A rapid assay for detection of cytomegalovirus (CMV) in saliva was evaluated as a screening method for congenital infection. Samples of saliva were examined by detection of early antigen fluorescent foci (DEAFF) and standard tissue culture (TC). Results were compared with those from urine DEAFF. CMV was detected in saliva from 31 (1.7%) of 1870 newborns, 26 by DEAFF and TC, 1 by DEAFF alone, and 4 by TC alone. Urine DEAFF was positive in 28 of these 31 newborns. The sensitivities of various tests were saliva TC, 96.8%; saliva DEAFF, 87.1%; and urine DEAFF, 90.3%. A change in transport medium for 825 saliva samples resulted in improved sensitivities: saliva TC and saliva DEAFF, 100%; urine DEAFF, 92.3%. Screening saliva of newborns for CMV appears to be at least as sensitive a method for detecting congenital infection as detection of viruria; saliva can be collected with less difficulty and expense than urine.
To determine whether cytomegalovirus (CMV) infection in teenage girls is related to sexual activity, 254 girls 12-18 years old (mean, 15.8) attending a contraceptive counseling clinic were studied. Participants were screened for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis, and serum antibody to CMV was determined. Demographic and sexual history data were collected by interview. The mean number of lifetime sex partners was 2.2; 173 (68%) were seropositive. Race, greater than 3 years of sexual activity, and greater than 2 lifetime sex partners were significant risk factors for CMV infection (odds ratios [OR], 1.8-4.7; P less than .05). Using logistic regression analysis, a composite sexual activity variable was the most important risk factor for CMV infection (OR, 4.8; P = .003), followed by race (OR, 3.4; P = .004) and a sexually transmitted disease composite variable (OR, 2.4; P = .016). Sexual activity is an important risk factor for CMV infection in adolescent girls.
Young children in day care centers are an important source of hepatitis A virus (HAV) infection. The safety and immunogenicity of an inactivated HAV vaccine was evaluated in 57 children in day care centers. Nonimmune healthy children were given 0.5 mL of vaccine with subsequent doses: group A (28 children), second and third doses 1 and 2 months after the first; group B (29 children), second and third doses at 1 and 6 months. Antibody to HAV was measured before each dose and 8 months after the initial dose. All children developed antibody to HAV. Groups A and B had similar levels of antibody at 2 months; levels were lower in group B before the third dose and higher 8 months after the first dose. Local reactions after vaccination were reported in 17 children (29.8%). Minor systemic side effects that cleared spontaneously were observed in 27 children (47%).
Two rapid methods for the detection of cytomegalovirus (CMV) in saliva from congenitally and perinatally infected children were assessed by comparison with traditional virus isolation in tissue culture (TC). The polymerase chain reaction (PCR) was used to amplify a 300-bp segment of the CMV gB gene which was detected in ethidium bromide-stained agarose gels. A centrifugation-enhanced microtiter culture method with a monoclonal antibody for the detection of early-antigen fluorescent foci (DEAFF) was also used. Saliva specimens were collected with mouth swabs from children who were between the ages of 1 month and 14 years and who had either prenatal or perinatal CMV infection. One hundred sixty samples were tested by PCR and TC; 65 (40.6%) were found positive by TC, and 58 (36.8%) were found positive by PCR. Although four samples were found positive by PCR and negative by TC, saliva from seronegative and seropositive TC-negative adults were never found positive by PCR. One hundred fifty-two samples were tested by DEAFF and TC; 64 (42.1%) were found positive by TC, and 58 (38.2%) were found positive by DEAFF. With TC results as a standard, the sensitivity and specificity of DEAFF were, respectively, 90.6 and 97.7%. Because of the greater ease of collecting saliva than urine from newborns, both of these rapid methods merit evaluation in screening for congenital infection.
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