How is the congenital CMV screen done?
As of July 1, 2025, all babies born in Connecticut are to be screened for congenital Cytomegalovirus (CMV) as part of their newborn bloodspot screening carried out shortly after birth.
Every baby born in Connecticut receives a newborn screening (NBS) bloodspot test shortly after birth. This is done by taking a few drops of blood from the newborn’s heel one to two days after birth. The blood is sent to the CT Public Health Laboratory, Newborn Screening Program where it is tested for over 60 disorders. Newborn screening allows for early identification and treatment of infants with these conditions.
Infants who fail their newborn hearing screening at birth should also get a diagnostic test for cCMV. The birthing facility will take a sample of saliva or urine from your baby if they fail their hearing screening. The results will be reported to you or your baby’s doctor. If this is not completed at the hospital, your baby’s doctor will need to order it. It is very important this is done by 21 days of life, as the results could impact treatment plans.
What is CMV?
Cytomegalovirus is a common virus that can affect people of all ages, including pregnant women and babies. Most adults (50-80%) have been exposed by age 40. Many people with CMV do not realize that they have been infected because they do not feel sick or show symptoms.
How do people get CMV?
CMV is spread from person to person through direct close contact with body fluids like saliva, urine, blood, tears, and breast milk.
Contact with the saliva or urine of babies and young children is a common cause of CMV infection in pregnant people. During pregnancy, the virus can be unknowingly spread from the mother to the unborn baby. When an infant is born with CMV, it is called congenital CMV (cCMV).
What is cCMV?
Most babies with congenital CMV never show symptoms or have health problems. However, some babies may be sick at birth or develop long-term health problems. Congenital CMV can cause hearing loss, vision loss, and developmental delays.
Early identification and intervention help prevent babies who have hearing loss from falling behind other children in speech and language development.
Impact
- 1 in 200 infants is born with cCMV
- 1 in 5 of these infants will have a birth defect or permanent health condition
- CMV is the most common infectious cause of birth defects
What are the signs and symptoms of cCMV?
Some babies with cCMV will have symptoms at birth including:
- Very small head
- Smaller body than expected for age
- Skin rash
- Yellowing of skin and whites of eyes
- Weak muscles
Some babies (up to 20%) with cCMV will have permanent hearing loss. Hearing loss might be present at birth or show up later in childhood. It is important that babies with cCMV have regular hearing exams to identify any hearing loss early on. Early identification allows babies to start with therapies and treatment sooner.
Most babies with cCMV are born without symptoms of disease and are not expected to develop symptoms.
What happens if my baby screens positive for cCMV on their newborn screen?
If your baby tests positive for cCMV on their dried blood spot newborn screening, more testing is needed to know for sure if they have cCMV. Newborn screening cannot predict if a baby will have symptoms or not, which is why additional testing is important for children with cCMV. Congenital CMV infection is normally confirmed by testing a baby’s urine.
Your baby’s doctor will test their urine:
- If CMV is not found in your baby’s urine, the doctor will do a physical exam to rule out cCMV.
- If CMV is found in your baby’s urine, it means your baby has a CMV infection and more testing is recommended to look for health problems caused by cCMV.
This testing includes:
- Blood draw
- Physical exam
- Hearing testing by a pediatric audiologist (a doctor who specializes in early detection and treatment of hearing loss in children)
- Eye exam by an ophthalmologist (a doctor who specializes in eyes)
- Head ultrasound (a medical test that uses high-frequency sound waves to create live images from the inside the body)
- Meeting with a pediatric infectious disease specialist (a doctor who has specialized training in diagnosing, treating, and preventing infectious diseases in children)
Your baby’s doctor will work with a pediatric infectious disease specialist to coordinate these tests. Please contact the Connecticut Newborn Screening Network 📞 (860) 837-7870, with any additional questions.
For accurate results, this test should be done before your baby is 21 days old.
Resources for parents
Information for providers
Newborns with a positive newborn screening result for cCMV require further testing and evaluation. Diagnostic testing for cCMV must be performed within the first three weeks of life (the urine and blood testing should be prioritized).
The Connecticut Newborn Screening Network (The Network) will work with the baby’s primary care provider to advise and coordinate the necessary diagnostic testing.
Steps to take when notified of a positive cCMV result
-
Order CMV PCR on urine
If negative:
Perform a physical exam- If there are clinical findings consistent with cCMV (preterm, low birth weight, jaundice, enlarged liver or spleen, microcephaly, feeding issues, hypotonia, abnormal reflexes) refer baby to Infectious Disease (ID).
- If there are not any clinical findings consistent with cCMV no further follow up is required. cCMV is ruled out. If baby failed their hearing screen, follow up with audiology.
-
Ensure all testing is completed prior to 3 weeks of age. This includes:
- Physical Examination
- Order CBC, Bilirubin (T&D), and LFTs (AST, ALT)
- Head ultrasound
- Pediatric audiology evaluation
- Referral to pediatric ophthalmology
- Referral to Infectious Disease
If positive:
The Connecticut Newborn Screening Network (the Network) will be contacting your facility
Post diagnosis the primary care provider is responsible for development surveillance, audiology follow-up, and referral to birth to three.
cCMV Contacts
Infectious Disease/Immunology Specialists
Connecticut Children's Infectious Disease
Phone: 860-545-9490
Yale-New Haven Pediatric Infectious Disease
Phone: 877-925-3637
Audiology Referrals
Connecticut Children's Audiology
Locations: Hartford, Farmington Glastonbury
Phone: 860-545-9642
Lawerence + Memorial at Waterford - Outpatient Rehabilitation Services - Waterford
Location: Waterford
Phone: 860-271-5900
Fax: 860-271-4801 (for referrals)
UConn Speech & Hearing Clinic
Locations: Strorrs
Phone: 860-486-2629
Yale-New Haven Children's Hospital Pediatric Audiology
Location: New Haven, Trumbull
Phone: 877-925-3637