Screening Programs For Congenital CMV Found To Be Cost-Effective Interview with:

Dr. Soren Gantt MD, PhD, MPH Investigator, BC Children's Hospital Associate Professor, Department of Infectious and Immunological Diseases (Pediatrics) Faculty of Medicine, University of British Columbia

Dr. Soren Gantt

Dr. Soren Gantt MD, PhD, MPH
Investigator, BC Children’s Hospital
Associate Professor, Department of Infectious and Immunological Diseases (Pediatrics)
Faculty of Medicine, University of British Columbia What is the background for this study? What are the main findings?

Response: Cytomegalovirus (CMV) is a common virus that is usually transmitted through bodily fluids such as saliva, urine, blood, and breast milk, but it can also cause congenital infection (from a pregnant woman to her fetus). While it doesn’t usually cause problems for most children or adults, congenital CMV often causes serious problems. Congenital CMV causes 25 per cent of all childhood hearing loss and it’s the second most common cause of intellectual disability. Without screening, most infected newborns are not diagnosed in time to treat them with antivirals or provide other care that can make a big difference to improving their life-long outcomes.

Our study showed that screening programs for congenital CMV infection are cost-effective. We found that the cost of identifying one case of congenital CMV ranges from US$2000 to US$10,000 through universal screening, or US$566 to $2833 through a targeted screening approach. Our model showed that screening programs resulted in a net savings for the health care system of approximately USD$21 to $32 per newborn for universal screening or USD$11-$27 per newborn for targeted screening by reducing lifetime costs for therapies and lost productivity due to CMV-related health problems.

This finding addresses a major barrier to implementing CMV screening programs, as costs have often been viewed as an issue. What should readers take away from your report?

Response: By diagnosing newborns with congenital CMV, screening programs greatly increase opportunities to provide infected children with the best possible care. Some of these babies don’t have any obvious symptoms, which is why they are usually missed without screening. We can treat some infants who have congenital CMV with an antiviral medication, which can lead to better hearing and developmental outcomes. Typically, CMV in newborns has been diagnosed once they start showing symptoms – which can be too late for antivirals to be effective. Even without antiviral treatment, screening allows infected children to be followed closely for worsening hearing, and allows help for their speech and language development as early as possible. Our research proves that screening programs are cost-effective in addition to their medical benefits. This study removes a major obstacle to implementing CMV screening programs, as costs have often been cited as a concern. What recommendations do you have for future research as a result of this study?

Response: Developing a vaccine that prevents CMV is the highest priority. Until we have an effective CMV vaccine, however, I think that screening programs are critical to finding the most effective ways to improve the outcomes for infants with congenital CMV. Is there anything else you would like to add?

Response: Awareness of CMV is very important, to help congenitally infected babies and to avoid infections in the first place. Women can get CMV from anything that involves exposure to bodily fluids, especially from young children, from activities like changing diapers, sharing cups or spoons, and kissing on the mouth. Good handwashing and avoiding these exposures during pregnancy are important ways to prevent CMV infection. Thank you for your contribution to the community.


Cost-effectiveness of Universal and Targeted Newborn Screening for Congenital Cytomegalovirus Infection
Soren Gantt, MD, PhD, MPH1,2,3; Francois Dionne, PhD4; Fred K. Kozak, MD3,5; et al
JAMA Pediatr. Published online October 10, 2016. doi:10.1001/jamapediatrics.2016.2016

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on October 12, 2016 by Marie Benz MD FAAD