By Ethan Covey
A universal newborn screening and population-based surveillance program for congenital cytomegalovirus (cCMV), which was implemented in Minnesota during 2023, may facilitate understanding of the incidence of cCMV and identify groups at increased risk, according to a recent study.
Congenital CMV is the most frequent infectious cause of birth defects and nongenetic cause of permanent hearing loss in U.S. children, affecting approximately 0.5% of U.S. births (MMWR Morb Mortal Wkly Rep2024;73[32]:703-705).
Minnesota is the first state in the nation to implement a universal cCMV screening program, which began in February 2023.
“Universal screening for cCMV provides us with information on an entire population, something that does not often occur in infectious disease surveillance and therefore provides a better estimate of how common cCMV truly is in Minnesota,” said Tory Kaye, MPH, the senior epidemiologist in newborn screening at the Minnesota Department of Health. “Knowing CMV infection status at birth allows us to follow children over time, to determine if screening helps them receive care and have better outcomes.”
From Feb. 6, 2023, through Feb. 5, 2024, the Minnesota Department of Health screened 60,115 infants. Congenital CMV was detected in 0.31% of the tests. Among the 176 confirmed cases of cCMV disease or infection, infant assessments were completed for neuroimaging (91%), audiology (89%) and ophthalmology (80%). All three assessments were completed for 75% of those with cCMV.
Ms. Kaye noted that the ease of implementing similar programs in other states depends on multiple particulars.
“A state’s ability to implement a screening test is conditional on many factors, such as how conditions are added to their panel, screening instruments they have available, staff capacity, funding and programmatic structure,” she said.
Future research will aim to address questions raised during the first year of cCMV screening.
“About one-third of the infants identified with cCMV in Minnesota had at least one clinical finding, and 15% had nonspecific abnormalities found on brain imaging,” Ms. Kaye said. “It is unclear whether these nonspecific findings contribute to symptomatic disease or later adverse outcomes, and providers are faced with deciding whether to treat with antiviral therapy, which has considerable risks associated.
“Following these children and documenting health and developmental outcomes will help inform these decisions in the future,” she said.
Ms. Kaye reported no relevant financial disclosures.
