Raines Kelley, Heitman Kristen Nichols, Leung Jessica, Woodworth Kate R, Tong Van T, Sugerman David E, Lanzieri Tatiana M
ASRT, Inc., Contracting agency to the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Birth Defects Res. 2023 Jan 1;115(1):11-20. doi: 10.1002/bdr2.2098. Epub 2022 Oct 3.
Congenital cytomegalovirus (cCMV) is not a nationally notifiable condition, and little is known about how U.S. health departments (HDs) currently conduct cCMV surveillance.
We surveyed U.S. HDs that conduct cCMV surveillance or screening activities identified through a web-based assessment. Meetings were held with each HD to enhance our understanding of survey responses.
Ten states are systematically collecting cCMV case data to track cCMV cases during early infancy and to provide resources and services to families. Cases are ascertained using cCMV diagnostic codes, reported diagnosis, or laboratory results. Data elements collected for each case include demographics (all 10 states), clinical signs (8 states), laboratory data (4 states), treatment (4 states), and long-term outcomes (1 state). Annual number of cases reported by HDs ranged from 3 to 47 cases/year in seven states, which was much lower than the expected number of cCMV cases. All 10 HDs have the ability to analyze data collected and four disseminate findings. Major challenges of surveillance reported by HDs were lack of standardized case definitions, personnel constraints, and limited funding.
A comprehensive account of cCMV disease burden is severely limited by low case ascertainment and paucity of data on long-term outcomes. A standardized public health case definition for cCMV would improve consistency in measuring disease prevalence across jurisdictions and over time. Surveillance for cCMV has the potential to increase disease awareness and inform strategies to prevent cCMV-associated disabilities.
先天性巨细胞病毒（cCMV）感染并非全国法定报告疾病，目前对于美国卫生部门（HDs）如何开展cCMV监测知之甚少。
我们对通过网络评估确定的开展cCMV监测或筛查活动的美国卫生部门进行了调查。与每个卫生部门举行了会议，以加深我们对调查回复的理解。
有10个州正在系统收集cCMV病例数据，以追踪婴儿早期的cCMV病例，并为家庭提供资源和服务。通过cCMV诊断编码、报告的诊断结果或实验室结果来确定病例。为每个病例收集的数据元素包括人口统计学信息（所有10个州）、临床体征（8个州）、实验室数据（4个州）、治疗情况（4个州）和长期预后（1个州）。7个州卫生部门每年报告的病例数为3至47例/年，远低于预期的cCMV病例数。所有10个卫生部门都有能力分析所收集的数据，其中4个部门会传播研究结果。卫生部门报告的监测主要挑战包括缺乏标准化的病例定义、人员限制和资金有限。
cCMV疾病负担的全面评估因病例确诊率低和长期预后数据匮乏而受到严重限制。cCMV的标准化公共卫生病例定义将提高跨辖区和跨时间衡量疾病患病率的一致性。cCMV监测有可能提高疾病认知度，并为预防cCMV相关残疾的策略提供信息。
