By Prim. Univ.-Prof. Dr. Gabriele Halwachs-Baumann MSc, MBA (eds.)
Congenital cytomegalovirus (CMV) an infection is the most typical intrauterine transmitted viral an infection, with a massive effect on fetuses and newborns. during this publication the heritage of this sickness, its pathophysiological historical past, epidemiology and indicators, in addition to diagnostic and healing ideas, can be mentioned. seeing that financial features are gaining increasingly more value in health and wellbeing politics, one bankruptcy is devoted to this factor within the context of congenital CMV an infection. The content material is predicated at the newest clinical findings and written in an comprehensible demeanour, permitting folks no longer operating within the box of congenital CMV to additionally benefit from it. therefore, this booklet is of curiosity for doctors, nurses, midwives, economists, but in addition for women and men who are looking to tell themselves approximately this topic.
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Additional resources for Congenital Cytomegalovirus Infection: Epidemiology, Diagnosis, Therapy
As mentioned above, there is a common sequence of processes that serve as the foundation for all viral infection. First, the infecting virus must migrate to the primary site of infection. In the case of CMV this host–host transmission is done by contact of mucosal secretions containing infectious virus of one person with the respiratory, gastrointestinal or genitourinary tract of another person. In this context the salivary gland seems to be one major site of CMV harbourage [36–38], and it could be presumed to be one predominant portal for virus entry.
Sinzger et al.  assumed a tempting scenario where monocytes rolling along the vascular endothelium take up infectious virus from productively infected endothelial cells at one site of the body, diﬀerentiate upon transmigration through an activated endothelial layer at a diﬀerent site of the body, and release virus progeny into the corresponding organ after maturation into tissue macrophages. This hypothesis might reﬂect one possibility of virus spread during active primary infection. Monocytes might play a role not only in virus spread during primary infection, but also in the case of reactivation of CMV in seropositive individuals.
In parallel to the increase in fetal IgG levels maternal levels of IgG and IgA decrease throughout pregnancy to a level of 60–70 % of the initial concentration in early pregnancy . From the IgG subclasses IgG1 is the predominant immunoglobulin in the fetal circulation, followed by IgG4 and IgG3. IgG2 has a slow linear rise throughout pregnancy, but fetal IgG2 levels remain signiﬁcantly below maternal concentrations . 2 The host 33 In contrast to normal pregnancies, where mainly IgG passes through the placental barrier (to a lower extent IgA is transported, and there is no transport of IgM), in moderate inﬂammation transport of IgG and IgA, and to a lesser degree IgM, increases.