Short Report |
Risk factors for cytomegalovirus seropositivity in a population of day care educators in Montréal, Canada
1 Community Health, Dalhousie University, Halifax, Nova Scotia, Canada
2 Microbiologie, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada
3 Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada
4 Medicine, McGill University, Montreal, Quebec, Canada
5 CCISD, Quebec City, Québec, Canada
6 Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
7 Clinical Epidemiology, Montreal General Hospital, Montreal, Quebec, Canada
Background Horizontal transmission of cytomegalovirus (CMV) is common in the day care setting. Day care educators appear to be at a high risk of infection; however, studies are limited.
Aims To determine the proportion of CMV-seropositive female educators in the day care setting and to identify associated risk factors.
Methods Educator- and day care-level risk factors for CMV seropositivity were obtained by questionnaires from day care educators and directors, respectively. Sera were collected from educators and analyzed by enzyme-linked immunosorbent assay. Significant independent risk factors for CMV seropositivity were determined using a multivariable logistic regression model which was fitted using the generalized estimating equation method.
Results CMV seroprevalence in 473 female educators from 81 day care centers in Montréal, Canada, was 57%. Significant risk factors for CMV seropositivity were (i) increasing age (OR5-yr = 1.19; 95% CI = 1.05–1.35), (ii) low-income country of birth (OR = 10.23; 95% CI = 2.64–39.50) or middle-income country of birth (OR = 4.99; 95% CI = 2.39–10.40), (iii) having 
2 children of their own (OR = 1.98; 95% CI = 1.19–3.31) and (iv) child-to-educator ratio >6 (18–35 months old) in a day care center (OR = 1.87; 95% CI = 1.25–2.81).
Conclusions Day care educators have risks for CMV infection related to their work in the day care setting, as well as personal risk factors. A review of current guidelines for the prevention of CMV infection in day care is needed to ensure that recommendations are evidence based.
Keywords Congenital infection; cytomegalovirus; day care educators; occupational risk
Correspondence to: Theresa Gyorkos. Division of Clinical Epidemiology, Montreal General Hospital, 1650 Cedar Avenue, Montreal, Quebec, Canada. e-mail: theresa.gyorkos{at}mcgill.ca