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Cytomegalovirus transmission in a Midwest day care center: possible relationship to child care practices
Insights
Cytomegalovirus (CMV) infection is common in Iowa day care centers, especially among toddlers. Child care practices may facilitate CMV spread, posing a risk to unvaccinated adults.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Cytomegalovirus (CMV) is a common virus with significant public health implications.
- Day care centers are known environments for infectious disease transmission among young children.
Purpose of the Study:
- To investigate the epidemiology of cytomegalovirus (CMV) infection and transmission.
- To assess CMV prevalence and identify transmission patterns in a large Iowa day care setting.
Main Methods:
- Conducted a 9-month epidemiological study in a large Iowa day care center.
- Measured CMV prevalence and viral titers in children's urine and saliva.
- Utilized restriction enzyme analysis to characterize CMV isolates.
Main Results:
- Overall CMV prevalence ranged from 21% to 22%, reaching 71% in toddlers.
- High CMV titers (up to 3 x 10(4) PFU/mL) were observed in infected children.
- Restriction enzyme analysis revealed two distinct CMV isolate clusters, suggesting transmission within age groups.
Conclusions:
- Child care and hygiene practices likely contribute to CMV spread in day care centers.
- High CMV excretion rates and low adult seropositivity in Iowa indicate a risk of primary CMV infection for Midwest adults interacting with children.
Abstract:
The epidemiology of cytomegalovirus (CMV) infection and transmission in a large Iowa day care center was studied. Over the 9 months of the study the overall CMV prevalence rates were 21% to 22%, with rates as high as 71% in toddlers. Titers of CMV in the urine or saliva of infected children were as high as 3 X 10(4) plaque-forming units of CMV per milliliter, similar to titers of CMV observed in some congenitally infected infants. Restriction enzyme analysis of CMV isolates from children in the center demonstrated two major clusters with similar patterns, one among 2- and 3-year-old children and another among infants. The clustering of similar CMV isolates among nonambulatory infants suggests that child care or hygienic practices may contribute to the spread of CMV infection in day care centers. Furthermore, the relatively high prevalence of CMV excretion in this center and the low seropositivity rates to CMV among adults in Iowa suggest that adults in the Midwest who have contact with children in day care centers may be at risk for primary CMV infection.