Cytomegalovirus and the national health and nutrition examination surveys.

Bate et al [1] present stimulating work on the seroprevalence of cytomegalovirus (CMV) in the United States during 2 periods, 1988–1994 and 1999–2004, which showed that the prevalence of CMV infection remained stable between these 2 periods. Such studies are rare, and many countries clearly lack epidemiologic data. The past decade has seen numerous studies of the management and consequences of CMV infection during pregnancy, but most of these studies were heterogeneous and based on small numbers of patients. More recent studies have sought to evaluate prevention strategies [2, 3] and treatments [4, 5], whereas others have focused on vaccine development [6]. Both options are important and certainly not mutually exclusive. Bate et al [1] remind us, “Compared with a maternal nonprimary infection (i.e., reinfection or reactivation), a maternal primary infection is more likely to transmit CMV from mother to fetus (1% vs. 32%)” (p. 1439). We must note, how-