Bate · Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2010 · serial cross-sectional survey · n=36,949

Cytomegalovirus seroprevalence in the United States: the national health and nutrition examination surveys, 1988-2004.

Cited 681 times in the scientific literature.

Level 4 - case-series / case-control

Serial cross-sectional population-based survey (observational/cross-sectional)

PubMed 20426575 · doi:10.1086/652438 · record verified 2026-08-26

What was done

Serum samples from the National Health and Nutrition Examination Survey (NHANES) 1999–2004 were tested for cytomegalovirus (CMV)–specific immunoglobulin G (IgG) antibody to estimate nationally representative seroprevalence and assess trends in the United States. Results were compared with NHANES III (1988–1994). The study evaluated participants aged 6–49 years: 21,639 in NHANES III and 15,310 in NHANES 1999–2004 (total n = 36,949).

What was found

Overall age-adjusted CMV seroprevalence in NHANES 1999–2004 was 50.4%, showing no significant change compared to NHANES 1988–1994. Seroprevalence was higher among non-Hispanic black and Mexican American children than non-Hispanic white children and rose more rapidly with age. Older age, female sex, foreign birthplace, lower household income, higher household crowding, and lower household education were independently associated with CMV seropositivity (no odds ratios or confidence intervals were provided in the abstract).

Why it matters

Because roughly half of US individuals aged 6–49 years remain seronegative, a substantial proportion of women of reproductive age remain susceptible to primary CMV infection during pregnancy, which carries the highest risk of congenital disability. The findings identify distinct demographic and socioeconomic disparities that can guide targeted vaccine development and prevention strategies.

Limits

The study is limited to individuals aged 6–49 years, excluding younger children and older adults. The cross-sectional design cannot directly determine incidence of primary infection or link serostatus to congenital CMV cases. Exact numerical effect sizes, odds ratios, and confidence intervals for demographic predictors were omitted from the abstract.

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