Cytomegalovirus as an occupational risk in daycare educators

Abstract

BACKGROUND: Cytomegalovirus (CMV) infection continues to be an important occupational risk in the daycare setting. A comprehensive update of scientific evidence is timely to inform and promote appropriate preventive measures. METHODS: A review of the literature was conducted to examine the evidence for an occupational risk of CMV infection in daycare educators. Sources included Medline, government documents and additional references from published bibliographies. The key words used for searches were 'child day care centres' or 'nurseries' and 'cytomegalovirus' or 'cytomegalovirus infection'. RESULTS: Eight CMV seroprevalence studies on daycare educators in industrialized countries were found: four in the United States, three in Canada and one in Italy. Risk factors for seropositivity were older age, nonwhite race, foreign birth, birth in a low-or middleincome country, diaper changing, having children at home, and a child to educator ratio greater than 6:1 in children 18 to 35 months of age. Risk factors for seroconversion were younger age and working with young children. These studies suggest that daycare centres may be a high-risk setting for CMV infection. DISCUSSION: Recommendations to prevent CMV infection in this setting include handwashing, selective serological screening, avoiding work with younger children if pregnant and, in some cases, preventive leave from work. Evaluation and expert opinion of the effectiveness of various preventive options for CMV acquisition are needed to ensure that recommendations are evidence-based.

Clinical Utility of Viral Load in Management of Cytomegalovirus Infection after Solid Organ Transplantation

“…Primary CMV infection occurs most commonly during the first 2 decades of life (13). In immunocompetent individuals, primary CMV infection is generally asymptomatic.…”

Cytomegalovirus hepatitis after bone marrow transplantation: An autopsy study with clinical, histologic and laboratory correlates

“…A slide containing tissue sections adjacent to those on the slide used for IHC was washed with a sodium chloride‐sodium citrate (SSC) solution, treated with 50% formamide and covered with DNA‐CMV probe (Enzo) 1.5 μg/mL in hybridization cocktail, denatured at 95°C. for 20 minutes and hybridized at 37 degrees C. for 4 hours . Nonhybridizing probe was washed with high and low stringency SSC washing buffers.…”

“…Cytomegalovirus is a ubiquitous virus, usually causing acute but largely self‐limited infections in childhood before settling into a lifelong latency throughout the body . CMV can be activated from latency in people whose cellular immunity is suppressed, after which CMV infection can be documented by finding the virus in the bloodstream, urine and saliva .…”

Child Care Provider Awareness and Prevention of Cytomegalovirus and Other Infectious Diseases

“…Among persons aged 6-49 in the United States, 50.4 % are seropositive for CMV (Bate et al 2010). People associating with or having close contact with young children, either domestically or in the workplace, are at particularly high risk for CMV infection (Joseph et al 2006). CMV seroprevalence rates are higher among parents who have children in child care (Marshall and Adler 2009) indicating that a child may contract CMV at the child care facility and bring it home to their parents.…”