Seroprevalence and Risk Factors for Cytomegalovirus Infections in Adolescent Females

Cytomegalovirus (CMV) is a common infection with an estimate of seroprevalence in adolescents of 47%–89% [1–6]. Congenital CMV infection is the leading cause of birth defects and disability in the United States [7], affecting an estimated 8000 infants per year with sensorineural deafness, mental retardation, and/or seizure disorders [8–10], and an annual estimated financial burden of $1–2 billion [11]. The Institute of Medicine indicated a vaccine targeting 12 year olds would be highly cost-effective and designated it as a level I priority [12]. Because encouraging results from recent trials have renewed interest in CMV vaccines [13–16], it is important to learn more about the risk factors associated with acquisition of CMV, particularly in young women 12–17 years of age who may have increased rates of infection [6]. Previous studies indicate that CMV may be transmitted via saliva, urine (or handling of diapers), blood, cervical secretions, and semen [2, 17–23]. Because young women frequently engage in behaviors with children at the peak age of CMV shedding (1–2 year olds), they are at risk for coming into contact with body fluids containing CMV. This suggests that exposure to young children could be a major risk factor for transmission [24–25]. Therefore, we aimed to evaluate specific behaviors that may place adolescent females at increased risk of infection.