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Cytomegalovirus reinfection in young children
J F Bale1, S J Petheram, I E Souza
1Department of Pediatrics, University of Iowa College of Medicine, Iowa City, USA.
Insights
Children in group child care settings are at risk of repeated cytomegalovirus (CMV) infections. Analysis confirmed reinfection with new CMV strains in a significant percentage of young children.
Area of Science:
- Virology
- Pediatrics
- Infectious Diseases
Background:
- Cytomegalovirus (CMV) is a common virus with potential for reinfection.
- Group child-care environments facilitate the transmission of infectious agents among young children.
Purpose of the Study:
- To investigate the incidence of reinfection with novel cytomegalovirus (CMV) strains in children attending group child-care facilities.
- To understand the dynamics of CMV strain diversity in pediatric populations within communal care settings.
Main Methods:
- Analysis of 92 serial cytomegalovirus (CMV) isolates from 37 children (aged 8 months to 5 years 7 months) in child care centers (1986-1994).
- Utilized polymerase chain reaction (PCR) with primers for CMV a-sequence, glycoprotein B, and major immediate early (MIE) genes.
- Compared PCR products using size analysis and restriction fragment length polymorphisms to differentiate strains.
Main Results:
- At least 7 (19%) of the 37 children showed evidence of infection with multiple CMV strains.
- Reinfection with distinct CMV strains was confirmed in six children through MIE gene analysis of sequential isolates.
- Isolation intervals ranged from 11 weeks to over 3 years, with 2 to 6 isolates per child.
Conclusions:
- Children in group child care are susceptible to reinfection with different cytomegalovirus (CMV) strains.
- This risk of reinfection is comparable to that observed in immunocompromised adults or those with multiple sexual partners.
- Highlights the importance of understanding CMV transmission dynamics in pediatric populations.
Objective:
To determine the frequency of reinfection with new cytomegalovirus (CMV) strains in children in group child-care environments.
Methods:
Ninety-two CMV strains isolated serially from children attending child care centers were analyzed. Strains were obtained from 1986 to 1994, from 37 children attending one of six centers in the area of Cedar Rapids and Iowa City, Iowa. The CMV isolates were analyzed by a polymerase chain reaction-based algorithm using primers for the a-sequence, glycoprotein B, and major immediate early (MIE) genes of human CMV. The a-sequence polymerase chain reaction products were compared on the basis of size, and products derived from glycoprotein B and MIE genes were compared according to restriction fragment length polymorphisms.
Results:
Children were between 8 months and 5 years 7 months of age at the time of CMV isolation. The number of isolates ranged from 2 to 6 per child, and the intervals between the first and last CMV isolation ranged from 11 weeks to more than 3 years. At least 7 (19%) of the 37 children had evidence of infection with more than one CMV strain. In six of these children, reinfection with distinct strains was confirmed by analysis of the MIE gene products of sequential CMV strains.
Conclusions:
Children who attend child care centers, like adults who are immunosuppressed or have multiple sexual partners, are at risk of being reinfected with distinct CMV strains.