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9/26/2014  |   4:30 PM - 6:00 PM   |  

Case-Finding and Validation of Congenital Cytomegalovirus (cCMV) Related Hospital Admissions in Michigan Resident Children under One Year of Age

This study assessed the accuracy of congenital cytomegalovirus (cCMV) cases reported to the Michigan Birth Defects Registry (MBDR) and ascertained from Michigan Inpatient Database (MIDB) linked with birth files and death records and to provide baseline information on possible approaches to cCMV surveillance. Findings were used to describe infants diagnosed with cCMV by socio-demographic and clinical characteristics. Data from the MBDR, MIDB, birth files, and death records were utilized to identify hospital admissions for infants born from 2004 through 2011 who were less than 1 year of age and treated for cCMV. Approximately 180 infants were identified from these sources. A comprehensive, retrospective review of health records was performed at treating facilities for cases with a diagnosis of cCMV. Data related to the diagnosis and treatment of cCMV were compiled and results were analyzed. Of approximately 180 cases identified, 68 infants were investigated. Of these, about 84% were positive cases. About half the cases occurred in males (49.1%) and half in females (50.9%). About two-thirds of the infants (75.4%) had hematologic symptoms and more than a third (38.6%) had evidence of central nervous system involvement. Nearly a quarter (27.1%) had hearing impairment and 43.5% were on antiviral treatment or other medications. Results revealed that 20.0% of the infants had individual cases of other congenital conditions and death occurred in 5 infants. An investigation of a selection of cCMV cases confirmed most cases to be true positives. Case ascertainment from hospital discharge files linked with birth files and death records provided useful sources for identifying additional cases. Health record findings provided useful information about the clinical presentation of children with cCMV and its serious consequences. Potential future direction includes intersecting with other systems such as the Early Hearing detection and Intervention (EHDI) system for the proportion of children with hearing loss.

Evelyn Quarshie (Primary Presenter,Author), quarshiee@michigan.gov;
Evelyn works as the Birth Defects and EHDI epidemiologist in the Lifecourse Epidemiology and Genoics Division at the Michigan Department of Community Health. Prior to that, she worked with the Ohio Department of Health as an epidemiologist, working on nutrition, physical activity and tobacco use related activities.

ASHA DISCLOSURE:

Financial - No relevant financial relationship exist.

Nonfinancial - No relevant nonfinancial relationship exist.

Lorrie Simmons (Author), SimmonsL@michigan.gov;
Lorrie joined the Michigan Birth Defects Registry as Quality Improvement Coordinator and Field Representative in 1998. She works with the Division of Vital Records and Health Statistics at the Michigan Department of Community Health.

Joan Ehrhardt (Author), EhrhardtJ@michigan.gov;
Joan serves as the Birth Defects Program Coordinator in the MDCH Genomics and Genetic Disorders Section. Prior to joining MDCH, she provided clinical genetic counseling services to individuals and families affected by genetic conditions and birth defects. The Birth Defects Prevention Program participates in outreach activities for target populations, health professional trainings, and the general public, and partners with state and local maternal and child health and chronic disease prevention programs to promote healthy choices pre- and inter- conception for improved reproductive outcomes for mother and child.

Robert Wahl (Author), WahlR@michigan.gov;
Robert serves as the Surveillance and Evaluation Section Manager in the Lifecourse Epidemiology and Genomics Division at the Michigan Department of Community Health.

Glenn Copeland (Author), CopelandG@michigan.gov;
Glenn serves as the Michigan BD Registry Director with the Division of Vital Records and Health Statistics at the Michigan Department of Community Health.

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