Laura Puhakka1, Maija Lappalainen2, Tuula Lönnqvist3, Riina Niemensivu4, Päivi Lindahl5, Tea Nieminen1, Raija Seuri6, Irmeli Nupponen7, Sunil Pati8, Suresh Boppana9, Harri Saxen1. 1. Department of Pediatric Infectious Diseases, Childrens Hospital. 2. Laboratory Services (HUSLAB), Department of Virology and Immunology. 3. Department of Child Neurology, Childrens Hospital. 4. Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 5. Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 6. Department of Pediatric Radiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 7. Department of Neonatology, Childrens Hospital. 8. Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama. 9. Pediatrics and Microbiology, University of Alabama at Birmingham, Birmingham, Alabama.
Abstract
BACKGROUND: Congenital cytomegalovirus (cCMV) infection is the most common congenital infection and causes significant morbidity. This study was undertaken to evaluate the benefits of screening newborns for cCMV and to understand the cCMV disease burden in Finland. METHODS: Infants born in Helsinki area hospitals were screened for CMV by testing their saliva with a real-time polymerase chain reaction assay. The CMV-positive infants and matched controls were monitored to determine their neurodevelopmental, audiological, and ophthalmological outcomes at 18 months of age. Griffiths Mental Development Scales, otoacoustic emission and sound field audiometry, and ophthalmologic examination were performed. RESULTS: Of the 19868 infants screened, 40 had confirmed cCMV infection (prevalence, 2 in 1000 [95% confidence interval, 1.4-2.6 in 1000]). Four (10%) infants had symptomatic cCMV. Griffiths general quotients did not differ significantly between the CMV-positive (mean, 101.0) and control (mean, 101.6) infants (P = .557), nor did quotients for any of the Griffiths subscales (locomotion, personal-social, hearing and language, eye and hand, performance) (P = .173-.721). Four of 54 CMV-positive ears and 6 of 80 CMV-negative ears failed otoacoustic emission testing (P = 1.000). The mean minimal response levels over the frequencies 500 Hz to 4 kHz in the sound field audiometry did not differ between CMV-positive (mean, 34.31-dB hearing level) and control (mean, 32.73-dB hearing level) infants (P = .338). No CMV-related ophthalmologic findings were observed. CONCLUSIONS: The prevalence of cCMV was low, and outcomes at 18 months of age did not differ between the infected infants and healthy control infants. With such a low burden in Finland, universal newborn screening for cCMV seems unwarranted.
BACKGROUND:Congenital cytomegalovirus (cCMV) infection is the most common congenital infection and causes significant morbidity. This study was undertaken to evaluate the benefits of screening newborns for cCMV and to understand the cCMV disease burden in Finland. METHODS:Infants born in Helsinki area hospitals were screened for CMV by testing their saliva with a real-time polymerase chain reaction assay. The CMV-positive infants and matched controls were monitored to determine their neurodevelopmental, audiological, and ophthalmological outcomes at 18 months of age. Griffiths Mental Development Scales, otoacoustic emission and sound field audiometry, and ophthalmologic examination were performed. RESULTS: Of the 19868 infants screened, 40 had confirmed cCMV infection (prevalence, 2 in 1000 [95% confidence interval, 1.4-2.6 in 1000]). Four (10%) infants had symptomatic cCMV. Griffiths general quotients did not differ significantly between the CMV-positive (mean, 101.0) and control (mean, 101.6) infants (P = .557), nor did quotients for any of the Griffiths subscales (locomotion, personal-social, hearing and language, eye and hand, performance) (P = .173-.721). Four of 54 CMV-positive ears and 6 of 80 CMV-negative ears failed otoacoustic emission testing (P = 1.000). The mean minimal response levels over the frequencies 500 Hz to 4 kHz in the sound field audiometry did not differ between CMV-positive (mean, 34.31-dB hearing level) and control (mean, 32.73-dB hearing level) infants (P = .338). No CMV-related ophthalmologic findings were observed. CONCLUSIONS: The prevalence of cCMV was low, and outcomes at 18 months of age did not differ between the infectedinfants and healthy control infants. With such a low burden in Finland, universal newborn screening for cCMV seems unwarranted.
Authors: Nancy A Otieno; Bryan O Nyawanda; Fredrick Otiato; Martina Oneko; Minal M Amin; Michael Otieno; Daniel Omollo; Meredith McMorrow; Sandra S Chaves; Sheila C Dollard; Tatiana M Lanzieri Journal: J Clin Virol Date: 2019-09-17 Impact factor: 3.168
Authors: Paddy Ssentongo; Christine Hehnly; Patricia Birungi; Mikayla A Roach; Jada Spady; Claudio Fronterre; Ming Wang; Laura E Murray-Kolb; Laila Al-Shaar; Vernon M Chinchilli; James R Broach; Jessica E Ericson; Steven J Schiff Journal: JAMA Netw Open Date: 2021-08-02