Above (from left to right): Debbie Zazvorka, Dr. Michelle Barton-Forbes, and Leah Ethier stand inside a Children's Hospital PMDU examination room.
March 7, 2025
Each year, on March 8, International Women’s Day is recognized around the world. International Women’s Day serves as a call-to-action to advance gender equity internationally and honours the various social, economic, cultural, and political achievements of women.
At LHSC, we celebrate International Women’s Day by recognizing the women of Team LHSC – women like Dr. Michelle Barton-Forbes, Division Head of Paediatric Infectious Diseases (ID) at Children’s Hospital at LHSC; Leah Ethier, ID Nurse Practitioner at Children’s Hospital; and Debbie Zazvorka, Program Coordinator at Children’s Hospital. By leading a regional program at Children’s Hospital, the team is helping advance care for infants with congenital cytomegalovirus (cCMV) — a viral infection.
While cCMV is common among the general population, its impact is greatest in pregnant women and the immunocompromised. If women become infected during their pregnancy, they can pass the infection along to their infants in the womb. cCMV is the most common congenital infection and the leading cause of non-genetic hearing loss in childhood.
“One fifth of newborns with cCMV will go on to develop neurodevelopmental delays or hearing loss,” says Dr. Barton-Forbes. “Without screening, only 1 per cent are diagnosed because at birth 90 per cent of infected infants have no symptoms. Early detection of cCMV allows for proper interventions, leading to treatment that can improve outcomes.”
The regional cCMV program at Children’s Hospital works with over 15 community paediatric partners who specialize in the follow up of patients who don’t show any symptoms. The team’s core leadership consists of Dr. Barton-Forbes, Program Director; Leah Ethier, Program Manager; and Debbie Zazvorka, Program Coordinator. They work with local and regional partners including pharmacists, audiologists, radiologists, anaesthesiologists, otolaryngologists (ear, nose and throat physicians), ophthalmologists, neurodevelopmentalists, and neurologists to ensure comprehensive, multidisciplinary support.
“We have an amazing team that works quickly to ensure that each infant is screened and diagnosed as early as possible,” explains Leah Ethier. “This ensures therapy begins early, taking place over six months with close follow up in our specialized cCMV clinic.”
The Southwest Ontario regional program is a part of one of the world’s first population-wide universal screening programs with the four other provincial paediatric academic programs and centers leading their respective regions. Universal screening began in Ontario in 2019 and is led by Newborn Screening Ontario. Since provincial program implementation, there has been incredible success with most babies born in Ontario obtaining screening for cCMV.
“Between 2014 and 2019, we diagnosed and treated three cases at LHSC. Since then, we have registered over 140 infants screening positive for cCMV ,” states Dr. Barton-Forbes. “By developing a cohesive program with a multidisciplinary team of local experts, we have been able to significantly improve care. Over these five years, we have tweaked our local process to improve effective, timely delivery of care, streamlining the process to those who truly need it.”
The provincial program is now a model for other programs nationally and internationally. Leah Ethier and Dr. Barton-Forbes note that since the population-based screening has been so successful, other provinces and states are adopting similar programs with each at various stages of exploration and implementation.
The program is also raising awareness and promoting a better understanding of cCMV among both paediatric and obstetric care clinicians in the province.
“Education is an important part of the work we do,” says Leah. “A greater understanding of cCMV is of significant benefit to children, expectant mothers, and their families.”
The provincial team continues to lead the way through their work on cCMV, exploring avenues for research and education. You can read more about the provincial leads and their work in a recently published article in JAMA Pediatrics.
Dr. Barton-Forbes, Leah and Debbie represent LHSC’s many women physicians, researchers, and health-care professionals advancing patient care and inspiring future generations. This International Women’s Day, we celebrate the work of individuals like Dr. Barton-Forbes, Leah and Debbie who continue to pave the way and make their mark on patient-centred care at LHSC and beyond.