Water sports, safe or not?
Oct 3, 2006
In a past "ask the experts" someone had asked if water sports were safe. You responded (and I am paraphrasing) that urine was sterile and could not transmit std's. I have since read and discussed with my MD, that CMV is often cultured from urine. Perhaps for someone with a stable immune system this may not be a problem but, couldn't it be a problem for a person that has no immune system?
Response from Dr. Frascino
You are correct: CMV can be transmitted via urine (saliva and breast milk, too, by the way), if the infected fluids come into contact with mucous membranes (not intact skin). CMV infection can cause a mono-like illness that usually resolves spontaneously. Generally CMV is harmless, except in selected populations, such as pregnant women (it can have an affect on fetuses) and those with severely compromised immune systems (organ-transplant recipients, people with advanced-stage AIDS, etc.).
So to directly respond to your question, yes, CMV can be a problem in someone with severe immunodeficiency. I'll post a question from the archives that gives additional information about the CMV risk to HIV-positive folks.
CMV prevention for newly pos. NICU RN
Oct 31, 2005
Thank you so much for being such a great source for questions! I'm a 29 y/o male and have been working as an RN in the NICU for 3 years. Last month I tested positive for HIV. I've been using this site to gather data to back-up my beliefs that unprotected sex between two positive men is still dangerous and irresponsible. It's been determined that I've most suredly got a naive and non-virulent version of this little b#sta%d. In doing my research, I was reminded that CMV, though only a mere nuisance to the non-immunocompromised adult population, may be a significant problem for myself. I am aware that, as a nurse in the NICU, I am at increased risk for contracting CMV. I am also of the understanding that simple universal precautions are sufficient enough to prevent infection of this virus. One of the things that has help me psycho-socially in the past weeks since my diagnosis is that I work in an environment that is not contraindicated to me giving patient care. My babies are all safe from me. The support that I have recieved from my Unit managers and co-workers who I have decided to confide in has been tremendously empowering. This is my family here at work and I don't plan on going anywhere else. So my question is...Am I safe from my babies?
Response from Dr. Frascino
Sorry to hear about your recent HIV diagnosis. Are you under the care of an HIV/AIDS specialist? If not, you should consult a competent HIV/AIDS specialist at your earliest convenience. That specialist will give you very specific advice, not only regarding CMV, but also on a wide range of other issues as well. Regarding CMV, the virus is extremely common. Most epidemiological studies indicate that 50%-85% of the U.S. population tests positive for CMV (past infection) by they time they are 40. A healthy immune system generally keeps this virus in check. Your HIV/AIDS specialist will check the health of your immune system (CD4 cell count, etc.) and also determine if you've been exposed to CMV ("CMV IgG" test). CMV is a member of the herpes virus family and is found in saliva, urine, semen and cervical secretions. It can be spread by sexual contact. It can also be easily spread by other forms of physical contact. If you are CMV-IgG negative and work with infants or young children, the precautions to avoid infection include:
1. thorough hand washing after contact with urine or saliva and
2. avoiding oral contact with saliva or objects covered in saliva.
I am glad your coworker and unit managers are supportive. I am a Board Certified Pediatrician a career path I followed prior to continuing on with my postdoctoral studies in the field of Adult and Pediatric Clinical Immunology, Allergy and Asthma and subsequently moving into the field of HIV medicine. I have many vivid memories of long nights in the NICU (Neonatal Intensive Care Unit). NICUs are unique wards that require dedicated and compassionate RNs. Thank you for your service to these struggling infants!
Good luck. Stay well.
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