Read Full Text: Universal newborn screening for congenital CMV infection: What is the evidence of potential benefit? (2014)
Journal: Reviews in Medical Virology
Year Published: 2014
Ranked 12th on our 2014-2019 list of the 50 most influential articles
Article overview for OTs
Congenital cytomegalovirus (cCMV) infection is a leading cause of childhood disability, including hearing loss, cognitive deficits, and vision impairment.
The number of children with cCMV-related disabilities is similar to, or greater than, better-known conditions such as Down’s Syndrome and spina bifida.
This article sought to explore the evidence as to whether newborn cCMV screening could allow for early detection—which, in turn, might improve outcomes for those infected.
Overall, it was estimated that several thousands of children in the US could benefit from screening, detection, and early intervention.
Occupational therapy’s role in this article
Occupational therapy is mentioned in the article as a non-pharmaceutical intervention for children with cCMV. However, no direction is given regarding what type of occupational therapy interventions were recommended. (Hopefully this is something we can discuss in the comments.)
One thing that research indicated, though, is that the earlier deficits are detected and addressed, the better. Specifically, the review of evidence concluded:
- There is good evidence of the potential benefit of non-pharmaceutical interventions provided by nine months of age.
- There is fair evidence of non-pharmaceutical and antiviral therapy interventions for congenital CMV-related cognitive deficits and hearing loss occurring between nine and 24 months of age.
- There is poor (insufficient) evidence of the efficacy of non-pharmaceutical interventions for children with delayed hearing loss occurring after 24 months of age (as well as for children with visual impairments).
Advocacy for screening within our hospitals
A definitive diagnosis of congenital CMV requires the detection of the virus within the first two to three weeks after birth. If developmental disabilities become apparent at a later date, it is not possible to definitively associate them with congenital CMV if this initial test had not been administered.
This is even more complicated by the fact that children may or may not be symptomatic at birth; this is why standardized screening could be so important. If developmental disabilities appear at a later date and screening was not initially performed at birth, it could result in a “diagnostic odyssey.” This basically means it could lead to a whole slew of unnecessary tests and avoidable stresses on the patient and family, all of which could have been prevented with earlier screening.
If I may make a personal recommendation that was not found in the article, The National CMV Foundation is a great resource for further understanding of CMV, as well as for updates on screening research. You can also find a list of hospitals that have adopted standardized screening processes for CMV.
Pediatric OTs at increased risk of CMV infection
One more thing I’d like to mention—and, this was not in this article, but I thought it was important to share—recent research has illuminated the lack of awareness among pediatric therapists about their increased risk for acquiring CMV infection. If you are pediatric OT, this is important to consider when you are contemplating CMV screening during your own pregnancy.
It is certainly worth reading through Mayo Clinic’s overview of CMV, but here are the basics to be aware of:
CMV often presents in healthy adults as with common symptoms such as:
- Fatigue
- Fever
- Sore throat
- Muscle aches
It is spread through bodily fluids, including:
- blood
- urine
- saliva
- breast milk
- tears
Your risk of acquiring CMV infection is dramatically decreased through universal precautions, so don’t forget to wash those hands!
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