With no vaccine available, early detection, hygiene practices, and public education are vital to prevent long-term disabilities caused by Human Cytomegalovirus in Kashmir’s children
Dr Umer Majeed Khaja
While the birth of a child is a moment of joy for families across Kashmir, a largely unrecognised viral infection—Human Cytomegalovirus (CMV)—continues to pose a silent threat to newborn health. CMV is a common virus worldwide and usually causes mild or no illness in healthy adults. However, when transmitted from a pregnant woman to her unborn child, it can result in congenital CMV infection, which is a leading cause of childhood hearing loss and neurodevelopmental disability.
In India, CMV infection is widespread, with studies showing that a significant proportion of women of reproductive age have been exposed to the virus. Available data suggest that these trends are likely similar in Kashmir. A preliminary seroprevalence study conducted in the Kashmir Valley reported evidence of recent CMV infection among pregnant women, highlighting the potential risk of transmission to the fetus. Nationally, congenital CMV infection is estimated to occur in up to 2 per cent of live births, with a subset of affected infants developing serious long-term complications.
Why CMV Matters
Most adults infected with CMV experience either no symptoms or mild, flu-like illness. In contrast, newborns infected before birth may face serious consequences. Although the majority of babies with congenital CMV appear healthy at birth, many later develop sensorineural hearing loss, the most common long-term outcome. Others may experience vision problems, developmental delay, or neurological impairment. Infants who show symptoms at birth—such as jaundice, enlarged liver or spleen, low platelet counts, or breathing difficulties—are at particularly high risk of severe outcomes.
How CMV Spreads
CMV is transmitted through direct contact with bodily fluids, including saliva, urine, blood, and breast milk. Pregnant women may acquire the infection through close contact with young children, especially during activities such as feeding, changing diapers, or sharing utensils. Primary infection during pregnancy carries a higher risk of fetal transmission than reactivation of a previous infection.
Risk Factors InThe Region
Pregnancy itself is a key risk period for CMV transmission. Young mothers, women with frequent exposure to young children, and those from densely populated or resource-limited settings may be at increased risk. Studies from India have also highlighted CMV-associated complications such as preterm labour and fetal distress, underscoring the need for greater vigilance during pregnancy.
Prevention Through Awareness
At present, there is no licensed vaccine for CMV. While complete prevention is not always possible, simple hygiene measures can reduce the risk of infection, particularly during pregnancy. These include regular handwashing after contact with young children, avoiding sharing food or utensils, and minimising exposure to saliva and urine. Awareness and counselling of pregnant women remain practical and achievable strategies to lower the risk of congenital CMV infection.
Diagnosis And Treatment
Congenital CMV can be diagnosed by detecting viral DNA in urine or saliva samples of newborns using molecular tests. Early diagnosis is crucial, as antiviral treatment in symptomatic infants has been shown to reduce the progression of hearing loss when initiated promptly. Long-term follow-up, particularly hearing assessment, remains essential for affected children.
Local Efforts AndTheWay Forward InKashmir
The Department of Microbiology at Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, is making efforts to strengthen laboratory-based detection of congenital Cytomegalovirus to enable early clinical assessment in newborns. Awareness of CMV remains low among the general population and pregnant women, and the infection is often under-recognised in routine healthcare. To address this gap, an Indian Council of Medical Research (ICMR)–funded study is underway to screen large numbers of neonates using real-time PCR on urine samples collected through filter paper cards, a feasible and cost-effective approach. This initiative aims to generate reliable epidemiological data on the burden of congenital CMV in the Kashmir Valley and support the integration of CMV screening and awareness into maternal and child health programs.
A Call For Public Awareness
CMV remains underdiagnosed and under-recognised, despite its significant impact on child health. Routine counselling during pregnancy, improved hygiene awareness, and early newborn screening can help reduce the burden of congenital CMV in Kashmir. Increased public and professional awareness is a crucial first step toward protecting the hearing, development, and future well-being of our children.
The writer is a molecular biologist and is currently working as a Research Scientist at the Department of Microbiology, SKIMS Srinagar
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