Newborn screening for congenital infectious diseases.

Eurico Camargo Neto,Roberto Giugliani,Jaqueline Schulte,Rosélia Rubin

doi:10.3201/eid1006.030830

Eurico Camargo Neto, Roberto Giugliani + Show 2 more

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https://doi.org/10.3201/eid1006.030830

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Abstract

To estimate the prevalence of congenital toxoplasmosis, Chagas disease, cytomegalovirus, and rubella, blood samples on dried blood spot (DBS) from neonates (day 3–20 of life) were screened for immunoglobulin (Ig) M against Toxoplasma gondii, cytomegalovirus, rubella virus, and IgG against Trypanosoma cruzi by methods used for serum and adapted for use with DBS. Positive samples were further analyzed for IgM and IgG in serum from neonates and mothers. DBS samples from 364,130 neonates were tested for Toxoplasma gondii–specific IgM, and 15,873 neonates were also tested for IgM against cytomegalovirus and rubella virus and for Trypanosoma cruzi–specific IgG. A total of 195 were diagnosed with congenital toxoplasmosis, 16 with cytomegalovirus, and 11 with congenital rubella. One newborn had a confirmed result for Chagas disease, and 21 mothers had positive serum antibodies. These results suggest that infectious diseases should be considered for future inclusion in programs for newborn screening of metabolic diseases in disease-endemic areas.

Highlights

To estimate the prevalence of congenital toxoplasmosis, Chagas disease, cytomegalovirus, and rubella, blood samples on dried blood spot (DBS) from neonates were screened for immunoglobulin (Ig) M against Toxoplasma gondii, cytomegalovirus, rubella virus, and IgG against Trypanosoma cruzi by methods used for serum and adapted for use with DBS
A neonatal screening program based on detecting immunoglobulin (Ig) M antibodies against Toxoplasma gondii alone would identify 70%–80% of congenital toxoplasmosis cases [3]
The serum was eluted with 200 μL of phosphate-buffered saline (PBS)/bovine serum albumin (BSA) buffer on an orbital shaker set at 100 rpm for 60 min and incubated for 14–16 h at room temperature

Summary

Introduction

To estimate the prevalence of congenital toxoplasmosis, Chagas disease, cytomegalovirus, and rubella, blood samples on dried blood spot (DBS) from neonates (day 3–20 of life) were screened for immunoglobulin (Ig) M against Toxoplasma gondii, cytomegalovirus, rubella virus, and IgG against Trypanosoma cruzi by methods used for serum and adapted for use with DBS. A study by Guerina et al [5] showed a prevalence of congenital toxoplasmosis of 1 per 10,000 live births in the United States, where 85% of women of Congenital Chagas disease has been reported, mostly in Latin America [7], where approximately 20 million persons are affected; 90 million others are at risk of being infected by the parasite [8]. The value of vaccination against congenital cytomegalovirus infection is not known, and screening of newborn infants has been recommended to indicate infants at high risk for deafness and to make early rehabilitation possible [18]. RESEARCH prevalence of anti-rubella antibodies from developing countries concluded that congenital rubella syndrome is an under-recognized public health problem and that appropriate data need to be collected to estimate the cost-effectiveness of a potential global rubella control program [20]

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