Public health concern from CMV in daycare centers

Cytomegalovirus infection did not appear to cause illness in the children; investigators who studied large numbers of young children who acquired CMV in day-care centers did not identify symptomatic infections (Adler, 1988a; Pass,

1990). However, the fact that CMV infection and shedding of virus were so common in children in day-care centers raised concern about the possibility that they would transmit virus to their caregivers (mothers and day-care workers), who were mostly women of childbearing age, and that increased CMV infection rates in these young women would result in increased occurrence of congenital CMV infection. A markedly increased rate of CMV infection was found in parents of children in day care compared with parents of children in home care, and infection in the parents was clearly related to whether or not their toddler was shedding CMV (Pass et al., 1986). As with child-to-child transmission, RFLP analysis confirmed transmission of CMV from children who acquired virus in day care to parents (Adler, 1986). Subsequent studies showed that day-care workers had increased rates of CMV infection ranging from around 8 percent to 20 percent per year, compared with a rate of around 2 percent in other adults (Adler, 1989; Pass et al., 1990; Murph et al., 1991). In addition, study of CMV infection in day-care workers and RFLP analysis of viral DNA from CMV isolated from children and workers showed that the children were the source of virus for the day-care workers (Adler, 1988b). The connection between day-care center CMV infections and congenital infection was confirmed in family studies that used RFLP analysis of CMV DNA to demonstrate that a child who acquired CMV in day care transmitted virus to its mother, and that this virus was transmitted transplacentally to a fetus (Pass et al., 1987).

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