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10/10/2023  |   3:15 PM - 3:40 PM   |  6613

Factors influencing expansion of targeted cCMV screening

Abstract Summary

Florida initiated targeted cCMV screening on January 1, 2023, based on failing the newborn hearing screen. Hospitals have had to adjust discharge preparations to accommodate the newborn infants for whom cCMV screening was triggered. This included contracting with an outside lab in many cases, nursing protocol adjustments, setting up reporting and communication channels with primary physicians, hospital documentation, state EHDI programs, and baseline referral teams for initial diagnostic assessments. None of the challenges associated with each hospital protocol is insurmountable, but they have nonetheless been challenges for a well-operating, coordinated screening program, particularly maintaining timely communication among physicians, EHDI follow-up coordinators, and referral resources. In the 2023 legislative session, a bill was submitted to expand the current targeted screening program to universal cCMV screening. This proposal came while hospitals and birthing centers were still establishing and settling in their respective protocols and laboratory arrangements. The results of this surprise legislative submission motivated an additional financial and logistical analysis of programmatic challenges and budgetary impacts. Several constituents with a significant interest in cCMV concluded that an incremental increase to include newborns of extreme prematurity and very low birth weight or admitted to intensive care units with severe illness, cardiac disease, or post-surgical status before 21 days of age. A report in the literature suggested that the incidence of cCMV may be as high as 2.1% among the newborns listed above in contrast to an estimated incidence of 0.5% mother-baby units. In addition, many infants born between 23 and 32 weeks gestational age will not be eligible for hearing screen until after 21 days of life. This presentation will discuss the financial and logistical considerations of expanding cCMV detection efforts based on Florida's experiences with a birth rate of 223,000 infants per year.

Learning Objectives

  • Advocate for incremental legislative expansion of cCMV screening
  • Identify financial and logistical pitfals to cCMV screening expansion
  • Identify premature infants at increased risk and modify legislative expansion appropriately




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Robert Fifer | Primary Presenter

Dr. Fifer is an audiologist and Associate Professor of Clinical Pediatrics at the Mailman Center for Child Development. He oversees the newborn hearing screening program in Jackson Memorial Hospital and has participated with the Florida Department of Health as a stakeholder for the development of cCMV screening guidelines. He is also the audiology representative to the Genetics and Newborn Screening Advisory Council and a member of the EHDI Advisory Committee for the Florida Department of Health.


Financial - Receives Salary for Employment from University of Miami.  

Nonfinancial - No relevant nonfinancial relationship exists.


Financial - No relevant financial relationship exists.