548 ISOLATION OF CYTOMEGALOVIRUS (CMV) FROM TOYS AND HANDS IN A DAY CARE CENTER (DCC)

Abstract

CMV is transmitted readily among children in DCCs. Results of a previous study suggested that exchange of infected saliva by means of fomites may be important in the acquisition of CMV in DCCs. To explore the potential role of fomites in transmission of CMV in this environment we studied the oral excretion of CMV, oral behavior of toddlers, persistence of infectious virus on toys, and performed random environmental cultures in a single DCC in which over the past 3 years 70-80% of toddlers have had viruria. Oral behavior, recorded as the median number episodes/child/hour of hand or object to mouth contact, was 21 for children 12-36 months and 5 for those >36 months. Persistence of virus on toys was determined by culturing 9 toys which had been mouthed by known excreters of CMV immediately after removal from the mouth and at 10, 30, and 60 minutes. CMV was recovered from 8/9 (88%) immediately, 5/9 (56%) at 10, 2/9 (22%) at 30, and 0/9 at 60 minutes. We then cultured randomly selected toys in a toddler class as well as the hands and saliva of toddlers and the hands of 7 teachers. CMV was recovered from 1/7 toys, 10/30 (33%) saliva specimens, and the hands of 2 children and 1 teacher. Using restriction enzyme analysis, we examined the DNA extracted from the viruses isolated from the toy, the teacher's hand and saliva from one child. All were identical. These data, especially the recovery of virus with random survey cultures, suggest that contamination of objects may contribute to the high rate of CMV infection in this day care center.