A Legal Mapping Assessment of Cytomegalovirus-Related Laws in the United States

Importance: Congenital cytomegalovirus (CMV) infection is the leading infectious cause of birth defects in the United States, affecting approximately 1 out of 200 newborns. Increasing awareness of congenital CMV infection among policy makers and the public is critical for advancing the evidence base for prevention and intervention strategies, including behavioral interventions for pregnant women, newborn screening to enable timely interventions, and garnering support for vaccine development. Objective: To understand the current landscape of CMV-related statutes and regulations, we conducted a 50-state legal epidemiology study of laws expressly referencing "cytomegalovirus." Evidence Review: Our search yielded 101 statutes and regulations from 35 jurisdictions (34 states and District of Columbia). We systematically reviewed and coded the texts for themes. Findings: Laws addressed 3 main themes: (1) CMV awareness and education; (2) testing and reporting; and (3) the provision of services. Conclusions and Relevance: State-level CMV laws have been enacted to increase CMV awareness and to implement CMV testing for infants at a higher risk for infection, such as those who do not pass newborn hearing screening. This study provides a complete legal assessment of existing ways law is used to address CMV infection in the United States.