Ignored virus in pregnant mothers has serious effects

Jenipher had never heard of cytomegalovirus until she gave birth to her third child in Kisumu last week.

The baby was blind and researchers from the Kenya Medical Research Institute (Kemri) said congenital cytomegalovirus (CMV) which is prevalent in western Kenya was to blame.

The virus had passed from the mother, who had exhibited neither signs or symptoms, to her unborn baby through the placenta.

CMV contributes to neurological and sensory impairments or even infant death.

The infection can also cause developmental delays and mild cerebral palsy. It can be severe and life-threatening in people with compromised immunity such as those with HIV.

In most cases people carry the virus unknowingly, but this ignorance can have effects on babies, starting from when they are in the womb. While CMV is a relatively rare condition, it is also the most common infectious cause of disability in newborns. Yet pregnant women are not routinely warned about their risk of contracting the herpes-type virus and passing it on to their babies. In Nyanza, CMV prevalence is high because of the high rate of HIV in the region.

“Research has shown that people who are immuno-compromised like HIV-positive mothers are more likely to acquire CMV infection and are more likely to transmit it to unborn babies” said Dr Nancy Otieno who researches on infectious diseases at the Kenya Medical Research Institute (Kemri).

Cancer patients and organ transplant recipients are also at risk of serious CMV complications.

In healthy people, it causes a mild flu-like illness that lasts a few days or weeks. However, in susceptible people, such as those with suppressed immunity or unborn babies, CMV can be a dangerous infection.

STUDY

Signs and symptoms of babies with congenital CMV include premature birth, low birth weight, yellow skin and eyes (jaundice), enlarged and poorly functioning liver, purple skin splotches or a rash or both, abnormally small head (microencephaly), enlarged spleen and pneumonia.

According to a Kemri study that began in 2015, many women suffer from the infection without their knowledge. Of 2,000 mothers enrolled for the study, 90 per cent tested positive for the virus, even though they were asymptomatic.

Tests and dry blood spot specimens were also taken from their two-week-old babies and tested for the virus. The children will be monitored for up to two years to track their growth and development to identify the impact the virus might have on them. The study is in its final stage and findings will be released in a year.

In many countries, CMV prevalence stands at two per cent, while in Kenya it is four per cent. Infants born to mothers with HIV have a prevalence of five per cent.

“These are the world’s highest prevalence rates, given that other countries have in the past recorded prevalence rates of two per cent,” said Dr Otieno, the principal investigator.

The study will contribute to the body of knowledge on CMV and create awareness about the disease in Kenya.

Currently, little or no attention is given to CMV, a fatal infection that people live with without intervention from the public health system.

“Most of the mothers are treated for other illnesses and not CMV since the testing equipment is not easily available.

We don’t have treatment guidelines and equipment because nobody talks about the infection that is fatal in infants, more so in regions with high HIV prevalence. Testing equipment is only available in bigger hospitals such as Aga Khan and Avenue, and the tests are very expensive.

“Initially we (Kemri) did not have the equipment as well and had to send the specimens abroad, but because of the research we have acquired one,” Dr Otieno told Healthy Nation, adding that pregnant women and healthcare providers should be educated about CMV and how to prevent it.

“CMV serology testing should also be offered to women who develop flu-like symptoms and those who test positive should get regular check-ups to manage the virus.