Cytomegalovirus infection - ways of infection and disease prevention. Symptoms of cytomegalovirus infection

The date: 14.04.2019

Photo: Cytomegalovirus in the lungs under a microscope

Cytomegalovirus is so widespread among people that this infection can be attributed to sexual infections with a big stretch. Although it is transmitted precisely through close physical contact through body fluids - saliva, tears, mucus, semen, blood. The herpesvirus family is number 5, the name is often abbreviated to CMV or CMV.

For healthy people completely safe - manifestations, if any, are similar to a cold, go away on their own without treatment and without consequences. Antibodies remain in the blood, which will now protect the body from re-infection for the rest of its life.

In people with a poor immune system, the disease is severe. In them, CMV can cause irreversible damage to the nervous, respiratory, genitourinary and other systems. At risk are unborn or premature babies, pregnant women who have not previously encountered cytomegalovirus, patients HIV and AIDS and those undergoing immunosuppressive therapy.

Ways of transmission of cytomegalovirus

In external environment cytomegalovirus is quite stable - it can survive for hours, and even days. You can pick it up with any repeated close contact with a person whose infection is in the active phase. Kisses, shared towels, dishes, hygiene products are contagious.

Babies get infected from their mothers through breast milk, older children - from parents in the household way and from other children during games. Adults - during sex and in the household way. Rarely - with blood transfusion, organ transplantation.
The incubation period ranges from several days to several weeks.

The course of the disease in people with normal immunity

The virus primarily targets the epithelial cells that line the mucous membranes. Also lives in glandular tissue, multiplying in salivary glands ah, prostate and pancreas. May affect nervous tissue.

The course of the disease is highly dependent on the initial state of immunity. If the health is excellent, the symptoms of cytomegalovirus may be completely absent. But more often, the primary infection is similar to the common cold: sore throat, malaise, weakness, cough, pain in the muscles and joints, fever up to 38-39 degrees. The disease lasts 2-3 weeks and goes away on its own, after which the pathogen goes into a dormant state, being under the control of the immune system.

It is impossible to completely get rid of CMV. In a dormant state, he is beyond the reach of protective forces. But in the event of a reactivation of the virus or a new contact with it from the outside, the body will be ready for defense immediately. The antibodies remaining in the blood serum after the first time will now cope with it so effectively that a person will not notice anything, and it will be possible to establish the fact of the disease only by the results of the tests.

Bad news for those at risk: during the reactivation period, such a person, without knowing it, is still contagious. In Russia, 60% of the population over 6 years old are carriers, and all of them are potentially dangerous for those who should not be exposed to cytomegalovirus. Among the elderly, the carrier rate reaches 91%.

Cytomegalovirus in people with immunodeficiency

In all pregnant women, the body deliberately weakens immune system- so he protects himself from the fact that the fetus can be mistaken for a foreign object. Primary infection during the gestation period is especially dangerous for the baby, but the mother may also have health consequences.

Under certain conditions, weakening of the immune system is prescribed by doctors: autoimmune diseases, conditions after organ transplantation, chemotherapy treatment for oncological pathology.

And the infected HIV AIDS) know that they have to be afraid of any foreign microbes.

For all these people, cytomegalovirus infection is a particular danger. Complications can be serious:

inflammation of the liver tissue (hepatitis), including fulminant, resulting in organ failure with rapidly progressive liver failure;
inflammation of the retina of the eye, which without treatment leads to blindness;
inflammation of the lining of the colon (viral colitis);
inflammation of the lungs (pneumonia);
inflammation of the lining of the esophagus (viral esophagitis);
inflammation of the white and gray matter of the brain (encephalitis) or spinal cord(myelitis), inflammation of the meninges (viral meningitis), inflammation of the nerve fibers (polyneuropathy), neuritis of the auditory nerve, etc.

Without treatment, these conditions can pose a threat to life and health, cause irreversible processes. In such cases, antiviral drugs are used as a preventive measure. Cytomegalovirus is treated with valganciclovir, ganciclovir, or cidofovir. Be sure to constantly monitor the titer (amount) of antibodies and viral load. They also conduct a course of immunostimulating therapy, prescribe vitamins, immunomodulators (interferon is most often used). Even during pregnancy, the potential risk from prescribing drugs is lower than the risk associated with intrauterine infection of the child.

Most women experience CMV for the first time before conception. If this fact is known reliably, you can not be particularly afraid of it. In case of reactivation of the infection during the period of gestation, the risk of its transmission from mother to child is 1%, the risk of pathologies in the fetus is 0.1%. Yes, the numbers are non-zero, but against the background of other dangers, these probabilities are not serious.

If you are planning a child, or just thinking about it, or even just being among the women of childbearing age with a constant sex life- check in advance if you have antibodies to cytomegalovirus. To do this, it is enough to pass a single analysis for latent infections. Save the result.

The most unfavorable is the primary infection of a woman during pregnancy. Then the virus is transmitted to the baby in 40% of cases, and the risk of pathologies is 9%.

On average, one child per 150 newborns is born with a congenital form of cytomegalovirus infection. 80% of these children do not have severe symptoms of cytomegalovirus. But the absence of symptoms does not protect against long-term consequences.

The outcome depends on the period at which the infection occurred. In the first trimester, cytomegalovirus is one of the common causes missed or non-developing pregnancy. The reason is the anomalies in the development of the fetus, incompatible with life. The body itself prevents the birth of a seriously ill child. If this defense mechanism fails, the birth of a child with developmental anomalies is possible, the severity of which can vary widely. The most serious pathologies are the absence of the brain (anencephaly), microcephaly (an abnormally small head), etc.

Congenital cytomegalovirus in children also causes jaundice, skin rashes, viral pneumonia, and seizures. Possible birth weight loss, delayed prenatal development, convulsive syndrome, blindness, deafness, mental retardation. In the absence of serious illnesses, health problems may appear later in life. Children who have had congenital CMV infection are more likely to have problems with coordination, learning, and lag behind their peers.

Diagnosis of cytomegalovirus

The basis for the diagnosis of cytomegalovirus is linked immunosorbent assay(IFA). The method is based on the detection in the blood of specific antibodies produced by the body in response to the invasion of the pathogen. The more aggressive the disease, the higher the antibody titer.

In the acute phase, an increase in antibody titer occurs due to class M immunoglobulins. The presence of anti-CMV-IgM in the blood serum indicates that the virus is in the active phase. In the body remain from 1 to 3 months after treatment.

In chronic infection, the titer of antibodies to class G cytomegalovirus (anti-CMV-IgG) increases.

Doctors recommend testing immediately when symptoms of SARS occur in women in position. In the presence of a high titer of immunoglobulins M, prophylactic treatment with antiviral drugs is carried out. This strategy helps to prevent severe complications in the fetus.

Above, we described why it is so important to establish whether the primary infection occurred during or before pregnancy. Not everyone is tested for latent infections in advance. Gestation lasts 9 months, while class M immunoglobulins are not present in the blood for long. In such cases, an ELISA analysis is performed for the avidity of IgG to cytomegalovirus. The method allows you to clarify the timing of infection and the activity of the virus. Its principle is based on indicators of the "strength" of antibodies. The longer the microbe is present in the body, the more the immune system has the ability to resist the disease. Over time, antibodies improve their ability to bind the pathogen. Conversely, brand new, still "green" antibodies do not fight the virus very effectively.

Avidity is displayed as the percentage of highly avid CMV antibodies. The higher the %, the longer the penetration of the microbe occurred. High avidity (more than 85-90%) makes it possible to exclude primary infection in the last 3 months.

A more accurate, but more expensive method for diagnosing CMV using PCR (polymerase chain reaction, PCR) is also used. For the study, saliva, discharge from the genital organs, washings from the bronchi, cerebrospinal fluid, and blood serum are suitable. Pregnant women take cervical mucus. The method is based on the determination of the genetic information of the pathogen in the samples. The sequence of genes in each bacterium or virus is unique, like the pattern of the retina. In the presence of genetic information characteristic of the pathogen, the method allows you to determine the fact of infection (qualitative analysis), the approximate amount of the pathogen in the body and the degree of its activity / replication (viral load, quantitative analysis).

Prevention of cytomegalovirus

Prevention is relevant only for people with immunodeficiencies and pregnant women without class G antibodies. They will have to:

Pay special attention to hygiene. For example, washing hands not as usual, but very carefully, turning off the tap through a napkin and holding the handle in in public places gloved.
Avoid contact with children. They are contagious in the first place.
Refuse intimacy and even from kissing, if the partner is immune to CMV. At any moment, he may have a reactivation of the virus, and then he will become contagious.

Refers to conditionally pathogenic microflora. Under the influence of certain factors, it is activated, i.e., vivid symptoms appear. The virus can be in the human body in an inactive form throughout life and manifest itself only under certain conditions.

Cytomegalovirus is a virus that belongs to the group of herpes viruses. This virus has an oval shape and a diameter of 150-250 nm. Inside there is virus DNA and when it enters a normal cell, it is introduced into the cell nucleus and mixed with human DNA. Against this background, the affected cell begins to synthesize not only its own proteins, but also the proteins of the virus.

After the infection enters the body, it enters the bloodstream and affects the cells of phagocytes, leukocytes, etc. Later, these cells increase in size, i.e., they turn into cytomegals.Most of the world's population is carriers of the virus. It should be noted that even with a primary infection, a person forever becomes a carrier of the infection.

A viral infection enters the body in several ways: airborne, sexual, alimentary, intrauterine. Most often, the virus enters the body from a carrier through a kiss or sexual intercourse. After entering, the virus penetrates through the cell membrane and after infection of the cell, proteins are synthesized that produce CMV particles.

CMV infection can be present in saliva, urine, seminal fluid, feces, and cervical secretions.

In most cases, infection occurs in childhood when the child is in contact with carriers. Adults also become infected with cytomegalovirus, most often through sexual contact. However, infection can often be due to a violation of the rules of personal hygiene.

It is not possible to immediately recognize CMV because the infection has a long incubation period of about 2 months. Until this period, the disease may not manifest itself, but under certain factors (stress, hypothermia, decreased immunity) it develops sharply.

More information about CMV can be found in the video:

In a latent form, the infection can be observed in everyone. When exposed to certain factors, an exacerbation occurs. Most often, symptoms appear when the immune system is weakened. The work of the immune system is affected by unfavorable ecology, insufficient intake of nutrients, vitamins, and malnutrition.

Symptoms of cytomegalovirus infection do not have specific signs. A viral infection can manifest itself in different ways, depending on the type of cell damage:

If the mucous membrane of the nasal cavity is affected, then the patient develops rhinitis and nasal congestion, sore throat, fever, etc. CMV in its clinical manifestations is similar to the symptoms of acute respiratory viral infections, so colds are often treated, and the viral infection continues to spread to other organs.
With the multiplication of cytomegalovirus infection in the organs gastrointestinal tract signs of disorder appear: constipation, abdominal pain, etc.
In men, CMV in most cases is asymptomatic.
In women, a viral infection with damage to the genital organs often develops endometritis, cervicitis, vaginitis.

How and when is an infection dangerous?

CMV infection is not dangerous in a latent form and with strong immunity. However, for a certain category of people, this virus is dangerous, namely:

HIV infected.
Patients on immunosuppressive therapy.
Pregnant women.
Newborns.

In people with immunodeficiency strong decline immunity, the virus begins to infect many internal organs during the transition to a generalized form. In patients, the infection affects the retina of the eye and, as a result, the person loses his sight.

Infection with the virus in the first trimester of pregnancy can lead to miscarriage, death of the fetus, or the birth of a baby with pathologies. If infection occurs in last dates or during childbirth, the baby is born with a cytomegalovirus infection.

Diagnostic methods

If the patient has a series characteristic symptoms for cytomegalovirus infection, the doctor will prescribe a test necessary tests to refute or confirm the diagnosis.Since the virus can be present in various fluids, blood, saliva, semen, urine are suitable for research.

There are several types of CMV diagnostics:

Cultural research. It is the conclusion in the collection of material and its further placement in a special environment in which all the necessary conditions are created for the virus to multiply. Then they study the nutrient medium and the cellular material in it.
(polymerase chain reaction). PCR diagnostics of cytomegalovirus allows you to identify and examine the DNA of the virus. This method of research with a positive result is not informative enough to distinguish between primary infection and relapse. However, the PCR method is considered quite sensitive and reliable and allows you to identify the infectious process in the early stages.
Sero diagnostics. She is is a blood test. The patient is usually taken blood for examination for the presence in it. If lgG antibodies are present in the blood, it only establishes the fact of transmission of the virus to the patient. However, this does not reflect the course of the infectious process, i.e. the disease is asymptomatic. In the presence of lgM immunoglobulins, an exacerbation of the course of the disease is diagnosed. An increase in antibody titer indicates the active stage of the pathological process.

causative agents Trichomonas vaginalis are unicellular microorganisms. The disease is transmitted sexually.

At acute and subacute 1 forms of trichomoniasis, the patient develops abundant vaginal discharge - leucorrhoea (they can be foamy or purulent), itching and burning in the vulva. You may feel heaviness in the lower abdomen. With severe itching, sleep disturbance is observed. In some cases, there is a burning sensation and pain when urinating. At chronic form diseases are marked leucorrhoea, sometimes itching in the vulva. Possible carriage of the disease (the carrier of the pathogen itself is not sick, but is able to infect a sexual partner).

In the presence of trichomoniasis, it is possible miscarriage, but this disease does not affect the development of the fetus, because. Trichomonas do not penetrate the transplacental barrier and fetal membranes.

Diagnosis is put according to the results of the examination, a microscopic examination of smears is also carried out, for which crops of material from the cervical canal and urethra are used.

For treatment trichomoniasis in pregnant women use specific antitrichomonas drugs, both topically (in the form of suppositories) and in the form of tablets. In the first trimester of pregnancy, only topical treatment can be used.

Chlamydia

causative agents are chlamydia - intracellular bacteria. Three ways of transmission of chlamydia are reliably recognized: intrauterine, sexual and contact (most relevant for children), in which the pathogen is transmitted through close household contact - through towels, hygiene items, household items.

Chlamydial infection can affect various departments urinary system. Cervicitis (inflammation of the cervical canal) is manifested by mucous, colorless, scanty, odorless discharge from the cervical canal. If the disease proceeds for a long time (more than 2 months) and acquires the character of a "descending", i.e. the mucous membrane of the vagina and vulva is involved in the process, then the discharge becomes abundant, mucopurulent. In addition, ascending infection also develops - the uterus, fallopian tubes, and ovaries are affected; as a result, endometritis develops - inflammation of the inner lining of the uterus, salpingitis - inflammation of the fallopian tube, salpingoophoritis - inflammation of the ovary and fallopian tube, which is manifested by discharge, pain in the lower abdomen.

A feature of the course of chlamydia during pregnancy is its asymptomatic. Discharge from the cervical canal is extremely scarce, and on examination, only small “cervical erosion” (a condition in which a damaged surface on the cervix is visible) can be detected.

The presence of a chlamydial infection (and especially an exacerbation of a chronic process or a primary infection with chlamydia during pregnancy) increases the likelihood spontaneous abortion(miscarriage) on early dates, missed pregnancy, premature rupture of membranes, premature birth. During pregnancy occurring against the background of urogenital chlamydia, often develops placental insufficiency- a condition in which an insufficient amount of oxygen and nutrients is supplied to the fetus. Chlamydia is often the cause ectopic pregnancy.

Chlamydial infection is transmitted to the fetus from the mother in 40-70% of cases. Chlamydia does not cause fetal malformations. Infection of the fetus during childbirth(when passing through the birth canal) occurs in 70% of cases of childbirth with a successful outcome of pregnancy in women suffering from chlamydia. 50% of children infected in this way suffer from sluggish conjunctivitis (trachoma), 10% develop chlamydial pneumonia and pleurisy, which occur without fever and typical signs diseases, and therefore difficult to diagnose and difficult to treat. Rarely, children develop inflammation of the middle ear ( otitis media) and lesions of the gastrointestinal tract. Infection of the newborn after childbirth occurs when the rules of hygiene are not observed already at home (the mother suffers from chlamydia and does not wash her hands before communicating with the child, the newborn does not have a separate towel, etc.).

Reliability diagnosis is achieved by several research methods: direct immunofluorescence (detection of chlamydia), cultural ("growing" of chlamydia), polymerase chain reaction (PCR) and ligase chain reaction (LCR) (detection of chlamydia DNA), serological method (determination of antibodies - protective proteins, produced by lymphocytes in response to the penetration of the pathogen to chlamydia in the blood).

Since the development of microbes occurs inside the cell, chlamydial infection is difficult to treat. treatment. Patients are prescribed antibacterial drugs tetracyclines and macrolides, fluoroquinolones. The treatment takes into account individual sensitivity to antibiotics. During pregnancy, treatment is carried out with drugs that do not have a negative effect on the fetus.

Ureoplasmosis, mycoplasmosis

pathogens - ureoplasmas, mycoplasmas. The disease is transmitted mainly through sexual contact, sometimes through household contact (through towels, bed linen, etc.). Possible carrier of the disease.

Ureoplasmas and mycoplasmas can cause colpitis- inflammation of the mucous membrane of the vagina, salpingoophoritis- inflammation of the fallopian tubes and ovaries, endomyometritis- inflammation of the inner lining and muscles of the uterus), which are manifested by profuse discharge, pain in the lower abdomen. These infections are characterized by a long course. These pathogens are isolated bartholinite(inflammation of the large vestibular gland of the vagina). The percentage of detection of mycoplasmas in patients suffering from pyelonephritis.

Pregnant women are at increased risk spontaneous miscarriages, premature effusion amniotic fluid. Ureaplasmas can cause septic postpartum complications (endometritis, etc.). The disease can cause development of placental insufficiency.

If the fetus is infected during childbirth, it is possible damage to the lungs, conjunctiva of the eyes, external genitalia.

For diagnostics the polymerase chain reaction method is used, the cultural method is the cultivation of mycoplasmas on special media.

At treatment patients are prescribed antibacterial drugs of the tetracycline series and macrolides, while taking into account individual sensitivity to antibiotics.

Papillomavirus infection

Pathogen - human papillomavirus. Transmission of the infection occurs only through sexual contact.

The virus can cause damage in the form of genital warts - skin formations that rise above the surface of the skin, located mainly in the region of the large and small labia, less often - in the vagina and on the cervix. Condylomas can also be located around the external opening of the urethra and anus. Genital warts are usually multiple. With abundant growth of condylomas, the structure resembles cauliflower or cockscombs. Skin warts are whitish or brownish in color, mucous membranes are pale pink or reddish in color. In the case of a secondary bacterial infection, profuse leucorrhoea, itching or pain may appear. Strongly overgrown warts cause difficulty in walking and sexual intercourse.

During pregnancy, spontaneous disappearance of genital warts is possible, but papillomavirus infection may also progress.

Papillomavirus infection itself does not affect the course of pregnancy, but since it is often combined with other sexually transmitted diseases, it increases the likelihood premature termination of pregnancy.

The infection does not affect the fetus. It is possible to transmit the virus from mother to child during pregnancy and childbirth. When a baby is infected during childbirth, papillomatous growths may appear on the child's vocal cords. (papillomatosis of the larynx).

For confirmation diagnosis it is necessary to detect the DNA of the virus in the patient's blood, which is usually done using a polymerase chain reaction.

When the disease is used as a local treatment, and immunomodulatory drugs. Papillomas are removed by mechanical, chemical or thermal (cold or cauterization) methods. During pregnancy, it is possible to use laser therapy and cryodestruction - the destruction of pathological skin formations with the help of a laser or the action of cold.

Cytomegalovirus infection

Pathogen Cytomegalovirus (CMV) is a member of the herpetic virus family. Infection can occur through saliva, blood, sexually, from mother to child - through breast milk.

The disease most often occurs in the form of acute respiratory infections, but can also cause damage to the central nervous system, liver, spleen, recurring pneumonia.

If there is an infection, it is possible miscarriage.

In case of primary infection or re-infection during pregnancy, the child may delay mental development, microcephaly, deafness, epilepsy, cerebral palsy. The likelihood of such complications is much higher with primary infection during pregnancy. The study of a smear from the vagina does not provide accurate information about possible intrauterine infection. There are also possible fetal malformations such as polycystic kidney disease (kidneys contain almost no structural tissue, consist of many cavities), heart defects.

During pregnancy virus can be detected , conducting research allocated from the cervical canal and urethra. It is also found in saliva, urine, semen, and amniotic fluid. Carry out the determination of antibodies in the blood of the patient. If there is a suspicion of fetal malformations (with unfavorable data ultrasound) it is possible to use invasive techniques for examining the fetus; in this case, amniocentesis is performed (puncture of the fetal bladder and amniotic fluid sampling) and the presence of antibodies is determined. The presence of class “M” immunoglobulin (Ig M) in the waters and blood of the mother indicates that the fetus is affected by the CMV virus.

At treatment pregnant women, specific antiviral drugs are not used. Patients are prescribed immunocorrective drugs. The issue of medical indications for artificial termination of pregnancy in acute cytomegalovirus infection is decided individually.

Herpes

pathogens diseases are of two types. Herpes simplex virus type 1 (HSV1) infects the skin, mucous membranes of the eyes, lips, and nose. The herpes simplex virus type 2 (HSV2) infects the genitals. There is a mixed infection: VPP + HSV2. HSV2 is transmitted sexually from a patient and a carrier of HSV (a person who does not show the disease). The disease is also transmitted through orogenital contact. In rare cases, infection occurs through the household route. Throughout a person's life, the virus can persist in the mucous membranes and nerves. Infection with the herpes virus can occur during fertilization, from semen. During pregnancy, viruses can cross the placenta. Finally, a child can become infected during childbirth, when passing through an infected birth canal.

A characteristic sign of herpes is the appearance of individual or multiple vesicles (vesicles) against the background of a hyperemic, edematous mucous membrane of the affected area. The size of the vesicles is 2-3 mm; a group of them occupies from 0.5 to 2.5 cm of the affected surface. This stage of the disease is short-lived (2-3 days), then the vesicles open, and irregularly shaped ulcers form on their basis. Ulcers are covered with a yellow coating, heal within 2-4 weeks without scarring. In place of the vesicles, large long-term ulcers can form, often covered with a purulent coating, due to the addition of a secondary infection. The rash of vesicles and the formation of ulcers are accompanied by complaints of itching, pain, and burning. Often, patients complain of heaviness in the lower abdomen, as well as dysuric phenomena - frequent, painful urination.

If there is an infection, it is possible miscarriage, premature birth.

In the fetus, the virus can cause malformations of the brain, scars on the skin, less often - limb hypoplasia, fetal growth retardation syndrome, meningoencephalitis, damage to the liver, spleen, kidneys, lungs. It can also cause fetal malformations. Such complications are likely if a primary or reinfection virus. If the mother is the carrier of the primary infection, then infection of the fetus occurs in 50% of cases. In the case of a secondary episode or relapse, the same figure is 8%.

The doctor puts diagnosis, observing characteristic rashes on the patient's skin. To detect HSV in the discharge from the affected organs, methods of fluorescent antibodies and the immunoperoxidase method are used. They also use the method of growing the virus in tissue culture, the electron microscopic method of recognizing HSV. Blood antibodies can be the result of both primary infection or exacerbation, and a previous herpes infection.

For treatment use antiviral drugs - both for internal and external use, immunocorrectors and vitamins. With the appearance of herpes during pregnancy or with an exacerbation of a herpes infection during this period, taking antiviral drugs orally is excluded.

Enteroviral infection

Pathogen - viruses of the Coxsackie group. The disease is transmitted by airborne droplets or through the placenta from mother to fetus.

The disease can manifest itself in a variety of ways, most often in the form of an acute respiratory viral infection, accompanied by diarrhea (loose stools). After past illness the carriage of the virus remains, that is, even the person who has been ill and is not sick at the moment can become a source of infection.

Carriers of the virus may experience premature termination of pregnancy. The risk group includes women who have had any febrile illnesses (ARI, influenza), especially in recent weeks pregnancy.

Maternal disease can cause encephalomyelitis, congenital heart defects in the fetus.

For staging diagnosis serodiagnosis is used - the detection of antibodies in the blood.

Treatment patients are treated with immunocorrective drugs.

If you pronounce the literal translation from Latin, it means - a large cell.

Statistics show that about 70% of the total female population are carriers of this pathogen. The greatest danger is primary infection, since there is a high probability of a negative impact on the health of the unborn baby.

Relatively low level of pathogenicity. After penetration into the human body, the disease may not develop long time. To provoke the development of cytomegaly, conditions are necessary under which the protective functions of the body are weakened (oncopathology, difficult childbirth).
The reproductive ability of the virus has low activity.
The destruction of the cell occurs due to the use of its protein fraction.
Reproduction of CMV stops after the restoration of the body's immune forces, while a repeated inflammatory process may appear after another decrease in immune defense.
Under the influence of the environment, there is a rapid death of cytomegalovirus. It is affected by both increased and low temperature, aseptic and disinfectants, alcohol-containing solutions.
The risk of infection is significantly increased by contact with a patient or carrier of CMV.
Most often, infection occurs in childhood, in which the clinical picture of the disease has severe symptoms. Infection of adults occurs asymptomatically, which significantly complicates the diagnosis.

The development of cytomegalovirus is facilitated by factors in which the body's defenses fail. Next pathological conditions are included in their composition:

AIDS disease.
Systemic diseases of the circulatory system.
Malignant neoplasms.
Extensive wound surfaces, including after burns.
The use of long courses of treatment with drugs of the pharmaceutical group of glucocorticoids or cytostatics (they suppress the immune system).

In some cases, the penetration of this virus is facilitated by:

polluted environment;
lack of sufficient vitamins, micro and macro elements;
transfer of the child to artificial feeding;
violation of the daily routine, which is accompanied by a lack of walks in the fresh air.

Ways of transmission of the virus

This type of pathological process is anthroponotic. It can only occur in humans, and can only be human.

In this regard, the following ways of infection are distinguished:

intrauterine. Infection of the baby occurs through the placenta.
During delivery. When the fetus travels birth canal mothers, the virus penetrates through the mucous membranes.
When hit in oral cavity infected saliva ().
If sexual intercourse occurs without the use of barrier contraception(no condom used).
With parenteral administration of donated blood or after an organ transplant operation.

The clinical picture of the manifestation of the virus in acute and chronic form in women

If a woman has strong immunity, then the virus that has entered her body is in the inactive phase of its development, and therefore does not cause clinical manifestations. The impetus for the appearance of its signs is the weakening, or failure of the immune system. This may occur as a result of:

prolonged hypothermia;
psycho-emotional breakdown after suffering a stressful situation;
excessive fatigue;
long-term chronic diseases;
pregnancy and childbirth.

After the penetration of CMV into the body, it begins to actively multiply, involving new cells in the process. At the same time, throughout (up to 2 months), the symptoms of the clinical picture may be absent.

The acute phase of the disease most often lasts about 6 weeks, it may be accompanied by symptoms resembling a cold or mononucleosis.

Unfortunately, characteristic features indicating the presence of cytomegalovirus in the body does not exist. Therefore, most women at the onset of the disease do not pay due attention to the problem that has arisen.

Initially, a woman has the following symptoms:

There is a rise in body temperature, which is badly lost.
There is a breakdown, weakness, muscle pain, and aching joints.
There is a hacking cough and symptoms of rhinitis.
Are increasing salivary glands, there is hypersalivation (increased separation of saliva).
There is an increase in the size of the cervical, submandibular, parotid lymph nodes, which are accompanied painful sensations in the throat.
Symptoms of anorexia appear.
Develops fear of bright, sunlight.

With timely treatment, and proper therapy, these symptoms may disappear in 2 or 4 weeks. Otherwise, the process flows into a chronic form. This threatens the appearance of the following pathological conditions:

endometritis;
vaginitis;
erosive lesions of the cervix.

In addition, women develop pulling pains in the lower abdomen, which are accompanied by vaginal discharge of an abnormally blue color.

Cytomegalovirus infection poses a particular threat during the period when a woman is carrying a child. Risk is created premature birth, spontaneous miscarriage or fetal fading

If the disease occurs in the first trimester of pregnancy, then the risk of physical and mental pathologies in the baby increases significantly, which can be expressed as follows:

The cranial box in a baby can be small, which leads to a violation of the structure of the brain.
Abnormal development of the cardiac septa leading to the development of heart defects.
developmental disorder hearing aid and visual organs.
Improper development of the lungs and kidneys.
In addition, such a baby will have a physical lag in development compared to his peers.

CMV disease in later dates pregnancy is not so dangerous for the unborn baby. But the risk of preterm birth remains the same. A child may be born with signs of hypoxia, and on the Apgar scale (determined by the degree of full-term child), will have low scores.

He may experience:

poor weight gain due to a weak sucking reflex;
yellowness of the skin (a sign of a violation of the biliary tract);
hemorrhagic rashes on the skin;
constant increase in body temperature;
failure in work digestive system, which is accompanied by vomiting (reminiscent of coffee grounds).

This condition of the child is severe, and often leads to death between the 14th and 20th day of life.

The course and complications of immunodeficiency conditions in women

long chronic course This pathology occurs against the background of immunodeficiency. At the same time, a woman develops a generalized lesion of various organs and systems:

Gastrointestinal tract, affected by cytomegalovirus, leads to the development of colitis or enterocolitis, in severe cases to cirrhosis of the liver. The mucous membranes of the esophagus and intestines can ulcerate, in which case there is a threat of a perforated ulcer. Penetration of the contents of the stomach or intestines into the abdominal space threatens with the development of diffuse peritonitis. This is a dangerous, complicated condition that requires surgical intervention.
genitourinary system can react with the appearance of inflammatory processes of the genital organs. In the kidneys, in a relatively short period of time, stones are formed, this is a consequence of a violation of metabolic processes in the body.
From the side of the nervous system encephalitis may develop, the psycho-emotional state is disturbed, with the appearance of symptoms of apathy and dementia (dementia).
In the respiratory system CMV can cause the development of pneumonia, which is characterized by an acute course, and is poorly amenable to drug therapy.
With damage to the visual organs, Cytomegalovirus infects the retina and contributes to its rapid necrosis. This initially leads to disruption. visual perception and eventually complete loss of vision.

Methods used to diagnose the presence of a virus in the body

To establish an accurate diagnosis, examining the patient, and listening to his complaints is not enough. Besides, this pathology it is necessary to differentiate (distinguish) from the disease mononucleosis. Its symptoms resemble the course of Cytomegaly, but unlike it, they are absent in the course of the disease, and the inflammatory process is not accompanied by an increase in lymph nodes, which are localized in the occipital region.

Therefore, the doctor prescribes additional methods studies for which biological material is taken. It can be:

and urine;
discharge of the salivary glands;
the contents of the bronchopulmonary secret;
breast milk;
genital scrapings;
tissue particles taken during a biopsy.

Currently, several methods are used, using which, with a high degree of confidence, we can talk about the presence of a virus in the body:

The most accessible and inexpensive method is with a microscope. A significant drawback is the low accuracy of this type of study (about 70%).
PCR. This technique is based on the detection of cytomegalovirus DNA particles, which makes it possible to determine its presence in the body. It's pretty precise analysis, but it has one drawback, which does not allow you to set the duration inflammatory process. Also, it can be attributed to an expensive type of diagnostics.
(IFA). This technique is based on the detection of antibodies that develop in the body in relation to the pathogen. It is used to make a diagnosis at any stage of the course of the disease, has a high informative accuracy.
Cytological examination. For this analysis, a small piece of tissue is taken and placed in a nutrient medium. The development of the virus is observed for 3 weeks. When cells are found big size, which have internal inclusions, a positive result is made on the presence of cytomegalovirus in the body.

The use of specific and non-specific therapies in treatment

This type of disease has its own specifics and features of the course. Therefore, due effective therapy can be provided by contacting medical institution to a specialist.

When implementing drug treatment(specific therapy), drugs are used that are able to eliminate the causes of the pathological process and restore the functioning of the immune system.

To suppress the multiplication of a viral infection, antiherpetic drugs are prescribed:

Ganciclovir;
Foxarnet;
Zovirax;
Acyclovir.

These dosage forms can only be prescribed by a doctor, due to the fact that they have toxic effects on the body. Incorrect use can lead to the development side effects, which will take a long time to eliminate. B vitamins;

dosage forms containing magnesium;

antioxidants.

To stimulate the immune system, you can use the methods of folk medicine (not specific therapy). The use of tinctures and decoctions gives positive results only if they are used not as a panacea, but as an additional therapy.

In this case, it is necessary to consult a doctor about the choice of a particular herbal remedy.

For this purpose, they usually resort to the appointment of the following infusions or decoctions:

echinacea tincture; decoction of echinacea;
tincture of Schisandra chinensis;
medicinal tea with thyme;
complex decoction based on immortelle, St. John's wort and chamomile;
tincture on birch buds.

Basic preventive measures to prevent the development of the virus

In medical practice, there is no specific prevention this pathology, therefore, you should adhere to the basic principles of hygiene that will help prevent the development of this disease:

First of all, it is necessary to exclude casual sexual contacts. Use a barrier method of contraception (condom).
AT active form disease, an infected person is the source of the infection. Therefore, personal care products, dishes, he should be separate.
Wash your hands frequently with soapy water.
When planning a pregnancy, it is necessary to make laboratory research for the presence of a viral infection.
The diet should include a high content of coarse fiber and. Food should be varied and contain a large number of micro and macro elements.
To create a good immune barrier, you need to play sports and harden the body.

These simple measures do not fully guarantee the development of cytomegaly. But in most cases, they prevent the development of this infection.

Cytomegalovirus poses a serious threat to the body of a girl and a pregnant woman. It can cause irreparable damage to the proper functioning of organs.

In order to prevent the occurrence of complications, it is necessary to consult a doctor who will prescribe the correct treatment.

Patients should remember that folk recipes, cannot cure this disease, since in most cases they mask clinical picture without eliminating the underlying cause of the pathological process.

Cytomegalovirus is a virus that is widespread throughout the world among adults and children, belonging to the group of herpes viruses. Since this virus was discovered relatively recently, in 1956, it is considered not yet sufficiently studied, and in the scientific world it is still the subject of active discussion.

Cytomegalovirus is quite widespread, antibodies of this virus are found in 10-15% of adolescents and young people. In people aged 35 years and over, it is found in 50% of cases. Cytomegalovirus is found in biological tissues - semen, saliva, urine, tears. When it enters the body, the virus does not disappear, but continues to live with its host.

What it is?

Cytomegalovirus (another name is CMV infection) is an infectious disease that belongs to the herpesvirus family. This virus infects a person both in utero and in other ways. So, cytomegalovirus can be transmitted sexually, by airborne droplets through the alimentary route.

How is the virus transmitted?

The routes of transmission of cytomegalovirus are diverse, since the virus can be found in blood, saliva, milk, urine, feces, seminal fluid, and cervical secretions. Possible airborne transmission, transmission by blood transfusion, sexual contact, possibly transplacental intrauterine infection. An important place is occupied by infection during childbirth and when breastfeeding with the milk of a sick mother.

There are frequent cases when the carrier of the virus does not even suspect about it, especially in situations where the symptoms are almost not manifested. Therefore, you should not consider every carrier of cytomegalovirus as sick, since existing in the body, it may never manifest itself in a lifetime.

However, hypothermia and the subsequent decrease in immunity become factors provoking cytomegalovirus. Symptoms of the disease are also manifested due to stress.

Cytomegalovirus igg antibodies detected - what does this mean?

IgM are antibodies that the immune system begins to produce 4-7 weeks after a person is first infected with cytomegalovirus. Antibodies of this type are also produced every time when the cytomegalovirus, which has remained in the human body after a previous infection, begins to multiply actively again.

Accordingly, if a positive (increased) titer of IgM antibodies against cytomegalovirus was detected in you, then this means:

that you have recently been infected with cytomegalovirus (not earlier than within the last year);
That you were infected with cytomegalovirus for a long time, but recently this infection began to multiply again in your body.

A positive titer of IgM antibodies can persist in human blood for at least 4-12 months after infection. Over time, IgM antibodies disappear from the blood of a person infected with cytomegalovirus.

Development of the disease

The incubation period is 20-60 days, the acute course is 2-6 weeks after incubation period. Being in the body in a latent state both after infection and during periods of attenuation is an unlimited time.

Even after the course of treatment, the virus lives in the body for life, maintaining the risk of relapse, so doctors cannot guarantee the safety of pregnancy and full bearing even if a stable and prolonged remission occurs.

Symptoms of cytomegalovirus

Many people who are carriers of cytomegalovirus do not show any symptoms. Signs of cytomegalovirus may appear as a result of disorders in the immune system.

Sometimes in persons with normal immunity, this virus causes the so-called mononucleosis-like syndrome. It occurs 20-60 days after infection and lasts 2-6 weeks. It manifests itself as high, chills, fatigue, malaise and headache. Subsequently, under the influence of the virus, the body's immune system is restructured, preparing to repel the attack. However, in case of lack of strength, the acute phase passes into a calmer form, when vascular-vegetative disorders often appear, and lesions also occur. internal organs.

In this case, three manifestations of the disease are possible:

Generalized form- CMV damage to internal organs (inflammation of the liver tissue, adrenal glands, kidneys, spleen, pancreas). These organ damage can cause, which further worsens the condition and has high blood pressure on the immune system. In this case, antibiotic treatment is less effective than with the usual course of bronchitis and / or pneumonia. However, it can be observed in the peripheral blood, damage to the walls of the intestine, blood vessels of the eyeball, brain and nervous system. Outwardly manifested, in addition to enlarged salivary glands, skin rash.
- in this case, it is weakness, general malaise, headaches, runny nose, enlargement and inflammation of the salivary glands, fatigue, a little fever body, whitish plaques on the tongue and gums; sometimes it is possible to have inflamed tonsils.
Organ damage genitourinary system - manifests itself in the form of periodic and non-specific inflammation. At the same time, as in the case of bronchitis and pneumonia, inflammation is difficult to treat with traditional antibiotics for this local disease.

Particular attention should be paid to CMVI in the fetus (intrauterine cytomegalovirus infection), in the newborn and children early age. An important factor is the gestational period of infection, as well as the fact whether the infection of the pregnant woman occurred for the first time or the infection was reactivated - in the second case, the probability of infection of the fetus and the development of severe complications is much lower.

Also, in the case of infection of a pregnant woman, fetal pathology is possible, when the fetus becomes infected with CMV that enters the blood from outside, which leads to miscarriage (one of the most common causes). It is also possible to activate a latent form of the virus that infects the fetus through the mother's blood. Infection leads either to the death of the child in the womb / after childbirth, or to damage to the nervous system and brain, which manifests itself in various psychological and physical diseases.

Cytomegalovirus infection during pregnancy

When a woman becomes infected during pregnancy, in most cases she develops acute form diseases. Possible damage to the lungs, liver, brain.

The patient complains about:

fatigue, headache, general weakness;
increase and soreness when touching the salivary glands;
discharge from the nose of a mucous nature;
whitish discharge from the genital tract;
abdominal pain (due to increased uterine tone).

If the fetus is infected during pregnancy (but not during childbirth), the development of congenital cytomegalovirus infection in a child is possible. The latter leads to serious illnesses and lesions of the central nervous system (mental retardation, hearing loss). In 20-30% of cases, the child dies. Congenital cytomegalovirus infection occurs almost exclusively in children whose mothers first become infected with cytomegalovirus during pregnancy.

Treatment of cytomegalovirus during pregnancy includes antiviral therapy based on intravenous injection acyclovir; the use of drugs for the correction of immunity (cytotect, intravenous immunoglobulin), as well as conducting control tests after the course of therapy.

Cytomegalovirus in children

Congenital cytomegalovirus infection is usually diagnosed in a child in the first month and has the following possible manifestations:

cramp, trembling of the limbs;
drowsiness;
visual impairment;
problems with mental development.

The manifestation is also possible at an older age, when the child is 3-5 years old, and usually looks like an acute respiratory disease (fever, sore throat, runny nose).

Diagnostics

Cytomegalovirus is diagnosed using the following methods:

detection of the presence of the virus in body fluids;
PCR (polymerase chain reaction);
sowing on cell culture;
detection of specific antibodies in blood serum.