CMV is a virus with which most people eventually become infected. Children and staff in the childcare setting are especially likely to be infected. Children usually have no symptoms when they become infected with CMV. Occasionally, older children in childcare usually will develop an illness similar to mononucleosis, with a fever, sore throat, enlarged liver, and malaise. However, there is no reason to exclude a child excreting CMV from childcare.

CMV is spread from person to person by direct contact with body fluids such as blood, urine, or saliva. Thus, it may be spread through intimate contact such as in diaper changing, kissing, feeding, bathing, and other activities where a healthy person comes in contact with the urine or saliva of an infected person. CMV can also be passed from the mother to the child before birth. Congenital infection with CMV can cause hearing loss, mental retardation, and other birth defects. Since the greatest risk of damage to a fetus occurs during a woman's first infection with CMV, women who have never been infected with CMV are at risk of delivering an infant with CMV disease if they become infected during pregnancy. Childcare providers who are or may become pregnant should be carefully counseled about the potential risks to a developing fetus due to exposure to cytomegalovirus.

Female childcare providers who expect to become pregnant should:

·Be tested for antibodies to CMV.

·If test shows no evidence of previous CMV infection, reduce contact with infected children by working, at least temporarily, with children age 2 years or older, among whom there is far less virus circulation.

·Carefully wash their hands with warm water and soap after each diaper change and contact with children's saliva.

·Avoid contact with children's saliva by not kissing children on the lips and by not placing children's hands, fingers, toys, and other saliva-laden objects in their own mouths.

Note: Contact with children that does not involve exposure to saliva or urine poses no risk to a mother or child care provider and should not be avoided out of fear of potential infection with CMV.

© January 1997