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) infection 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 pre-adolescents.