Can we use evidence to align congenital cytomegalovirus (CMV) infection diagnosis and management practice in infants with hearing loss across tertiary children’s hospitals in NSW?

Dr Elizabeth Peadon1, Dr Philip Britton1,2,3, Dr Carolyn Cottier4, Ms Melanie Dowling5, Ms Janet Hodge6, Professor Alison Kesson1,2,3, Ms Judith McCloskey7, Dr Joanne McIntosh5, Professor Pamela Palasanthiran4,8, Ms Deepali Trackroo1, Dr Monica Wilkinson4,8, Professor William Rawlinson9,10

1The Children’s Hospital at Westmead, Westmead, Australia,

2Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia,

3Marie Bashir Institute for Infectious Diseases and Biosecurity, Sydney Medical School, The University of Sydney, Sydney, Australia,

4Sydney Children’s Hospital, Randwick, Australia,

5John Hunter Children’s Hospital, Newcastle, Australia,

6Hunter New England Local Health District, Newcastle, Australia,

7Western Sydney Local Health District, Sydney, Sydney,

8School of Women’s and Children’s Health, University of New South wales, Sydney, Australia,

9NSW Health Pathology, Randwick, Australia,

10Schools of Medical Sciences, Biotechnology and Biomolecular Sciences, and Women’s and Children’s Health, University of New South Wales, Sydney, Australia


As occurs in many tertiary care children’s hospitals, those in Sydney and northern NSW have had different approaches to screening, diagnosis and management of congenital cytomegalovirus (CMV) infection. The two Sydney children’s hospitals were brought under the one umbrella in the Sydney Children’s Hospitals Network (SCHN) in 2010, and practices are being harmonised to improve services. Over the past few years, families of infants with hearing loss have become more aware of congenital CMV and the variations in practice. International expert consensus guideline for prevention, diagnosis and therapy of congenital CMV continue to highlight the importance of targeted CMV testing in infants with hearing loss (1).

Questions from clinicians, families, and the  publication of the international guideline in 2017 provided impetus for the children’s hospitals to review their practices in this area. In 2018, a working group representing paediatric hearing services, audiology, infectious diseases and virology met to work towards an evidence-based SCHN and JHH approach to the diagnosis and management of congenital CMV infection in infants with hearing loss. This collaboration has now expanded to include other partners including the SWISH coordinators.  We aim to have the entire state progressing to best international practice in this area. The work has led to a grant proposal to trial targeted congenital CMV infection screening within the scope of the SWISH.

This presentation will discuss changing practice for congenital CMV infection diagnosis and management for infants with hearing loss across tertiary children’s hospitals. The evidence, enabling factors, what we can learn from others’ experiences and the challenges will be discussed in the setting of increasing expectations and needs from families.

  1. Rawlinson WD, Boppana SB, Fowler KB, et al. Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy. Lancet Infect Dis. 2017;17(6):e177-e88.


Dr Elizabeth Peadon (MBBS, DCH, MPH, PhD, FRACP) is a developmental paediatrician and the Head of the Deafness Centre at The Children’s Hospital at Westmead.  Dr Peadon works with children who have permanent hearing loss and their families regarding the aetiology of hearing loss, management and associated developmental issues.