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* Transmission is caused by oral, anal, or genital contact including - intercourse, kissing, or any direct skin-to-skin contact which allows for the transfer of bodily fluids.
* A person is considered contagious when these symptoms are present - active sores, and healing lesions.
* Herpes is still contagious when no symptoms are present. A person who has genital herpes is potentially always shedding the active virus.
* Some people do not get typical blister-like sores but they harbor active virus in their saliva, vaginal, or penile secretions, and can shed the virus without knowing they have herpes.
* Lesions can occur deep inside the vagina where they cannot be seen or felt, but can transmit the virus.
* Oral herpes can be transmitted to the genitals, and vice versa. Symptoms are similar.
* Auto-inoculation - An infected individual can spread the virus to other parts of there body by touching an area shedding virus and then touching, scratching, or rubbing another susceptible part of the body.
* Towels are especially conducive for herpes transmission.

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Babies. Babies infected before birth who become sick with CMV have symptoms affecting many major organs including the liver, brain, eyes, and lungs. The baby may suffer from convulsions, lethargy, a rash that looks like tiny red pinpoints on the skin, and breathing problems. Surviving babies often have such permanent damage as mental retardation, small brain or water on the brain (micro- or hydrocephalus), hearing loss, eye inflammations, poor coordination, and liver disease.

Children. Young children have few, if any symptoms. They may experience a mild cold- or flulike illness with fever, but you can’t tell it apart from any other mild viral illness.

Adults. Very few adults, including pregnant women, have any symptoms. Symptoms will be so mild—achiness, a low fever, sore throat—that you won’t be aware you are sick.

Tests

Because the virus is excreted in blood, urine, saliva, cervical secretions, and breast milk, CMV can be grown in any of these samples. It is not difficult to grow the virus, and the test is available in most large hospital and commercial labs. The virus grows slowly, however, and you may wait from two to six weeks for results.

You can also have your blood tested for the CMV antibody. If you have the antibody, you’ve been previously infected with CMV, but this test won’t tell whether the virus is present in your blood, urine, or saliva.

Newborns with possible congenital CMV infection must have virus cultured from their urine, nose, eyes, or spinal fluid to confirm CMV as the cause of illness.

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You catch CMV from close, intimate contact with infected urine; saliva; respiratory, vaginal, or cervical secretions; breast milk; or semen. It can be sexually transmitted, but most people get CMV through close household contact. Poor people are much more likely to be infected as young children, probably because they live in crowded conditions.

Babies get it from their mothers before birth, during delivery, or in the first few weeks of life. The baby is infected during pregnancy if its mother has either a first-time CMV infection or a reactivation of a past one.

Women who have toddlers attending child care are often infected. CMV transmission is rapid in these places because urine and saliva are passed from child to child on dirty hands. Young children rarely have symptoms, but they excrete the virus in their urine and saliva for months to years. Anyone working in child care or in any area with lots of young diapered children is exposed to CMV.
It is often transmitted from blood transfusions because so many people, including blood donors, have CMV infections with no symptoms.

Most people are infected with CMV before they reach adulthood, but very few people experience any symptoms or signs of illness. People with AIDS and organ transplant recipients are at highest risk for serious CMV infection—either pneumonia or retinitis, an eye infection. Often, their own latent CMV infections will reactivate as their immune systems either weaken or are suppressed by drugs to prevent organ rejection.

People who need organ transplants are tested for antibodies to CMV. Doctors will try to match CMV-negative organ donors to CMV-negative organ recipients. But a match isn’t always possible and the CMV-negative organ recipient faces a risk of serious CMV infection from the transplanted organ weeks to months later. To prevent this, the doctor will give the transplant recipient an injection of CMV antibody.

CMV-negative organ recipients who need blood transfusions will receive CMV-negative blood. This blood is hard to come by and is saved for people who really need it. If no CMV-negative blood is available, the blood can be filtered to remove the cells containing CMV. Otherwise, transplant patients may become ill if they receive CMV-infected blood.

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