Pediatricians and Pediatric Specialists

A child with CMV will have numerous medical professionals and specialists in their life, but for their parents, it's often their family pediatrician that they turn to when they have questions. What can they do? What can they expect? Stop CMV provides the latest information on testing, treatment, and outcomes, offering a comprehensive resource about this virus and the many forms it can take. By involving parents, we also offer a personal view of the virus and insight to some of the questions and concerns a family might have when they first receive this life-changing diagnosis.

What infants require CMV testing?

Infants who fail a newborn hearing screening or present any the following symptoms at birth should be tested for congenital CMV:

• Thrombocytopenia
• Petechiae (purpura)
• Jaundice of unknown etiology
• Microcephaly of unknown etiology
• Small size at birth/IUGR
• Premature birth of unknown etiology
• Liver problems
• Spleen problems
• Lung problems
• Bleeding problems
• Growth problems
• Seizures
• Hearing loss
• Vision loss
• Mental disability

What outcomes will these children have?

Permanent health problems or disabilities that MAY occur due to congenital CMV infection (Note: just because an infant is diagnosed with congenital CMV, it does not mean that they will develop the following):

• Hearing loss
• Vision loss
• Mental disability
• Feeding issues/Failure to Thrive (FTT)
• Sleeping issues
• Sensory issues
• ADHD/Autism
• Small head/small brain (Microcephaly)
• Intercranial calcifications
• Lack of coordination
• Cerebral palsy
• Seizures
• Death

Are there any treatments for CMV?

Yes. Ganciclovir and Valganciclovir are antiviral treatments that may be beneficial to a newborn with symptomatic congenital CMV. Ganciclovir and Valganciclovir may prevent hearing loss and improve head and brain growth. They can also help combat immediate medical concerns caused by CMV, such as thrombocytopenia (low platelets), organ failure (most commonly spleen and/or liver), hepatitis, and pneumonitis. Treatments generally last from 6 weeks to 6 months and are administered orally or through an IV or PICC line.

Ganciclovir and valganciclovir can have serious side effects and parents should consult with a doctor before beginning treatment. Children receiving these treatments should have regular blood counts to avoid problems with severe neutropenia (low white blood cells) or anemia (low red blood cells).

For more information, contact treatment@stopcmv.org.

What medical follow-up will these children require?

At birth, the child should have the baseline laboratory tests completed to determine what organs in the body have been affected by the virus, including the following:

• complete blood count
• platelet count
• liver function test
• computerized tomography (CT) brain scan
• eye exam by an ophthalmologist
• hearing test

If any procedures or laboratory results are abnormal, follow up testing should be conducted.

According to the CDC, any infant diagnosed with congenital CMV infection should have his or her hearing and vision tested annually, regardless of the outcome of any initial tests at birth. If the child has delayed hearing or vision problems, early detection can help his or her development.

Because a child with congenital CMV may have special needs, her or his growth and development should be followed carefully.

Routine immunizations (shots) are recommended for all children born with congenital CMV.

What other specialists will they need to see?

You may need to refer the child to any of the following medical specialists as issues arise or further examination becomes necessary:

Medical Specialties (Highest priority and listed in alphabetical order, not importance)

• Audiology
• Infectious Disease
• Neurology
• Ophthalmology

Other Medical Specialties (As needed and listed in alphabetical order, not importance)

• Allergy & Immunology
• Cardiology
• Ear, Nose and Throat (ENT)/Otolaryngology
• Endocrinology
• Gastroenterology
• Nephrology
• Orthopedic Surgery
• Pulmonology
• Urology

Should I discuss CMV prevention with pregnant parents?

Yes. Anecdotal evidence suggests that many pregnant mothers with a young child in the home are at increased risk of contracting the CMV virus from routine caregiving and contact with that child. Many pregnant women are not aware that a variety of germs and viruses carried by their children can cause damage to their unborn child. Pediatricians with interest in providing CMV awareness and support information to their patients should communicate precaution measures to the pregnant parents within their practice... read more

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