Cytomegalovirus seroprevalence and childhood sources of infection: A population-based study among pre-adolescents in the United States

Background: Among pre-adolescents, the importance of different sources of cytomegalovirus (CMV) infecrion is unclear. Objective: To assess the importance of several CMV sources among pre-adolescent children. Study design: We used data from a United States population-based sample conducted from 1988 to 1994: 4-10-year-old participants (n=3386) of the Third National Health and Nutrition Examination Survey. We tested available sera for CMV-specific-IgG and assessed CMV prevalence differences by surrogates for exposure to childhood CMV Sources (maternal CMV serostatus, breast-feeding, older sibling CMV serostatus, and child care center attendance). Results: CMV infection was more prevalent (70%) among Mexican American children with foreign-born householders than among children with native-born householders (31% non-Hispanic White, 39% non-Hispanic Black, and 37% Mexican American children). Child's serostatus was associated with their mother's (prevalence difference range (PDR)=33-40%) and older sibling's serostatus (PDR=39-50%). Breast-feeding was associated with CMV in some racial/ethnic and householder groups (PDR=-5.1% to 22.7%). There was little difference in CMV seroprevalence by child care center attendance (PDR = -6.5% to -0.4%). Conclusions: This study expands understanding of CMV by identifying the importance of householder nativity and demonstrating the importance of family transmission among the general population of preadolescents. (C) 2008 Elsevier B.V. All rights reserved.