<i>Notes from the Field:</i> Universal Newborn Screening and Surveillance for Congenital Cytomegalovirus — Minnesota, 2023–2024
Tory Kaye, Elizabeth Dufort, Sondra D. Rosendahl, Jenna Hullerman Umar, Amanda Pavan, Karissa Tricas, Lexie Barber, Carrie Wolf, Ruth Lynfield
Abstract
Congenital cytomegalovirus (cCMV) is the most frequent infectious cause of birth defects and the most frequent nongenetic cause of permanent hearing loss in U.S. children; cCMV affects approximately 0.5% of U.S. births.Among infants with cCMV infection, approximately 10% have clinical findings at birth (1).Early identification of cCMV infection could improve outcomes through the use of antiviral therapy when indicated, and audiology and developmental screenings (1).A recent Minnesota study found average dried blood spot sensitivity of 75% for detection of cCMV infection (2).In February 2023, Minnesota became the first U.S. state to implement universal newborn screening for cCMV.To evaluate performance and feasibility of newborn screening and to describe the epidemiology of cCMV, statewide surveillance was initiated.This report describes the first year of these activities. Investigation and Outcomes Minnesota Department of Health Newborn Screening RecommendationsUnless parents opt out, all Minnesota-born infants are screened for the presence of cytomegalovirus (CMV) using a qualitative real-time polymerase chain reaction (PCR) assay performed on a dried blood spot at the Minnesota Department of Health.*Infants whose assay detects CMV are recommended to have diagnostic PCR testing, performed on urine, within the first 21 days of life.For infants with diagnosed cCMV, recommended evaluations include complete blood count, liver function testing, neuroimaging, and audiologic and ophthalmologic assessments.In addition, infants with evidence of CMV infection within the first 90 days of life are voluntarily reported to the Minnesota Department of Health by clinicians or through electronic laboratory reporting.The Minnesota Department of Health newborn screening program follows all identified infants with cCMV to ensure linkage to care and to evaluate long-term outcomes.* https://www.health.state.mn.us/people/newbornscreening/program/ newbornscreeningpanel.pdf Evidence of CMV infection includes CMV-positive culture, antigen, or nucleic acid amplification testing, from any specimen source.