Cytomegalovirus (CMV) infection, the most common congenital viral infection in humans, can severely damage the developing central nervous system of the fetus when primary maternal infection occurs during pregnancy. A significant proportion of congenitally infected infants experience major sequelae, including mental retardation, spastic quadriparesis, blindness, and deafness. Women of childbearing age in occupations which involve extensive close contact with infants and young children may be at particularly high risk of acquiring CMV infection. Recent studies have determined that large numbers of children in day care centers or facilities providing services for handicapped children excrete CMV in urine or saliva. These facilities are typically staffed by young women, 40% to 60% of whom may be susceptible to primary CMV infection. Thus infection with CMV poses a potentially serious occupational health hazard for women of childbearing age who work in these areas. Several questions regarding the epidemiology of CMV infection in day care centers or facilities for handicapped children remain unanswered. In this study we intend to determine: (1) the prevalence and incidence of CMV infection among (a) day care workers and (b) professional staff providing educational services for handicapped children; (2) whether horizontal transmission of CMV infection occurs among children and workers in day care settings; and (3) the prevalence and incidence of CMV infection among children in day care compared with children cared for in their own homes. These objectives will be accomplished by: (1) determining CMV seroconversion rates using indirect hemagglutination and latex agglutination assay to monitor CMV antibody at 6 month intervals for a 3 year period among 100 employees of day care centers and 100 professional staff working with handicapped children as compared to 200 community controls; (2) mapping viral isolates from CMV-infected children and/or workers using restriction enzymes analysis to compare strain simularities; and (3) culturing for CMV, the urine and saliva of 100 children in day care centers and 100 children cared for in their own homes, at 6 month intervals over a 3 year period. These studies will determine the degree of occupational risk of primary CMV infection for adults working in day care centers or in preschool programs for handicapped children.
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