Most people have no idea what a cytomegalovirus infection is. At the same time, according to doctors, all people are either infected with this virus, or have already been ill with it and become lifelong virus carriers. Many did not even realize that they were sick. And although it may seem that the enemy is not as terrible as he is portrayed, cytomegalovirus infection in children can be dangerous and have serious consequences. Especially for infants and children with a weak immune status. What is dangerous cytomegalovirus infection, its treatment, symptoms and consequences - this will be discussed in this article.
What is this?
Cytomegalovirus infection is an opportunistic infectious disease that manifests itself exclusively in the presence of an immunodeficiency status of the body. Sometimes this disease is called cytomegaly (a disease associated with damage to cells by a virus with the formation of specificinclusions and an increase in their size). In accordance with the international classification, cytomegalovirus pancreatitis, hepatitis, pneumonia and other (unrecorded) diseases are distinguished.
Cytomegalovirus infections are congenital and acquired. The former are very dangerous, the latter are often asymptomatic or with minimal symptoms, without causing much concern. But having been ill, a person becomes a carrier of cytomegalovirus for the rest of his life and may well infect others. This infection is especially dangerous for some groups of people: patients after organ transplants, HIV carriers and AIDS patients, in the presence of oncological diseases. Cytomegaloviruses are found in all points of the Earth and in all social groups. According to various sources, from 60 to 90% of people are virus carriers.
Cytomegaly pathogen
The disease is caused by human herpesvirus type 5 (Human betaherpesvirus 5). It is this species that is called cytomegalovirus and, along with other 7 types of herpesviruses, is a representative of the genus Cytomegalovirus. All of them have the peculiarity of being free in the human body for a very long time. The pathogen was discovered in 1956, and today there are three strains that cause cytomegalovirus infections in children and adults.
The development of the pathogen occurs in the cells of the connective tissues, which become giant and accumulate viral particles. The extracellular form (virion) of cytomegalovirus consists of 162 particles, has an icosahedral shape (sixteen-sided) anddiameter up to 200 nanometers, the genetic material is contained in the DNA molecule. The causative agent most often lives in the salivary glands, where it is predominantly found. In addition, the pathogen is able to spread through the bloodstream and affect various organs and systems of the body.
Ways the virus enters the body
Infection with cytomegalovirus infection can occur in a variety of ways. Only close contact with an infected person is important. The virus is found in all body fluids: saliva, semen and vaginal secretions, blood and lymph, and breast milk. Transmission routes:
- Airborne.
- When kissing.
- Sexual.
- Blood transfusion and organ transplant.
- Intrauterine through the placenta (antenatal) and at birth (internal).
- Through mother's breast milk.
And although the pathogen itself is not highly contagious (contagious), with close contact the risk of infection is very high. Cytomegalovirus retains its virulence in the environment at room temperature and is resistant to antibiotics. Inactivated by disinfectants, esters, alcohol.
What happens in cells
After the initial penetration into the body, the virus, using the interaction of the glycoprotein shell, finds target cells and penetrates inside. The DNA of the virus is integrated into the DNA of the host cell and starts the processes of its own replication. This is how daughter virions accumulate in cells, the cell and its nucleushypertrophy, and its cytoplasm is visualized as a thin strip ("owl's eye" effect). Cellular changes lead to tissue inflammation, vasculitis and edema.
Clinic and manifestations
Cytomegalovirus infection has an incubation period of 20-60 days. The acute period usually lasts 2-6 weeks. Symptoms of cytomegalovirus infection in women, men and children in the acute phase are manifested in fever up to 37-38 ° C, chills, fatigue, pain of various localization, signs of general intoxication. At this stage, the human immune system is preparing to repel the invading pathogen. With a high immune status, the body copes with cytomegalovirus infection, the symptoms quickly disappear or are suppressed at the very beginning. If immunity is weakened, the acute form flows into a calm, sluggish, chronic, which may have the following manifestations:
- According to the type of acute respiratory viral infection, all the symptoms of SARS are present.
- Generalized cytomegalovirus infection - lesions of internal tissues and organs. In this case, the infection can lead to bronchitis, pneumonia, inflammation of the liver and kidneys, intestinal walls, nervous system, vessels of the sclera of the eyeball, pancreas and other organs. In addition to enlarged salivary glands and cervical lymph nodes, it can manifest as a rash. These inflammatory processes occur due to a reduced immune status and in combination with bacterial infections.
- Cytomegalovirus lesions of the genitourinary system - periodic and non-specific inflammations that are not treatableantibiotics.
Cytomegalovirus infection during pregnancy
It is during the period of bearing a child that this infection becomes threatening.
The risk of fetal infection, severity, symptoms, consequences of cytomegalovirus infection in children depend on the nature of the course of the disease in a pregnant woman. If the infection is primary and the woman does not have immunity to the cytomegalovirus, the infection rate of the fetus is 30-50%. In this case, cytomegalovirus infection in a woman can be asymptomatic. With secondary infection of a pregnant woman, intrauterine infection of the fetus is about 2%. In addition, this infection can lead to miscarriage, stillbirth, or severe deformities in the child if the mother had primary infection or an acute course of the disease in the 1st and 2nd trimester.
Treatment of cytomegalovirus infection in women during pregnancy is carried out only with a sufficiently high risk of infection of the fetus. That is why even at the stage of pregnancy planning it is recommended to be examined for the presence of this infection.
Congenital cytomegalovirus infection in children: symptoms and consequences
The most severe form of cytomegaly development is associated with intrauterine infection. However, only 10% of children have a congenital form of infection, of which there are no symptoms of cytomegalovirus infection in children in 90% of cases. And at the same time, the absence of symptoms in a newborn with suspected congenital cytomegaly does not indicate the he alth of the baby. The disease canmanifest itself during the first 10 years of life in violation of the formation of teeth, reduced visual or hearing acuity, and even in mental retardation or mental retardation.
In the presence of congenital cytomegalovirus infection in children, the symptoms are manifested in the form of prematurity, infantile jaundice, increased drowsiness, problems with sucking and swallowing. Often such infection leads to an increase in the liver, spleen, convulsions, strabismus, blindness and deafness, micro- and hydrocephalus. As a consequence of cytomegalovirus infection in children, the cardiovascular, digestive, and musculoskeletal systems may be affected, which manifests itself in their abnormal development.
Acquired cytomegaly
The most important thing is to identify the nature of this disease in an infant. If antibodies to the virus are detected in the first three days of life, this indicates a congenital cytomegalovirus infection. If the antibody titers in two consecutive tests with an interval of a month increase rapidly - the infection is acquired, which develops from the moment of infection during childbirth and in the first weeks after birth.
The incubation period of the disease is from 20 to 60 days. In most cases, the disease proceeds without symptoms and becomes a virus carrier (latent form).
In the case of an acute course, the baby may experience a developmental delay (physical and mental), impaired motor activity (decreased or increased activity), impaired vision and hearing, hemorrhages under the skin. Howthe consequences of the development of cytomegalavirus infection may appear pneumonia, pancreatitis, hepatitis, diabetes. The acute course of the disease is more often observed in children under the age of six and proceeds as a respiratory viral infection with all the accompanying symptoms. The main difference from SARS is a longer duration of the disease (from 2 weeks).
Typical course and rare complications
After the age of 6, a child, receiving a cytomegalovirus infection, suffers it almost asymptomatically. The immune system of a six-year-old is already formed and can cope with the infection. But with a low immune status, manifestations similar to SARS are possible (weakness, fatigue, slight fever, runny nose, muscle pain, chills). In rare cases, the lymph nodes increase, a whitish coating appears on the tongue. The duration of the disease is from 2 weeks to 2 months.
We have already written about severe complications of congenital infection. With acquired cytomegaly, there are no serious complications and the disease does not go into a generalized form. But if the symptoms of cytomegalovirus infection do not disappear for two months or more, you should contact your pediatrician and undergo a thorough examination.
Infection Diagnosis
Diagnosis of cytomegalovirus is included in the complex of TORCH infections, the analysis of which is called TORCH screening and is used in obstetrics, gynecology and pediatrics to detect potentially dangerous viral diseases (TO - toxoplasma, R - rubella (rubella), C- cytomegalovirus, H - herpes). This screening is based on enzyme immunoassay (determination of the level of antibodies of proteins - immunoglobulins G and M). This is an expensive study, but accurate (95%) and allows you to determine the stage of infection.
In addition to this screening, a cultural method is used. In this case, the virus is isolated in human tissue cell culture. Expensive, long (14 days), but fairly accurate method.
The cytoscopic method is based on the detection of characteristic pathologies in cells. The material for analysis is biological fluids (urine, saliva). Pretty accurate, but not informative.
The polymerase chain reaction method detects the DNA of the virus and its rate of reproduction. Fast and accurate (99.9%) method, but not widely used in laboratories due to its high cost.
Is the therapy effective?
Is treatment of cytomegalovirus infection necessary? Symptoms in women, men and children are very similar and in the typical course of the disease do not require the use of special medications. All treatment comes down to maintaining the immune forces of the body, to reducing intoxication, and this is primarily bed rest and drinking plenty of water. It is worth lowering the temperature only if it rises above 39 ° C. In severe forms of the course of the disease, drugs based on immunoglobulins and antiviral drugs are used. But their list and dosage should be compiled by a doctor based on the results of tests and examination of the patient.
A special case is cytomegalovirus infection in women (withwith or without symptoms) during pregnancy. Drugs can be prescribed only by a doctor and in exceptional cases. Remember, people in white coats studied for a very long time before making assignments. It is unlikely that two hours of studying the Internet has made you competitive with them.
What traditional medicine advises
In folk medicine, for the treatment of this infection, herbal preparations are used, including licorice root (by the way, doctors also pin certain hopes on it - it contains linoleic acid), kopeck, leuzea, alder cones, medicinal chamomile flowers and a series of. All this is infused in boiling water and taken four times a day.
Another collection - burnet root, thyme, string, wild rosemary, birch buds, yarrow. Herbs in equal proportions insist in boiling water for 12 hours and are recommended to be taken 3 times a day.
One more collection: lungwort, primrose roots, plantain leaves, violets, raspberries, string, nettle, birch, meadowsweet flowers, dill and wild rose. The mixture is infused in boiling water for 10 hours. Drink no more than one glass of infusion per day.
To increase and strengthen immunity, it is recommended to take infusions of ginseng, lemongrass, echinacea and leuzea. Tea with rose hips and an abundance of citrus fruits in the diet will enrich the body with vitamin C, which is useful for organizing immunity resistance to various infections.
Such vitamin green teas are unlikely to harm, but to add strength to the body, most likely, they will help.
What about prevention?
As already mentioned, cytomegaloviruses andother no less harmful pathogens are all around us. By itself, cytomegalovirus in our cells, when it is not active, does not pose a danger to us. But there is no way to get rid of it. There are no specific preventive measures for this infection. Vaccination has not yet been invented (many laboratories around the world are working in this direction, but there are no drugs certified by WHO yet), but no one has canceled the rules of personal hygiene. In addition, a strong immune system will protect the body from the invasion and spread of herpes viruses. A he althy lifestyle, a balanced vitamin diet, feasible physical activity - and the body will thank you with an increase in defense mechanisms.
Cytomegalovirus is a virus of paradoxes. He can be an invisible life partner and become a dangerous killer under certain conditions. Elimination of conditions favorable for the release of the virus from the underground is the main goal of preventive actions.
Separately, it is necessary to note preventive measures for those who are planning to have a baby. As you understand, once having been ill, you will forever remain a carrier of cytomegalovirus. But a double TORCH screening for pregnant women will help stop the development of infections and protect the unborn child.
It is unlikely that your newborn baby will be completely safe from this virus. But still, the later his body meets these pathogens, the more likely it is that the disease will go away in a mild form. May be notour grandmothers are so wrong when they say that it is impossible to show a baby to strangers, at least until a month of his life.
And finally, hygiene, hygiene, hygiene. Observe yourself and teach your children, because cleanliness is the key to he alth. Stay he althy!
