The Commonwealth of Virginia is the location of our current home. Newborn
blood-spot
screening
is mandated by the Code of Virginia, Title 32.1 – Health, Chapter 3 – Medical
Care
Services,
Statutes 32.1 – XXXXXXXXXXVDH, XXXXXXXXXXThe mission of the Virginia Department
of
Health
(VDH) Newborn Screening Program (NSP) is to prevent permanent disability,
mental
retardation,
or death through early identification and treatment of infants who are affected
by
certain
heritable disorders and genetic disease. Mission statement in mind, the VDH
NSP,
without
question, helps with early intervention. The Program is a comprehensive and
coordinated
system
consisting of education to parents, 28 dried-blood spot screening tests as
recommended
by
the American College of Medical Genetics, follow up and referral, diagnosis,
medical and
dietary
management, and treatment. Services provided by the VDH NSP make it possible
to
identify
whether newborns have disorders that may result in serious problems if treatment
is not
started
soon after birth. Every newborn in The Commonwealth is tested a few days after
birth
unless
a parent declines on the basis that the test conflicts with their religious
beliefs. The
Division of Consolidated Laboratory
Services, Virginia Department of General Services,
conducts
the newborn dried blood spot screening tests in collaboration with the
Virginia
Department
of Health. VDH newborn screening nurses coordinate follow-up activities until
the
infant
is screened negative, diagnosed with a disease, or reaches six months of
age. Infants
diagnosed
with certain heritable disorders or genetic diseases through newborn
blood-spot
screening
are referred to the Care Connection for Children network for care coordination
services.
Regarding
VDH’s efforts toward screening in an academic context, Friis & Sellers
(2009) would
likely
give a synchronized nod (Friis & Sellers, XXXXXXXXXXGeneral consensus exists
justifying the commitment of
resources
to implement and carry out newborn screenings as is done by VDH; the
American
College
of Medical Genetics and citizens of Virginia support it. If issues are captured
via
screening,
morbidity and mortality along with health care system impact may be mitigated.
From
a
scientific perspective, medical knowledge at a very early age serves to provide
clinicians with
better
understanding of patient medical history and helps lead treatment modalities.
The diseases within The
Commonwealth’s
screening panel are treatable in some manner, hence the program is
ethically
sound.
Considering the five attributes of good screening tests, those performed by VDH
are
simple,
rapid, inexpensive from a cost-benefit perspective, safe, and acceptable (by
parents and a
professional
medical organization specializing in genetics). On the acceptability front,
dried-
blood
spot screening tests are about as minimally invasive as current technology will
allow.
Perhaps in
the future, blood sampling will not be required and saliva or cheek swab will
suffice. Due to the
American
College of Medical Genetics’ support of the entire panel of screening tests, one
may
argue
in favor of reliability and validity for basing of future diagnostic testing and
referral to
specialty
care providers.
References:
Friis, R. and Sellers, T.
(2009).
Epidemiology for Public Health Practice, 4th ed. Sudbury, MA;
Jones and Bartlett Publishers.
Virginina Department of
Health (VDH XXXXXXXXXXVirginia Newborn Screening Program. Retrieved on June 19,
2013 from http://www.vahealth.org/VNSP