New clinical pathway for deaf and hard of hearing newborns
06/11/2023
Babies with hearing loss now have access to CMV screening at their Royal Children’s Hospital audiology appointment.
Congenital cytomegalovirus (cCMV) occurs when the virus CMV affects unborn babies during pregnancy, causing life-long disability in more than 400 Australian babies born every year. Although it is the most common infection that causes hearing loss in at least 20% of deaf and hard of hearing children, cCMV is often undiagnosed because accurate testing must occur in the first three weeks of a baby’s life. Early diagnosis of the infection gives families the opportunity to consider treatment options, and although international guidelines now recommend early screening for cCMV in babies with hearing loss, this is not yet integrated into Australian standards for clinical care.
Research at the Centre for Community Child Health has previously demonstrated that early cCMV screening with a simple saliva swab was feasible, acceptable and cost neutral. Utilising these findings, the Royal Children’s Hospital Audiology Department has now implemented screening for cCMV in babies diagnosed with hearing loss who are less than three weeks old as part of their normal clinical care.
In the last 12 months, 12 deaf or hard of hearing babies aged three weeks or younger were offered a saliva swab to test for cCMV. From this screening process, four babies were confirmed to have cCMV and were able to see a specialist within the ideal treatment window to discuss their options. Two families chose to give an oral medication to their babies in an effort to reduce long-term complications of cCMV, and the remaining eight families were able to be reassured that their child’s hearing loss was not due to cCMV infection during pregnancy.
The Centre for Community Child Health researchers are part of the Australasian cCMV Register that will determine whether early treatment of cCMV for deaf and hard of hearing babies will prevent hearing loss progression and developmental disabilities. Also at the Centre, researchers are using the GenV study to find better ways to detect cCMV in newborns.
On Monday 27 November, the Inaugural Congenital CMV Symposium brought together 52 researchers, families, and a range of health professionals including maternal fetal medicine specialists, paediatricians, infectious diseases specialists, audiologists, early intervention specialists and hearing screening staff. The day highlighted the range of research initiatives around Australia on cCMV, including research around cCMV awareness and education, screening in pregnancy and newborns, treatments and vaccines, animal models for prevention and treatment strategies, as well as a national platform – the Australian CMV Register – to provide evidence on outcomes. Importantly, families with lived experience provided a powerful narrative for cCMV research.
The event was kindly supported by Mercy Perinatal and the MCRI Infection Immunity Theme.