Feb. 8, 2023
Minnesota becomes first state to screen all newborns for congenital cytomegalovirus
Common virus can lead to hearing loss in about 20% of diagnosed cases
Earlier this week the Minnesota Department of Health (MDH) became the first state in the nation to screen all newborns for congenital cytomegalovirus (cCMV), a common viral infection that can have serious health effects for children if not detected early.
Each year, about 400 Minnesota infants and their families benefit from the life-changing, sometimes lifesaving, treatments or interventions indicated through newborn screening. As scientific knowledge has advanced, Minnesota has expanded its newborn screening panel to help detect more conditions that can benefit from early interventions and/or treatment. Congenital cytomegalovirus becomes the newest addition to the more than 60 conditions for which Minnesota newborns are screened.
Congenital cytomegalovirus is the most common viral infection in newborns. It occurs when the infection is passed from a pregnant person to their unborn baby and can cause a range of problems, including hearing loss. Officials estimate that up to 300 babies out of 65,000 born each year in Minnesota will have cCMV.
Most conditions included in the state’s newborn screening panel are inherited through the genes of one or both parents. However, cCMV is an infectious disease. It is the first infectious disease added to the panel in Minnesota.
“Adding congenital cytomegalovirus to our newborn screening program is a big advance in protecting and improving the health of all Minnesota children,” said Minnesota Commissioner of Health Dr. Brooke Cunningham. “Parents of children at risk for permanent hearing loss will receive early support that can help them prevent potential developmental delays.”
Pilot studies suggest that most babies with cCMV have no symptoms of the disease at birth and are not expected to develop symptoms. However, about 20% of babies diagnosed with cCMV will have symptoms either at birth or later in childhood.
Of that 20%, about half will have permanent hearing loss as the only symptom of the disease. The hearing loss may be present at birth or show up later in childhood. For this reason, it is important that children with cCMV have regular hearing exams even if no other symptoms are present at birth.
Symptoms at birth may include hearing loss, but a small portion of babies will also have other signs of disease such as a very small head, a smaller body than expected for age, skin rash, yellowing of skin and whites of eyes (jaundice), and/or enlarged liver and spleen. These children are also at risk for intellectual disabilities, hearing loss, vision loss and other health problems.
Screening for cCMV helps identify infants at risk for hearing loss and who may benefit from follow-up monitoring and early access to interventions such as sign language, hearing aids and cochlear implants. Newborn screening cannot predict if a baby will have symptoms, which is why additional testing is important for children with cCMV. Follow-up urine testing within 21 days will determine whether the baby was infected with cytomegalovirus at birth. If cytomegalovirus is found in the baby’s urine, more testing will be recommended to look for symptoms of the disease.
Screening for cCMV uses a quantitative real-time polymerase chain reaction (qPCR) screening method to identify CMV DNA in dried blood spots. Research by the University of Minnesota and the Centers for Disease Control and Prevention showed it was feasible to use dried blood spots to screen for cCMV. Most studies or tests for cCMV have used saliva or urine.
Newborn screening is a set of tests that check babies for serious, rare disorders. Most of these disorders cannot be seen at birth but can be treated or helped if found early. Routine newborn screening includes a blood spot screen, hearing screen and pulse oximetry screen. If a condition is detected, MDH contacts the child’s health care provider to discuss the result, educate them about the condition and review the recommended follow-up.
More information on the Newborn Screening Program can be found on the MDH website.