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Symptomatic Congenital Cytomegalovirus Infection Is Underdiagnosed in British Columbia

Brendan Sorichetti1, Oran Goshen2, Julie Pauwels1

  • 1Child and Family Research Institute, Vancouver, British Columbia, Canada; Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.

The Journal of Pediatrics
|November 25, 2015
PubMed

Insights

Congenital cytomegalovirus (CMV) infection diagnosis is significantly missed in infants. Clinician-initiated testing identified only a small fraction of expected symptomatic congenital CMV cases in British Columbia.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Congenital cytomegalovirus (CMV) infection is a leading cause of non-genetic sensorineural hearing loss in children.
  • Early diagnosis and intervention for symptomatic congenital CMV can improve outcomes.
  • Current diagnostic approaches rely heavily on clinician-initiated testing.

Purpose of the Study:

  • To evaluate the effectiveness of clinician-initiated testing for diagnosing congenital cytomegalovirus infection in infants.
  • To estimate the proportion of symptomatic congenital CMV cases potentially missed by current testing strategies.

Main Methods:

  • Retrospective review of infant records tested for congenital CMV infection.
  • Data collected from British Columbia, Canada, between 2006 and June 2014.
  • Calculation of infection rates per live births.

Main Results:

  • Out of 701 infants tested, 14 (approximately 4.2 per 100,000 live births) had a positive congenital CMV test.
  • This rate suggests a substantial underdiagnosis of symptomatic congenital CMV cases.
  • Over 90% of expected symptomatic cases were likely not diagnosed through clinician-initiated testing.

Conclusions:

  • Clinician-initiated testing is insufficient for capturing the majority of symptomatic congenital CMV infections.
  • There is a critical need for improved screening and diagnostic strategies for congenital CMV.
  • Enhanced diagnostic approaches are essential to identify infants with congenital CMV and facilitate timely management.

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