17th ANNUAL EARLY HEARING DETECTION & INTERVENTION MEETING
March 18-20, 2018 • Denver, CO
| Hearing Trajectory in Children with Congenital Cytomegalovirus Infection
Hearing Trajectory in Children with Congenital Cytomegalovirus Infection
An estimated 15-20% of all cases of bilateral moderate to profound sensorineural hearing loss (SNHL) among young children are attributable to congenital cytomegalovirus (CMV) infection. In the United States, 20,000 children are born with congenital CMV infection annually; 90% are asymptomatic at birth. Infants with symptomatic congenital CMV disease are 8 times as likely to be diagnosed with SNHL within the first 8 weeks of life as those with asymptomatic infection. However, asymptomatic infection may contribute as many or an even greater number of SNHL cases during infancy as symptomatic disease. Additionally, 5% of children with asymptomatic congenital CMV infection may develop severe hearing loss in at least one ear by age 12 months, and half of these meet current candidacy criteria for cochlear implantation. We examined data from cohorts of 92 children with asymptomatic congenital CMV infection identified by newborn screening at Women’s Hospital of Texas, Houston TX, during 1982-1992 and 76 children with symptomatic congenital CMV disease, the majority of whom were identified by referrals. In this presentation, we will describe factors that were predictors of SNHL among symptomatic (clinical signs at birth and brain imaging findings) and asymptomatic (brain imaging findings) case-patients. We will present longitudinal data on hearing assessments through age 18 years to describe and compare the progression of SNHL among symptomatic and asymptomatic case-patients with congenital/early-onset and delayed-onset SNHL. Congenital/early-onset SNHL frequently resulted in severe to profound loss in both symptomatic and asymptomatic case-patients. Frequency-specific hearing levels were not significantly different between symptomatic and asymptomatic case-patients, except at 0.5 and 1 kHz. We anticipate our findings will be helpful to inform guidelines for audiologic monitoring and intervention in children with congenital CMV infection.
- Define risk factors for sensorineural hearing loss among children with symptomatic and asymptomatic congenital CMV infection
- Describe the progression of sensorineural hearing loss in congenital CMV infection from infancy to 18 years of age
- Compare the progression of sensorineural hearing loss among children with symptomatic and asymptomatic congenital CMV infection by congenital/early-onset and delayed-onset of hearing loss
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Presenters/Authors
Tatiana Lanzieri
(), CDC, uyk4@cdc.gov;
Dr. Tatiana Lanzieri, MD, MPH is a subject matter expert on congenital cytomegalovirus in the Division of Viral Diseases at the U.S. Centers for Disease Control and Prevention (CDC).
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Winnie Chung
(), Centers for Disease Control & Prevention, wchung@cdc.gov;
Winnie Chung, Au.D, a Health Scientist with CDC, is the subject matter expert with the Early Hearing Detection & Intervention (EHDI) team. Winnie Chung has been an audiology provider in various clinical setting from 1990 to 2009. She began her involvement in EHDI in 2001 providing outpatient hearing screening and diagnostic for newborns at Kaiser Permanente San Francisco and Oakland. From 2004 to 2009, besides coordinating Rhode Island state newborn hearing screening program, she also provided audiological services in the tertiary neonatal intensive care unit and managed the audiology outpatient clinic at Woman & Infants' Hospital. She joined CDC as a health scientist in April of 2009 providing technical assistance to state EHDI programs and investigating public health related issues for the CDC-EHDI team.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Jessica Leung
(), Centers for Disease Control and Prevention, JLeung@cdc.gov;
Jessica Leung is an epidemiologist in the Division of Viral Diseases at the National Center for Immunization and Respiratory Diseases
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Chantal Caviness
(), Baylor School of Medicine, ACCavine@texaschildrens.org;
Dr. Chantal Caviness is a pediatrician and holds a PhD in Epidemiology. She is an Associate Research Director for the section of pediatric emergency medicine and guides clinical research methodology within the section. She directs the clinical research and evidence-based medicine teaching initiatives within the section. She is a Co-Investigator for the National Children’s Study, which is the largest pediatric cohort study to be conducted within the United States. She is a Co-Investigator in an Emergency Medical Services for Children (EMSC)-funded project for pediatric asthma management in the emergency department.
ASHA DISCLOSURE:
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Nonfinancial -
Jason Baumgardner
(), Centers for Disease Control and Prevention, uxu2@cdc.gov;
Jason Baumgardner is a statistician with the Division of Viral Diseases at the National Center for Immunization and Respiratory Diseases.
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Nonfinancial -
Peggy Blum
(), Texas Children's Hospital, pxblum@texaschildrens.org;
Peggy Blum is a an audiologist at Texas Children's Hospital in Houston.
ASHA DISCLOSURE:
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Nonfinancial -
Stephanie Bialek
(), Centers for Disease Control and Prevention, zqg7@CDC.GOV;
Dr. Stephanie Bialek currently serves as the branch chief of the Division of Parasitic Diseases at the Center for Global Health.
ASHA DISCLOSURE:
Financial -
No relevant financial relationship exist.
Nonfinancial -
No relevant nonfinancial relationship exist.
Gail Demmler-Harrison
(), Baylor School of Medicine, gdemmler@bcm.edu;
Dr. Gail Demmler-Harrison, MD, is a pediatric infectious diseases specialist, clinical virologist, and the Principal Investigator for the Houston Congenital Cytomegalovirus (CMV) Longitudinal Study. Dr Demmler is a Professor of Pediatrics at Baylor College of Medicine and Attending Physician at Texas Children's Hospital, Houston, Texas and she has studied the biology, epidemiology, diagnosis, clinical manifestations, long term effects, treatment, and prevention of CMV infections for over 30 years at these institutions.
ASHA DISCLOSURE:
Financial -
Receives Salary for Employment from Baylor College of Medicine .
Nonfinancial -
No relevant nonfinancial relationship exist.