State Senator Janet Petersen has introduced new legislation that proposes screening all Iowa newborns for congenital cytomegalovirus (“CMV”) infection. The bill, Senate File 2057, also seeks to educate expecting parents and healthcare providers about the risks posed by CMV. If successful, Iowa would join five other states that have enacted CMV laws, four in 2015 alone.
The legislation would be the most progressive in the country if approved in its current form. Only Connecticut and Utah require CMV screening at present, and only for a subset of newborns, those with evidence of hearing loss. In Illinois, Texas, and Hawaii, the laws focus instead on providing educational materials to pregnant women and women who may become pregnant.
Despite its potential to generate savings by improving health outcomes, mandating CMV screening has been challenged in other states due to its high cost. The cost of screening newborns for CMV could total $4 million annually in Iowa, according to estimates cited by the Des Moines Register.
Iowa State Senator Janet Petersen
Because CMV viral load is low in blood, it is a poor fit for detection using routine blood tests that screen for multiple conditions in parallel. CMV is best detected with saliva or urine-based tests, which are used less frequently in routine screening. Further, CMV is a congenital infection and a proper diagnosis can only be made if the CMV virus is detected within a week of birth. This adds to the administrative challenge.
In early February, lobbyists for Iowa medical and health care groups were registered as undecided on the bill. However, they were reported to have questioned the medical necessity of screening all infants for the virus, saying it was not common practice.
Because universal CMV screening is not currently common practice, congenital infection often goes undetected because many affected infants do not present symptoms at birth. For instance, some researchers estimate that, because of onset later in life, only about half of the hearing loss resulting from congenital CMV infection is detected by universal newborn hearing screening. As a result, much of the hearing loss and many other CMV-related disabilities remain undetected for years after birth and are never linked to congenital CMV infection, and are therefore not optimally managed.
According to the U.S. Centers for Disease Control and Prevention, each year, approximately 5,000 U.S. infants will develop permanent problems due to CMV, some of them severe, including deafness, blindness, and mental retardation.
Learn how to lend your support to Iowa’s proposed CMV legislation by visiting the National CMV Foundation >>