Safety and immunogenicity of an inactivated hepatitis A vaccine in preschool children.

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%).

Neonatal screening for congenital cytomegalovirus infection by detection of virus in saliva.

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.

Cytomegalovirus infection in sexually active adolescents.

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.

Cytomegalovirus infection among employees of a children's hospital. No evidence for increased risk associated with patient care.

Employees of a children's hospital were studied to determine the prevalence of antibody to cytomegalovirus (CMV) and the incidence of CMV infection between 1984 and 1988 in relation to patient contact. At enrollment, 783 (63%) of 1250 employees had antibody to CMV. By logistic regression analysis, age greater than 30 years, black race, fewer than 16 years of education, employment for more than 1 year, female sex, and being married were each associated with seropositivity at enrollment. Three hundred workers who were seronegative initially were followed up; 13 seroconverted over a median follow-up interval of 1.96 years, 2.2% per year. Administrative, patient-care, laboratory, and support personnel were included among seroconverters. There were no statistically significant differences in the incidence of CMV infection when employees were grouped by job type, number of hours per week of patient contact, or nursing unit. The incidence of CMV among employees of a children's hospital was similar to the rate expected for the general population. Risk of CMV infection was not increased by patient contact in this setting.