Cytomegalovirus (CMV) in early childhood education and care services

Cytomegalovirus (CMV) is a common viral infection that affects many people.

This page has information about the risks of CMV infection in childcare facilities and the steps you can take to stay safe.

What is CMV?

CMV is a common viral infection that affects many people.

The first time that a person is infected with CMV is called a primary infection. After a primary infection, the virus can live in the body in an inactive or dormant state. It can periodically become active again causing a reactivation of infection. This may occur when a person becomes ill or stressed. A previously infected person can also be infected with a different strain of CMV, and this is called a reinfection.

How is it spread?

CMV is spread occupationally from person-to-person by contact with body substances, including urine and saliva. An infected person can pass the virus to another person even though they do not have symptoms.

CMV can also be transmitted from a mother to her baby during pregnancy. This is called congenital infection.

Who is at risk from infection?

People who have occupational contact with young children, in particular:

workers in early childhood education and care services
health care workers caring for infants and children
patients whose immune system is impaired.

The health effects

CMV infection does not usually cause illness in healthy people, and people may be unaware that they have been infected. Occasionally it causes a flu-like illness with fever, sore throat and swollen glands. CMV infection can however cause serious illness in people who have an impaired immune system.

CMV and pregnancy

The most severe form of congenital CMV infection generally occurs in infants born to mothers who became infected for the first time while pregnant. A small number of babies who have been infected with CMV during pregnancy have symptoms at birth. Many of these infants will have lifelong disabilities of varying degrees. The majority of infants who have been infected with CMV during pregnancy do not have symptoms at birth. However, some of these children may develop disabilities later in childhood, such as hearing loss, learning difficulties and developmental delay.

Women working in early childhood education and care services who are pregnant, or expect to become pregnant, should discuss CMV with their doctor, and inform their employer so that their individual risk can be assessed and managed.

In a landmark decision in NSW, a childcare worker and her severely disabled son were awarded $4.65 million. A Court of Appeal ruled that the child's disabilities resulted from the woman being infected with cytomegalovirus (CMV) at work (Hughes v SDN Children's Services 2002).

How to prevent infection

There is currently no vaccine to prevent against infection with CMV. Good hygiene practices, including hand hygiene, are the most important way to prevent CMV infection.

CMV infections are common among children attending early childhood education and care services, but most children will not have symptoms and their infection will be unknown. Children known to have CMV do not need to be excluded from the service because the virus may persist in their urine and saliva for months to years.

The occupational risks of CMV infection in childcare facilities should be managed using a risk management approach, as outlined in the How to manage work health and safety risks code of practice 2021 (PDF, 0.65 MB).

Control measures may include:

installing hand washing facilities close to nappy changing areas
washing hands frequently, especially after contact with urine and saliva and after removing disposable gloves
using disposable hand wipes or alcohol-based hand rub for situations where hand washing facilities are not readily available
covering cuts with water-resistant dressings
using disposable gloves for activities that involve contact with urine and saliva
providing information to workers about CMV risks and work practices to reduce the risk of infection
purchasing equipment and toys that are easily cleaned
instructing workers not to kiss children on the mouth and face
implementing cleaning programs for surfaces and items that are soiled with urine and saliva, including nappy change mats, potties, feeding utensils and toys
implementing procedures for hygienic nappy changing and the storage and disposal of soiled nappies
taking steps to prevent urine from spraying into the face of workers if infants pass urine during nappy changing (especially infant boys)
implementing laundry procedures for linen that is soiled with urine and saliva, e.g. make sure that soiled personal clothing and linen are placed in a sealed bag and sent home with the child for washing
implementing procedures for cleaning up accidental spills of urine that could occur during toilet training
relocating workers who are pregnant, or who expect to become pregnant, to care for children aged over two to reduce contact with urine and saliva.