<P> Early identification of individuals with sickle cell disease and other hemoglobinopathies allows treatment to be initiated in a timely fashion . Penicillin has been used in children with sickle cell disease, and blood transfusions are used for patients identified with severe thalassemia . </P> <P> Most jurisdictions did not start screening for any of the organic acidemias before tandem mass spectrometry significantly expanded the list of disorders detectable by newborn screening . Quebec has run a voluntary second - tier screening program since 1971 using urine samples collected at three weeks of age to screen for an expanded list of organic acidemias using a thin layer chromatography method . Newborn screening using tandem mass spectrometry can detect several organic acidemias, including propionic acidemia, methylmalonic acidemia and isovaleric acidemia . </P> <P> Cystic fibrosis (CF) was first added to newborn screening programs in New Zealand and regions of Australia in 1981, by measuring immunoreactive trypsinogen (IRT) in dried blood spots . After the CFTR gene was identified, Australia introduced a two tier testing program to reduce the number of false positives . Samples with an elevated IRT value were then analyzed with molecular methods to identify the presence of disease causing mutations before being reported back to parents and health care providers . CF is included in the core panel of conditions recommended for inclusion in all 50 states, Texas was the last state to implement their screening program for CF in 2010 . Alberta was the first Canadian province to implement CF screening in 2007 . Quebec, New Brunswick, Nova Scotia, Newfoundland and Prince Edward Island do not include CF in their screening programs . The United Kingdom as well as many European Union countries screen for CF as well . Switzerland is one of the latest countries to add CF to their newborn screening menu, doing so in January 2011 . </P> <P> Disorders of the distal urea cycle, such as citrullinemia, argininosuccinic aciduria and argininemia are included in newborn screening programs in many jurisdictions that using tandem mass spectrometry to identify key amino acids . Proximal urea cycle defects, such as ornithine transcarbamylase deficiency and carbamoyl phosphate synthetase deficiency are not included in newborn screening panels because they are not reliably detected using current technology, and also because severely affected infants will present with clinical symptoms before newborn screening results are available . Some regions claim to screen for HHH syndrome (hyperammonemia, hyperornithinemia, homocitrullinuria) based on the detection of elevated ornithine levels in the newborn screening dried blood spot, but other sources have shown that affected individuals do not have elevated ornithine at birth . </P>

When did they start screening for cystic fibrosis