Congenital cytomegalovirus infection in Israel: Screening in different subpopulations

Background: The incidence of congenital cytomegalovirus in Israel has never been determined, either in general or in relation to various population subgroups. We recently proved the utility of newborn urine polymerase chain reaction as a screening tool for congenital CMV. Objectives: To define the incidence of congenital CMV infection in two different subpopulations, as a model for the entire population of Israel. Methods: Urine specimens were randomly collected from 2,000 newborns in Shaare Zedek Medical Center, Jerusalem, and HaEmek Medical Center, Afula (1,000 specimens each). These hospitals have many characteristic differences, presumably representing the diverse population of Israel. Urine specimens were subjected to a CMV PCR reaction and positive specimens were validated by urine viral culture. Maternal seroprevalence was determined in a representative sample of the mothers in each hospital. Epidemiologic characteristics of the mothers were extracted from hospital records and compared. Results: The population in Shaare Zedek Medical Center was mostly Jewish (97.7%) and urban (87.0%), as compared to that of HaEmek Medical Center (49.2% and 61.0%, respectively, P < 0.01). Nevertheless, CMV seroprevalence was similar: 81.5% and 85%, respectively. Ten (1.0%) and 4 (0.4%) newborns, respectively, were found to have congenital CMV infection (not significant). Conclusions: The combined incidence of congenital CMV infection in the study population was 0.7% (95% confidence interval 0.3-1.0%). If this rate is extrapolated to the entire population of Israel, then a total of 945 cases of congenital CMV can be expected among the 135,000 annual deliveries. A nationwide screening program for congenital CMV should be considered.