symptoms in babies
Pregnant women who become infected are at low risk of transmitting the virus to their babies. If it’s the first time you’ve had the infection (primary CMV), risk of transmitting the virus to the baby is higher than it is with reactivated infection. Transmission usually occurs during the first half of pregnancy, usually the first trimester.
Most babies who are infected before they’re born appear healthy at birth, but a few develop signs over time — sometimes not for months or years after birth. The most common of these late-occurring signs is hearing loss. A small number may develop vision impairment as well.
Babies with congenital CMV who are sick at birth tend to be very sick. Signs and symptoms include:
- Yellow skin and eyes (jaundice)
- Purple skin splotches or a rash or both
- Small size at birth (or low birth weight)
- Enlarged spleen
- Enlarged and poorly functioning liver
Symptoms in people with compromised immunity
An illness resembling infectious mononucleosis is the most common presentation of CMV in people with weakened immune systems (immunocompromised). CMV also can attack specific organs. Signs and symptoms may include:
- Ulcers in the digestive tract, possible causing bleeding
- Inflammation of the brain (encephalitis)
- Behavioral changes
- Visual impairment and blindness
Most people infected with CMV who are otherwise healthy experience few if any symptoms. When first infected, some adults may have symptoms similar to mononucleosis, including fatigue, fever and muscle aches.
When to see a doctor
If you have a weakened immune system and you’re experiencing what may be signs or symptoms of CMV infection, see your doctor. CMV infection in people with compromised immunity can be fatal. People who are immunocompromised because they have undergone bone marrow or organ transplants seem to be at greatest risk.
If you develop a mononucleosis-like illness while you’re pregnant, see your doctor so that you can be evaluated for CMV infection. Talk to your doctor about the possible risks to your unborn baby if you have the virus.
If you have CMV but are otherwise healthy, and you’re experiencing any mild, generalized illness, you could be in a reactivation period. Practical self-care steps, such as getting plenty of rest, should be enough for your body to control the infection. You probably don’t need to see your doctor.
When your child should see a doctor
If you know you were infected with CMV during your pregnancy, let your baby’s doctor know. Your doctor should follow your baby to ensure he or she has no vision or hearing problems. However, newborns who are well otherwise are unlikely to develop life-threatening disease later.