title: Cytomegalovirus infection in the Netherlands: seroprevalence, risk factors, and implications.
abstract: BACKGROUND
  Cytomegalovirus (CMV) infections occur worldwide and are usually asymptomatic in healthy individuals. In fetuses and immunocompromised persons, they can cause severe disease and disabilities.
  
  
  OBJECTIVE
  To determine the CMV seroprevalence and risk factors for CMV infection in the Netherlands.
  
  
  METHODS
  In a cross-sectional population-based study (PIENTER-2, 2006-2007), sera and questionnaire data were collected from 6386 individuals. Sera were tested for CMV-specific IgG antibodies using enzyme-linked immunosorbent assay (ELISA).
  
  
  RESULTS
  The CMV seroprevalence in the general population (6 months-79 years) was 45.6%. Age and country of origin were the most prominent independent risk factors. The seroprevalence was significantly lower in native Dutch and Western individuals (41.5%) than in non-Western individuals (76.7%). Multivariable logistic regression analysis showed that age, lower educational level, first-generation migrancy, and among native Dutch/Western individuals, female gender and having contact with young children, were independently associated with CMV seropositivity. The geometric mean concentrations of antibodies increased with age and were higher in women than in men.
  
  
  CONCLUSIONS
  CMV seroprevalence in the Netherlands is relatively low compared to other countries. This is in line with our finding of a higher seroprevalence among migrants compared to the native population. The higher seroprevalence in women and individuals who have contact with young children is especially important for women of reproductive age. Preventing CMV infection in these women, through counseling on hygiene or possible future vaccination, may lead to a decrease of congenital CMV infections.
authors.affiliation: National Institute for Public Health and the Environment, Epidemiology and Surveillance Unit, P.O. Box 1, 3720 BA Bilthoven, The Netherlands; Leiden University Medical Center, Department of Medical Microbiology, P.O. Box 9600, 2300 RC Leiden, The Netherlands. Electronic address: marjolein.korndewal@rivm.nl.
authors.forename: M J
authors.initials: MJ
authors.lastname: Korndewal
authors.affiliation: National Institute for Public Health and the Environment, Epidemiology and Surveillance Unit, P.O. Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: liesbeth.mollema@rivm.nl.
authors.forename: L
authors.initials: L
authors.lastname: Mollema
authors.affiliation: National Institute for Public Health and the Environment, Centre for Immunology of Infectious Diseases and Vaccines, P.O. Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: irina.tcherniaeva@rivm.nl.
authors.forename: I
authors.initials: I
authors.lastname: Tcherniaeva
authors.affiliation: National Institute for Public Health and the Environment, Centre for Immunology of Infectious Diseases and Vaccines, P.O. Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: fiona.van.der.klis@rivm.nl.
authors.forename: F
authors.initials: F
authors.lastname: van der Klis
authors.affiliation: Leiden University Medical Center, Department of Medical Microbiology, P.O. Box 9600, 2300 RC Leiden, The Netherlands. Electronic address: a.c.m.kroes@lumc.nl.
authors.forename: A C M
authors.initials: AC
authors.lastname: Kroes
authors.affiliation: Leiden University Medical Center, Willem-Alexander Children's Hospital, P.O. Box 9600, 2300 RC Leiden, The Netherlands. Electronic address: h.m.oudesluys-murphy@lumc.nl.
authors.forename: A M
authors.initials: AM
authors.lastname: Oudesluys-Murphy
authors.affiliation: Leiden University Medical Center, Department of Medical Microbiology, P.O. Box 9600, 2300 RC Leiden, The Netherlands. Electronic address: a.c.t.m.vossen@lumc.nl.
authors.forename: A C T M
authors.initials: AC
authors.lastname: Vossen
authors.affiliation: National Institute for Public Health and the Environment, Epidemiology and Surveillance Unit, P.O. Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: hester.de.melker@rivm.nl.
authors.forename: H E
authors.initials: HE
authors.lastname: de Melker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003140:Communicable Disease Control / Q000379:methods*; D003430:Cross-Sectional Studies; D003586:Cytomegalovirus Infections / Q000453:epidemiology* / Q000517:prevention & control; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007223:Infant; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G
keywords: Congenital CMV infection; Cytomegalovirus (CMV); Risk factors; Seroepidemiology; Seroprevalence