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 – 32.1-69 (VDH, 2013). The 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, 2009). General 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). (2013). Virginia Newborn Screening Program. Retrieved on June 19, 2013 from http://www.vahealth.org/VNSP