Although some of these diseases are less well-known in the United States than other STDs, they are still important -- some are especially significant for pregnant women. Many of these infections are of serious concern for people in other parts of the world, particularly in developing countries.
SymptomsIn healthy adults, CMV usually produces no symptoms of infection. Occasionally, however, mild symptoms of swollen lymph glands, fever, and fatigue may occur. These symptoms may be similar to those of infectious mononucleosis.
DiagnosisThe ELISA (enzyme-linked immunosorbent assay) test is commonly used to detect levels of antibodies (disease-fighting proteins of the immune system) in the blood. A number of other blood tests can suggest a diagnosis of CMV infection, but no blood test can reliably diagnose it. Although CMV can be isolated from urine or other body fluids, it may be excreted months or years after an infection; therefore, isolation of the virus from these fluids is not a reliable method of diagnosing recent infection.
ComplicationsBabies can be infected with CMV in the uterus if their mothers become infected with the virus or develop a recurrence of a previous infection during pregnancy. Although most babies infected with CMV before birth do not develop any symptoms, CMV is the leading cause of congenital infection in the United States. An estimated 6,000 babies each year develop life-threatening complications of congenital CMV infection at birth or suffer serious consequences later in life, including mental retardation, blindness, deafness, or epilepsy. Investigators supported by NIAID are currently studying how the virus interferes with normal fetal development and at which stages the fetus is most susceptible to infection. Congenital CMV is the most common cause of progressive deafness in children. When CMV is acquired after birth, or if it reactivates, it can be life-threatening for persons with suppressed immune systems, such as those receiving chemotherapy or persons who have received immunosuppressant drugs for organ transplantation. Persons with HIV infection or AIDS may develop severe CMV infections, including CMV retinitis, an eye disease that can lead to blindness.
TreatmentNIAID scientists are testing new antiviral drugs that might be effective against CMV infections. The antiviral drugs foscarnet and ganciclovir have been approved for treating people with AIDS-associated CMV retinitis.
PreventionThere is no intervention to prevent CMV. Use of the male condom may reduce risk although virus in the saliva would be transmitted by kissing or oral intercourse. Some experts believe that primary or first-time exposure during pregnancy is a major cause of CMV infection in newborns. Infants infected before or just after birth are likely to be shedding CMV in saliva and urine, which can infect others. Hand washing and proper handling of diapers may reduce risk. Scientists are working to develop a vaccine and other methods to provide immunity to CMV and offer protection against severe disease.
SymptomsThe primary symptom of infestation is itching in the pubic area. Scratching may spread the lice to other parts of the body; thus, every effort should be made to avoid touching the infected area, although this may be difficult.
DiagnosisPubic lice are diagnosed easily because they are visible to the naked eye. They are pinhead size, oval in shape, and grayish, but appear reddish-brown when full of blood from their host. Nits, the tiny white eggs, also are visible and usually are observed clinging to the base of pubic hair.
TreatmentLotions and shampoos that will kill pubic lice are available both over the counter and by prescription. Creams or lotions containing lindane, a powerful pesticide, are most frequently prescribed for the treatment of pubic lice. Pregnant women may be advised not to use this drug, and a physician's recommendations for use in infants and small children should be followed carefully. Itching may persist even after the lice have been eradicated. This is because the skin has been irritated and requires time to heal. A soothing lotion such as calamine may offer temporary relief.
PreventionAll persons with whom an infested individual has come into close contact, including family and close friends as well as sex partners, should be treated to ensure that the lice have been eliminated. In addition, all clothing and bedding should be dry-cleaned or washed in very hot water (125° F), dried at a high setting, and ironed to rid them of any lice. Pubic lice die within 24 hours of being separated from the body. Because the eggs may live up to six days, it is important to apply the treatment for the full time recommended.
SymptomsScabies causes intense itching, which often becomes worse at night. Small red bumps or lines appear on the body at sites where the female scabies mite has burrowed into the skin to lay her eggs. The areas most commonly affected include the hands (especially between the fingers), wrists, elbows, lower abdomen, and genitals. The skin reaction may not develop until a month or more after infestation. During this time, a person may pass the disease unknowingly to a sex partner or to another person with whom he or she has close contact.
DiagnosisScabies may be confused with other skin irritations such as poison ivy or eczema. To make an accurate diagnosis, a doctor takes a scraping of the irritated area and examines it under a microscope, to reveal the presence of the mite.
TreatmentAs with pubic lice, lindane is an effective treatment for scabies. Pregnant women should consult a doctor before using this product. Nonprescription remedies such as sulfur ointment also are available. Sulfur is fairly effective but may be objectionable because of its odor and messiness. Itching can persist even after the infestation has been eliminated because of lingering skin irritation. A hydrocortisone cream or ointment or a soothing lotion may provide relief from itching.
PreventionFamily members and sex partners of a person with scabies are advised to undergo treatment. Twenty-four hours after drug therapy, a person with scabies infestation is no longer contagious to others, even though the skin irritation may persist for some time. As with pubic lice, special care must be taken to rid clothing and bedding of any mites.
ResearchSTD research that is supported and conducted by NIAID will help in the search for new ways to diagnose, treat, and prevent these infections. This is important not only for the well-being of our adult population but also for the health of future generations.
This article was provided by U.S. National Institute of Allergy and Infectious Diseases.