Occupational risk for cytomegalovirus, but not for parvovirus B19 in child-care personnel in France

Villemeur, Agathe Billette De; Gratacap-Cavallier, B.; Casey, Romain; Baccard-Longère, Monique; Goirand, Laurence; Seigneurin, Jean‐Marie; Morand, Patrice

doi:10.1016/j.jinf.2011.06.012

Cited by 18 publications

(21 citation statements)

References 36 publications

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“…However, none of them was associated with HCMV prevalence rate. So far, the previously reported results related to the influence of occupational contact with children on HCMV prevalence rates were contrary to our observations [ 21 , 37 – 40 ]. Based on those studies, we suggest that occupational contact with children is a population-dependent risk of HCMV infections.…”

Section: Discussioncontrasting

confidence: 99%

“…Beside the region and age, other socioeconomic risk factors for HCMV infections have also been reported [ 21 , 24 , 36 ]. Higher prevalence rates in correlation with lower socioeconomic status were determined in pregnant women from Finland (60.9 vs. 76.4 %) and India (63.4 vs. 96.9 %) [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…HCMV prevalence among pregnant women might also be affected by having children [ 21 , 25 , 28 ]. In our study, we observed a significantly higher prevalence of HCMV infection in pregnant women with offspring than in those without children (69.5 % vs. 57.3; PR = 1.56).…”

Section: Discussionmentioning

confidence: 99%

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Impact of socioeconomic risk factors on the seroprevalence of cytomegalovirus infections in a cohort of pregnant Polish women between 2010 and 2011

Wujcicka

Gaj

Wilczyński

et al. 2014

Eur J Clin Microbiol Infect Dis

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The purpose of this investigation was to perform an evaluation of the prevalence and socioeconomic risk factors for human cytomegalovirus (HCMV) infections in a cohort of Polish pregnant women between 2010 and 2011. HCMV-specific IgG and IgM antibody levels were assayed with enzyme-linked immunosorbent assay (ELISA) tests in serum samples collected from 1,250 pregnant women attending outpatient obstetric clinics and hospitalized at two hospitals in Lodz. The seroprevalence of anti-HCMV IgG and IgM antibodies was 62.4 and 2.2 %, respectively, and differed significantly between age-stratified groups (p ≤ 0.05). The highest IgG prevalence was observed in women above 36 years of age (76.2 %) and IgM in adolescent women aged 16–20 years (6.0 %). Of the various socioeconomic factors, age above 36 years, basic and professional education, and offspring were significantly associated with HCMV IgG prevalence rates (PRs; 1.89, 1.80, and 1.56, respectively). Financial status, occupational risk related to contact with children, and transfusions were not related to the prevalence of IgG antibodies. The IgM prevalence was not associated with any of the analyzed risk factors. A slightly higher prevalence was observed in women who were transfused in the past, but the relationship was not significant. The current data have revealed a decrease in HCMV IgG seroprevalence in our region during recent years (62.4 vs. 76.7 %). Basic and professional education, as well as bringing up offspring, were determined as significant risk factors for HCMV infections in Polish pregnant women [risk ratio (RR) 1.20 and 1.17, respectively], suggesting that the primary and secondary prophylaxis of cytomegaly is necessary during pregnancy, even if screening is not mandatory.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Impact of socioeconomic risk factors on the seroprevalence of cytomegalovirus infections in a cohort of pregnant Polish women between 2010 and 2011

Wujcicka

Gaj

Wilczyński

et al. 2014

Eur J Clin Microbiol Infect Dis

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“…CMV IgG seroprevalence was higher in pediatricians than in the controls, which was in accordance with another study that documented higher CMV seroprevalence in child caretakers (50). The CMV IgG titer suggested higher values for the high-exposure groups than the normal-exposure group.…”

Section: Discussionsupporting

confidence: 91%

Influence of Frequent Infectious Exposures on General and Varicella-Zoster Virus-Specific Immune Responses in Pediatricians

Ogunjimi

Smits

Heynderickx

et al. 2014

Clin. Vaccine Immunol.

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jReexposure to viruses is assumed to strengthen humoral and cellular immunity via the secondary immune response. We studied the effects of frequent exposure to viral infectious challenges on immunity. Furthermore, we assessed whether repetitive exposures to varicella-zoster virus (VZV) elicited persistently high immune responses. Blood samples from 11 pediatricians and matched controls were assessed at 3 time points and 1 time point, respectively. Besides the assessment of general immunity by means of measuring T-cell subset percentages, antibody titers and gamma interferon (IFN-␥)/interleukin 2 (IL-2)-producing T-cell percentages against adenovirus type 5 (AdV-5), cytomegalovirus (CMV), tetanus toxin (TT), and VZV were determined. Pediatricians had lower levels of circulating CD4؉ -naive T cells and showed boosting of CD8 ؉ effector memory T cells. Although no effect on humoral immunity was seen, repetitive exposures to VZV induced persistently higher percentages of IFN-␥-positive T cells against all VZV antigens tested (VZV glycoprotein E [gE], VZV intermediate-early protein 62 [IE62], and VZV IE63) than in controls. T cells directed against latency-associated VZV IE63 benefitted the most from natural exogenous boosting. Although no differences in cellular or humoral immunity were found between the pediatricians and controls for AdV-5 or TT, we did find larger immune responses against CMV antigens in pediatricians. Despite the high infectious burden, we detected a robust and diverse immune system in pediatricians. Repetitive exposures to VZV have been shown to induce a stable increased level of VZVspecific cellular but not humoral immunity. Based on our observations, VZV IE63 can be considered a candidate for a zoster vaccine.

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“…The risk of infection is considered to be highest for women with an infected child in the home, the risk increasing with the number of children present. Whilst not all well-designed studies demonstrate an occupational risk (de Villemeur et al, 2011;Stelma et al, 2009), others clearly do (Adler et al, 1993;Gillespie et al, 1990), including a large Danish study involving over 30 000 serum samples (Valeur-Jensen et al, 1999), which confirmed that the intensity of exposure to children at work is a significant risk factor for acute B19V infection. The cost in financial terms of antenatal screening for B19V is thought excessive (Gärtner et al, 2007), but that cost analysis may be underestimating the true burden of fetal loss and discounting the potential financial impact of occupational leave for non-immune women.…”

mentioning

confidence: 97%

The lack of routine surveillance of Parvovirus B19 infection in pregnancy prevents an accurate understanding of this regular cause of fetal loss and the risks posed by occupational exposure

Watt

Brown

Pathiraja

et al. 2013

Journal of Medical Microbiology

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In Europe, fetal loss due to Parvovirus B19 (B19V) is under-reported and a poorly addressed occupational risk to pregnant women. This is exemplified internationally, where it was unmentioned in the last two European Centre for Disease Prevention and Control (ECDC) annual surveillance reports or its 2009 special report on infections in pregnancy. To assess this potential for underestimating B19V fetal loss in pregnancy, we undertook a systematic review of practice in Northern Ireland in the management and reporting of B19V infections over a 12-month period of heightened transmission, one of six observed in a span of 9 years. Pregnant and non-pregnant women presented with symptomatic infection in 24 and 93 % of confirmed B19V infections, respectively, with no difference in viral loads. There was underinvestigation of viral causes of fetal loss, with only 143/2739 (5 %) tested for B19V, and a failure to follow up most non-immune women tested following rash contact. Occupational exposure was recorded in 31/60 (51.6 %) of pregnancies audited following rash exposure, the majority teachers or day care workers. Against a background seroprevalence of 66.5 % immunity in women of child-bearing years, two patterns of infection were identified. Firstly, pregnant women investigated for a rash or exposure to slapped cheek syndrome, where an infection incidence of 18 % was observed, resulted in 42 confirmed infections, all proceeding to healthy term deliveries. Secondly, pregnant women with unsuspected infection had six cases of confirmed B19V fetal loss, including four of 22 (18 %) diagnosed at autopsy, of which three were non-hydropic. While many studies have reported B19V fetal loss in pregnancy, there are no robust public health surveillance figures to draw on. That all six confirmed fetal losses came from the small number of miscarriages/stillbirths investigated, 143 out of 2739, suggests inadequate follow-up of those pregnancies where B19V-related fetal loss may be most common, and supports the need for enhanced surveillance pilots to address this significant gap in public health knowledge.

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Occupational risk for cytomegalovirus, but not for parvovirus B19 in child-care personnel in France

Cited by 18 publications

References 36 publications

Impact of socioeconomic risk factors on the seroprevalence of cytomegalovirus infections in a cohort of pregnant Polish women between 2010 and 2011

Impact of socioeconomic risk factors on the seroprevalence of cytomegalovirus infections in a cohort of pregnant Polish women between 2010 and 2011

Influence of Frequent Infectious Exposures on General and Varicella-Zoster Virus-Specific Immune Responses in Pediatricians

The lack of routine surveillance of Parvovirus B19 infection in pregnancy prevents an accurate understanding of this regular cause of fetal loss and the risks posed by occupational exposure

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