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Targeted salivary screening for congenital CMV in the UK is feasible, acceptable and may improve hearing outcomes
  1. EJ Williams1,6,
  2. S Kadambari2,
  3. JE Berrington1,
  4. S Luck3,
  5. C Atkinson3,
  6. S Walters4,
  7. ND Embleton1,
  8. A Davis5,
  9. P Griffiths3,
  10. M Sharland2,
  11. JE Clark6
  1. 1Neonatal Unit, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
  2. 2Paediatric Infectious Diseases Unit, St Georges Hospital, London, UK
  3. 3Center for Virology, University College London Medical School (Royal Free Campus), London, UK
  4. 4Audiological Medicine, Great Ormond Street Hospital, London, UK
  5. 5Newborn Hearing Screening Programme, NHS Newborn Hearing Screening and Physical Examination Programme, London, UK
  6. 6Paediatric Infectious Diseases, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK

Abstract

Background Congenital CMV (cCMV) causes up to 15% sensorineural hearing loss (SNHL) in the UK, however hearing outcomes may improve with ganciclovir treatment commencing in the first month of life. Targeted screening of infants who are ‘referred’ for further audiological testing after ‘no clear responses’ are found on their newborn hearing screen for CMV might identify these babies early enough to offer treatment.

Aims We present initial feasibility and acceptability data of targeted cCMV screening.

Methods Eligible infants from Northumbria and South-West London, (those' referred' for further hearing testing after their newborn hearing screening and <22 days old) had cCMV screening by PCR on urine and salivary samples. Infants screening positive had confirmatory CMV testing. Feasibility was measured by the number of infants correctly identified with cCMV and assessed for treatment by 28 days; acceptability was measured by parental anxiety (Spielberger STAI anxiety score).

Results Of 14,373 newborns 351 were' referred' for further hearing testing after their initial hearing screening and 248 families were approached with 152 (62%) agreeing to cCMV screening. Three newborns were found positive, all detected in time to allow assessment for treatment within 28 days. Salivary samples were easier to acquire with 95% (145) returning salivary samples and 41% (63) urine samples. Anxiety scores in study mothers were not significantly different to reference mothers.

Conclusions Targeted cCMV screening using saliva is feasible and acceptable to parents. Extending the National screening programme to include cCMV testing in all infants without clear early hearing responses may improve hearing outcomes. Economic analysis and mechanistic processes require further evaluation.

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