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- CMV is so good at evading the immune system that it can “superinfect”, where an individual who is already latently infected develops a second primary infection. This is quite unusual for a virus. In the case of CMV, superinfection depends on its ability to evade the response of CD8+ T-cells (18). The possibility of superinfection is a discouraging sign for vaccine development, since it indicates that the normal immune response is inadequate to prevent CMV infection.
- Interestingly, it’s been hypothesized that romantic kissing evolved as a method to reduce congenital CMV by ensuring that the mother was infected prior to pregnancy, rather than during pregnancy (21). I don’t know if this has any evidence, but it seems plausible. Overall I would still recommend trying to avoid CMV exposure prior to pregancy.
I know CMV only in the context of transplant medicine. I don't know of another pathogen that gets the same kind of respect and trepidation that this particular bug does, mainly because of how pernicious it is and how it can ruin otherwise wildly successful transplant outcomes months to YEARS after the fact. I am grateful that we are learning more about it so that we can develop counter protocols. I fear though that like with many diseases our ability to eliminate it or not will not be based on technology but on our willingness to apply such.