As summer fades into memory and winter encroaches, public prudence about the Zika virus is likewise evaporating. Last week, however, the New York Times ran a feature piece on another equally terrifying maternal infection: CMV, or cytomegalovirus. “CMV Is a Greater Threat to Infants Than Zika, but Far Less Often Discussed,” stated the headline of the Times piece, which detailed how a pregnant mother could catch the virus from a toddler in day care, causing birth defects such as deafness and microcephaly in her unborn child. CMV is undoubtedly scary, and Times’ reporting on affected mothers and children is heartbreaking. But it’s good to remember that CMV is—unlike Zika—a maternal health concern that’s been around for a long time and, sadly, just one of a handful of nasty infections you don’t want to catch in pregnancy.
CMV is part of a posse of contagions called the TORCH infections; TORCH is an acronym for toxoplasmosis, “other” (including syphilis), rubella, CMV, and herpes. These are diseases that, when acquired in utero or during the birth process, can cause significant harm to the fetus or neonate. Toxoplasmosis, which can be acquired through exposure to cat litter, can have dire effects similar to CMV, such as microcephaly and intrauterine growth restriction; herpes can cause congenital abnormalities and preterm birth.
Of course, there are vaccines for diseases such as rubella and chicken pox, both of which should be administered before or after pregnancy. Likewise there are preventive measures women can take against STDs. CMV is different because it’s a typical, even run-of-the-mill viral infection that most people come into contact with throughout their lives. You can’t get a shot or use a condom to protect yourself. For many of us, CMV presents with a mild fever, sore throat, fatigue—the symptoms of a cold, in other words, or simply the symptoms of feeling run-down during pregnancy. What’s also scary is that usually after a viral infection, your body develops immunity against the virus and cannot be reinfected with the same strain. With CMV, just because you’ve had it in the past does not mean your fetus is protected.
There’s also the issue of late diagnosis, and this goes for several of these TORCH infections: By the time the fetus is diagnosed with any major abnormalities such as microcephaly, women are well into their second trimesters and nearing the legal limit for most abortion procedures. This presents an entirely new and complex challenge wherein expectant parents are grieving the loss of a healthy baby, but also in a time crunch to decide what is best for their families.
So what’s a pregnant woman to do? It’s not feasible to fret your way through pregnancy or envelop yourself in protective gear for nine months. The only answer—and it’s an incomplete one—is perspective. Take whatever precautions you can, which amount to lots of hand-washing and avoiding contact with sick people. And remember that the chances of becoming infected with CMV and passing it onto your fetus is around 1 percent. That number is a lot scarier than Zika odds, but it’s still reassuringly low.
