Abstract Details
10/10/2023 | 11:45 AM - 12:10 PM | 6613
Timing of cCMV diagnosis - Retrospective study in Washington State
Abstract Summary
Congenital CMV (cCMV) is not a reportable disease in Washington State or included in the a state screening program. Thus there is no data on the infants born with cCMV. We conducted a retrospective study of infants with congenital CMV cared for at Seattle Children’s Hospital (SCH). The aim was to understand the methods of identification of congenitally infected infants and determine the number of infants who may have benefitted from universal or targeted screening. Medical records of patients cared for at SCH between 2009-2021 with a diagnosis of congenital CMV infection were abstracted. Data abstracted included birth history, CMV test details, audiologic evaluations, developmental information, and anti-viral treatment. A cohort of 112 patients with documented congenital CMV were identified. Sixty (54%) were diagnosed within 3 weeks of life; of these 42 (71%) were symptomatic at birth. Fifty-two (46%) were diagnosed after 3 weeks of age by CMV DNA PCR from the neonatal dried blood spots (DBS); of these 19 (37%) were symptomatic at birth but not identified as such and 33 (62%) had failed their newborn hearing screens. The mean age at diagnosis for this group was 11.4 months (range 1- 101.4 months) and most (37 (71%)) were tested because of sensorineural hearing loss diagnosed beyond a month of life. Of the entire cohort, 33 (29%) additional children would have been diagnosed at birth using a hearing targeted screening strategy and 52 (46%) would have been diagnosed at birth with a universal screening approach. Our data suggests that the existing practice of cCMV diagnosis based on clinician discretion does not sufficiently identify infants symptomatic at birth. The results of this research may impact clinical practice of multiple disciplines and provide important context when discussing the need for CMV screening in newborns.
Learning Objectives
- Understand the current methods of identification of congenital CMV within Washington State
- Examine the timing of diagnosis of infants in relation to presenting symptoms and outcome
- Identify the need for a proactive CMV screening in newborns
Presentation
Handouts
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Presenters
Mallory Baker | POC-Point of Contact, Primary Presenter, Co-Presenter, Author, Co-Author
mallory.baker@seattlechildrens.org;
Mallory Baker, AuD, CCC-A, is a pediatric audiologist at Seattle Children's Hospital. Prior to joining Seattle Children's, she practiced at the Children's Hospital of Philadelphia and the University of North Carolina Hospitals in Chapel Hill. Her professional interests include pediatric hearing loss diagnosis and intervention and congenital cytomegalovirus related hearing loss. Dr. Baker is also the founder and director of the Washington CMV Project. In 2020, she founded the Washington CMV Project to increase education about and awareness of congenital CMV and to advocate for newborn CMV screening in Washington State. Dr. Baker is also the current principal investigator on several studies researching congenital CMV and hearing loss.
ASHA DISCLOSURE
Financial - Receives Salary for Employment from Seattle Children's Hospital.
Nonfinancial - No relevant nonfinancial relationship exists.
AAA DISCLOSURE
Financial - Receives support from Employed by Seattle Children's Hospital for .
Ann Melvin | Co-Presenter, Author, Co-Author
ann.melvin@seattlechildrens.org;
Dr. Melvin is clinical director for the Infectious Disease Division at Seattle Children’s Hospital (SCH) and director of the SCH Pediatric HIV program. Her research interests are in the antiretroviral management of HIV disease in children and prevention and management of complications of HIV treatment. She is a co-chair of the DHHS Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children: Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection. Additional research interests include diagnosis and management of viral infections in infants, particularly HSV and CMV. She is also the Faculty Director of the Recruitment Support Service and co-director of the Safety Monitoring Program of the Institute for Translational Health Sciences of the University of Washington.
ASHA DISCLOSURE
Financial - No relevant financial relationship exists.
Nonfinancial - No relevant nonfinancial relationship exists.
AAA DISCLOSURE
Financial - No relevant financial relationship exists.