Politicians Debate the Benefit of Universal CMV Screenings for Infants

Although cytomegalovirus (CMV) is not nearly as well-known as other infections, the virus impacts many pediatric patients. The CDC notes that 0.5% of babies are born with congenital CMV. Additionally, roughly 50% of people are infected by the virus by 40 years old. Considering the high prevalence of CMV and the detrimental risks of congenital CMV, politicians have debated the benefits of mandating universal CMV screenings in infants.

In 2023, Minnesota became the first state in the United States to mandate universal screenings, adding it to the battery of newborn screenings providers do at birth. The Minnesota Department of Health (MDH) notes that newborn screenings significantly impact pediatric outcomes, allowing roughly 400 patients and parents to seek early treatment or intervention each year.

Data from health records note that roughly 300 babies are born with congenital CMV in Minnesota annually. The MDH believes screening for CMV, the most common viral infection in infants and newborns, could help even more infants and their families.

CMV symptoms can vary dramatically based on age and general health. Older health individuals may have typical flu-like symptoms, including fever, sore throat, fatigue, and swollen glands. Immunocompromised individuals may have more severe and rare reactions, including mononucleosis and hepatitis.

Congenital CMV has even more detrimental impacts. The virus, which can be transmitted to the infant during pregnancy, direct contact with saliva or urine, sexual contact, and organ transplants, can cause life-long complications when contracted congenitally or in infancy.

According to the CDC, congenital CMV can cause rash, jaundice, microcephaly, low birth weight, hepatosplenomegaly, seizures, and retinitis. Long-term effects may include hearing loss, developmental delays, and vision loss. Roughly 20% of infants with CMV will have a long-term health problem or symptoms, most notably hearing loss.

CMV can be screened through blood testing or saliva; however, the CDC recommends screening through a urine test for infants and newborns. If the test is positive or the infant has CMV symptoms, they may be treated with antiviral medications, including valganciclovir.

The National CMV Foundation advocates for improved CMV policy, explaining that the extent of policy varies. While 18 states have some level of CMV legislation, only Minnesota has implemented mandated screenings. Other states require some educational effort or screenings contingent on failing a hearing test.

Currently, other states have proposed or discussed CMV law. Indiana and Massachusetts have discussed universal newborn screenings. Other states, such as Michigan, are talking about educational efforts.

The CMV Foundation notes, “Effective legislation requires multiple stakeholders working together in advance of and beyond changing policy.” Collaboration by government officials, healthcare providers, parents, and public health experts may push nationwide universal screenings in the future.