Cytomegalovirus and Epstein-Barr virus infections

• On the basis of strong research evidence, congenital cytomegalovirus (cCMV) infection is a leading cause of sensorineural hearing loss (SNHL) and neurologic disabilities in children worldwide. Infants with symptomatic and asymptomatic infection are at risk of developing SNHL. Confirmation of cCMV is by isolation of the virus in saliva or urine by culture or polymerase chain reaction. (3)(4)(5) • On the basis of strong research evidence, postnatal CMV infection acquired through consumption of human milk is clinically relevant in extremely preterm infants. However, the benefit of withholding or pasteurizing human milk to prevent postnatal CMV infection has not been determined. (6) • On the basis of strong research evidence, antiviral treatment improves hearing outcome in children with symptomatic cCMV. (2)(7) • On the basis of expert opinion consensus, antiviral therapy is not recommended for infants with asymptomatic cCMV. • Epstein-Barr virus is a ubiquitous virus that causes a wide spectrum of illnesses ranging from infectious mononucleosis in young adults to lymphoproliferative disorders in the immunocompromised host and several malignancies. • On the basis of strong research evidence, management of infectious mononucleosis predominantly involves supportive therapy, with no clear benefit demonstrated with use of corticosteroids or antiviral therapy. (8)(9).