BILL NUMBER:  S2816

 TITLE OF BILL :  An act to amend the public health law, in relation
to the testing of certain newborns for cytomegalovirus and public
education thereon

 PURPOSE :

To provide testing for CMV if a newborn infant is identified as or
suspected of having a hearing impairment as well as to promote public
awareness and education of CMV.

 SUMMARY OF PROVISIONS :

Section 1 amends section 2500-a of the Public Health Law to require
that any newborn identified as or suspected of having a hearing
impairment be tested for cytomegalovirus unless a parent of the
newborn infant objects.

Section 2 adds section 2500-1 to the Public Health Law entitled
Cytomegalovirus Public Education. Subdivision (1) requires the
Department of Health to develop and publish informational materials
for women who may become pregnant, expectant parents and parents of
infants regards cytomegalovirus. Subdivision (2) directs the DOH to
publish the information required under section (1) to its internet
website and distribute information regarding birth defects, treatment
              

and resources to all hospitals performing cytomegalovirus testing
pursuant to public health law section 2500-a. Subdivision (3) allows
the Department to establish rules to implement the purpose of this
section.

Section 3 provides an immediate effective date.

 JUSTIFICATION :

Cytomegalovirus (CMV) is the most common congenital viral infection
and the leading non-genetic cause of deafness in children. Although
most CMV infections are silent, meaning the majority of people who are
infected with CMV have no signs or symptoms and while there are no
harmful side effects, its effects can be devastating to a fetus.
Every year, 20,000 to 40,000 infants are born with CMV and roughly 400
children die from CMV annually. Congenital CMV infection is largely
undetected because the majority of infants are asymptomatic at birth.
At least 20 percent (up to 8,000) infants have or develop permanent
disabilities, such as hearing loss, microcephaly, intellectual
deficits and vision abnormalities. While such cases are fortunately
relatively rare, CMV is four times more prevalent than Zika in the
U.S. and the state has spent millions to fight Zika.

CMV is transmitted by contact with saliva and urine-often from diaper
wearing children to adults. Pregnant women often get CMV from their
toddlers, especially toddlers in day care, as nearly one in three
children are infected by age five. Significantly, the American College
of Obstetricians and Gynecologists used to encourage counseling for
pregnant women on how to avoid CMV but last year, the college reversed
course claiming that patient instruction remains unproven as a method
to reduce the risk of congenital CMV infection.  However, it is hard
for mothers to protect themselves from a virus carried by the children
they care for, especially if they are unaware of the virus
itself--less than one in five pregnant women are aware of
cytomegalovirus. Few women are warned about this infection and
according to a federal survey, less than half of
obstetrician-gynecologists tell pregnant patients how to avoid CMV.
Researchers say that pregnant women do not worry about CMV only
because they do not know about it, which is why it is crucial for

women who are pregnant or may become pregnant to be aware of available
preventative measures, such as not sharing food with toddlers.

This legislation aims to raise public awareness and reduce the
transmission of CMV to a woman from a toddler by educating women about
the virus itself and simple preventative measures, such as washing
ones hands after changing infants and toddlers diapers. This
legislation also aims to promote earlier detection of CMV in infants
who are identified or suspected of having a hearing impairment. A test
for CMV can be done immediately upon receiving the results from the
newborn-infant hearing screening, which typically occurs at a facility
before a newborn is discharged. Significantly, infants who receive a
timely diagnosis can be given hearing aids or access to
early-intervention programs to have the best chance of learning to
talk. A study published in The New England Journal of Medicine last
year found that infants with CMV symptoms at birth who took an
antiviral drug for six months had moderately better hearing at 2 years
compared with newborns who took it for six weeks (see
http://www.nejm.org/doifful1/10.1056/NEJMoa1404599#t=article). Recent
evidence suggests that routine screening of newborns could allow
infected infants to receive consistent monitoring and treatment if
necessary, ultimately increasing his/her chance of optimize d
developmental care. This act is aimed at making parents aware of what
their options are if their child is determined to have CMV.

In 2013, the Utah legislature passed the Cytomegalovirus Public Health
Initiative, which requires CMV screening of newborns who did not pass
hearing tests. Connecticut, Hawaii, Illinois, Texas and Tennessee
subsequently followed suit. Idaho, Michigan, Minnesota, Pennsylvania,
South Carolina and Wyoming are currently working through similar
legislation.

 LEGISLATIVE HISTORY :

New bill.

 FISCAL IMPLICATIONS :

None.

 EFFECTIVE DATE :
This act shall take effect immediately.

                                
 
BILL NUMBER: S2816A

SPONSOR: HANNON
 
TITLE OF BILL:  An act to amend the public health law, in relation to
the testing of certain newborns for cytomegalovirus and public education
thereon

 
PURPOSE:

To provide testing for CMV if a newborn infant is identified as or
suspected of having a hearing impairment as well as to promote public
awareness and education of CMV.

 
SUMMARY OF PROVISIONS:

Section 1 amends section 2500-a of the Public Health Law to require that
any newborn identified as or suspected of having a hearing impairment be
tested for cytomegalovirus unless a parent of the newborn infant
objects.

Section 2 adds section 2500-1 to the Public Health Law entitled Cytome-
              

galovirus Public Education. Subdivision (1) requires the Department of
Health to develop and publish informational materials for women who may
become pregnant, expectant parents and parents of infants regards cyto-
megalovirus. Subdivision (2) directs the DOH to publish the information
required under section (1) to its internet website and distribute infor-
mation regarding birth defects, treatment and resources to all hospitals
performing cytomegalovirus testing pursuant to public health law section
2500-a. Subdivision (3) allows the Department to establish rules to
implement the purpose of this section.

Section 3 provides an immediate effective date.

 
JUSTIFICATION:

Cytomegalovirus (CMV) is the most common congenital viral infection and
the leading non-genetic cause of deafness in children. Although most CMV
infections are silent, meaning the majority of people who are infected
with CMV have no signs or symptoms and while there are no harmful side
effects, its effects can be devastating to a fetus.  Every year, 20,000
to 40,000 infants are born with CMV and roughly 400 children die from
CMV annually. Congenital CMV infection is largely undetected because the
majority of infants are asymptomatic at birth. At least 20 percent (up
to 8,000) infants have or develop permanent disabilities, such as hear-
ing loss, microcephaly, intellectual deficits and vision abnormalities.
While such cases are fortunately relatively rare, CMV is four times more
prevalent than Zika in the U.S. and the state has spent millions to
fight Zika.

CMV is transmitted by contact with saliva and urine-often from diaper
wearing children to adults. Pregnant women often get CMV from their
toddlers, especially toddlers in day care, as nearly one in three chil-
dren are infected by age five. Significantly, the American College of
Obstetricians and Gynecologists used to encourage counseling for preg-
nant women on how to avoid CMV but last year, the college reversed
course claiming that patient instruction remains unproven as a method to
reduce the risk of congenital CMV infection.  However, it is hard for
mothers to protect themselves from a virus carried by the children they
care for, especially if they are unaware of the virus itself--less than
one in five pregnant women are aware of cytomegalovirus. Few women are
warned about this infection and according to a federal survey, less than
half of obstetrician-gynecologists tell pregnant patients how to avoid
CMV.  Researchers say that pregnant women do not worry about CMV only
because they do not know about it, which is why it is crucial for women
who are pregnant or may become pregnant to be aware of available preven-
tative measures, such as not sharing food with toddlers.

This legislation aims to raise public awareness and reduce the trans-
mission of CMV to a woman from a toddler by educating women about the
virus itself and simple preventative measures, such as washing ones
hands after changing infants and toddlers diapers. This legislation also
aims to promote earlier detection of CMV in infants who are identified
or suspected of having a hearing impairment. A test for CMV can be done
immediately upon receiving the results from the newborn-infant hearing
screening, which typically occurs at a facility before a newborn is
discharged. Significantly, infants who receive a timely diagnosis can be
given hearing aids or access to early-intervention programs to have the
best chance of learning to talk. A study published in The New England
Journal of Medicine last year found that infants with CMV symptoms at
birth who took an antiviral drug for six months had moderately better
hearing at 2 years compared with newborns who took it for six weeks (see
http://www.nejm.org/doilii11/10.1056/NEIMoa140459544-article). Recent
evidence suggests that routine screening of newborns could allow
infected infants to receive consistent monitoring and treatment if
necessary, ultimately increasing his/her chance of optimize d develop-
mental care. This act is aimed at making parents aware of what their
options are if their child is determined to have CMV.

In 2013, the Utah legislature passed the Cytomegalovirus Public Health
Initiative, which requires CMV screening of newborns who did not pass
hearing tests. Connecticut, Hawaii, Illinois, Texas and Tennessee subse-
quently followed suit. Idaho, Michigan, Minnesota, Pennsylvania, South
Carolina and Wyoming are currently working through similar legislation.

 
LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This act shall take effect immediately.