Mrs Lauren McHugh1, Dr Rachael Beswick1, Dr Julia Clark1, Ms Delene Thomas1
1Healthy Hearing, Children’s Health Queensland, Nundah, Brisbane, Australia
Congenital cytomegalovirus (cCMV) is an important cause of childhood deafness and is potentially modifiable if diagnosed within the first month of life. Targeted cCMV screening of infants who do not pass on newborn hearing screening testing has been suggested as an easy, reliable and cost-effective approach to identify and treat babies to improve hearing outcomes. To determine whether targeted cCMV screening within the Queensland Universal Newborn Hearing Screening (UNHS) program is feasible and worthwhile, a four-year research study was undertaken (August 2014 – August 2018) at three Queensland tertiary maternity hospitals in Brisbane and Townsville.
Infants who did not pass UNHS were offered a salivary swab for CMV PCR at the point of referral to audiological services. Hearing screeners obtained informed written consent from caregivers and the salivary swabs were tested for CMV DNA by real time quantitative PCR. Parents of babies with a positive CMV PCR were notified, the babies medically assessed, and where appropriate, treatment (oral Valganciclovir) was offered by the Infection Management and Prevention Consultant.
In 2016 and 2017, preliminary outcomes demonstrated that this approach to cCMV was feasible and cost neutral. Irrespective of this evidence, consideration of how to realistically upscale targeted cCMV screening to a state-wide UNHS program was critical. Consultation with key stakeholders was undertaken and the feedback resulted in a decision to redesign the framework of cCMV screening in Queensland and to cease the research study after four years.
In this presentation, the outcomes of the cCMV targeted screening data will be provided and compared with state- wide Infection Management and Prevention Services data outcomes. The overall Queensland experience of four years will be analysed using both the data set and qualitative feedback collected during the four years, with a discussion of recommendations for future of Queensland cCMV screening.
Dr Rachael Beswick is the Director of Queensland’s newborn hearing screening program, Healthy Hearing. Rachael completed her Bachelor of Speech Pathology, Masters of Audiological Studies, and PhD at the University of Queensland, and recently completed her MBA at the Queensland University of Technology. Her primary areas of research lie in screening programs, risk factors, detection of postnatal hearing loss, and quality assurance processes. She has published several scientific papers, and has presented her research at both national and international conferences.
Lauren McHugh, Queensland Healthy Hearing speech pathologist, supports projects and quality in newborn hearing screening and early intervention.