Screening Program

In every ethnic, demographic, or racial group, there are certain inherited disorders that occur more frequently than in the general population. Such is the case for Ashkenazi Jewish individuals whose ancestors lived in Central or Eastern Europe. If you and/or your spouse are of Ashkenazi Jewish descent, the Center for Jewish Genetic Diseases conducts expert Jewish genetic disease screening and genetic counseling to individuals at risk for being carriers. Only board-certified genetic counselors, and clinical and molecular geneticists provide these services. 

What Is Genetic Screening?

Genes pass from biological parents to offspring. Genes occur as pairs, and the fetus inherits one part of each pair of genes from the egg and the other part from the sperm. A change in a gene, known as a mutation, can cause that gene not to work properly, which can lead to disease.

Certain diseases occur when both genes of a pair have the mutation and cause a recessive disease. In order to have a child with a recessive disease, each parent has a gene that works properly and a gene that does not. The biological parents are known as carriers and do not have any health problems related to that gene. Genetic screening can identify carriers by a simple blood test to determine if a couple is at risk to have a child affected with a specific disease.

What If We Are Both Carriers?

If both the egg donor and the sperm donor are carriers for the same disorder, there is a 25 percent risk with each pregnancy to produce a child affected with that disease. There is also a 50 percent chance that the child will be a disease-free carrier, and a 25 percent chance that the child will not inherit a non-working gene from either parent. If a couple is at risk to have a child with any of the diseases for which we screen, prenatal diagnosis is available to determine if the fetus is affected. Diagnosis is possible through either chorionic villus sampling (CVS) at 10-12 weeks of pregnancy or amniocentesis in the second trimester of pregnancy. In addition, new technologies are creating other reproductive options. When we identify a carrier couple, our genetic counselors can provide information and support that may be helpful in making important family planning decisions. 

Ideally, we will screen both members of a couple planning to produce offspring before there is a pregnancy or as there is a pregnancy to allow all available options to be considered. 

The Center for Jewish Genetic Diseases offers screening for the following nine diseases as briefly described below with frequency of occurrence and detection rate for each condition. 

Tay-Sachs Disease is a disorder in which the central nervous system progressively degenerates. This degeneration causes loss of coordination, seizures, difficulty swallowing, and poor pulmonary function. Symptoms usually appear at about 6 months of age. Eventually, children with Tay-Sachs disease become blind, severely mentally retarded, paralyzed, and unaware of their surroundings. There is no treatment, and average life expectancy is 3-5 years. About 1 in 25 Ashkenazi Jewish individuals is a Tay-Sachs carrier. The gene is also relatively common in the French Canadian population and the Cajun community in Louisiana. Carrier screening involves analysis of the enzyme responsible for Tay-Sachs disease. The detection rate for carriers is approximately 99 percent. 

Familial Dysautonomia (FD) is a severe disease of the autonomic nervous system. Autonomic nerves control functions such as swallowing, sweating, and the ability to cry with tears and to sense pain. Individuals with FD may have severe gastrointestinal problems and pulmonary complications such as pneumonia. The carrier frequency in the Ashkenazi population is 1 in 35. Testing for two common mutations provides a carrier detection rate of 99.5 percent. 

Canavan Disease is a progressive disease of the central nervous system for which there is no treatment. Symptoms, which begin in infancy, include poor head control, generalized weakness, and enlarged head size. Affected infants also develop seizure, regression of early developmental milestones, and severe mental retardation. Canavan disease is typically fatal in childhood, and there is no treatment. The carrier frequency in the Ashkenazi Jewish population is about 1 in 40. Testing involves analysis of common mutations in this gene, and the detection rate is about 97 percent. 

Niemann-Pick Disease is a severe neurodegenerative condition of infancy that cannot be treated. Symptoms, including loss of brain function and enlargement of the liver and spleen, appear by about six months of age. Average life expectancy is about two to three years of age. Approximately 1 in 70 Ashkenazi Jewish individuals carries the Niemann-Pick disease gene. Testing for the common mutations allows a detection rate for carriers of about 95 percent.

Gaucher Disease (Type I) is characterized by enlargement of the spleen and liver as well as blood abnormalities, including anemia, easy bruising, and impaired clotting. In addition, there are orthopedic problems, such as bone and joint pain and an increased susceptibility to bone fracture. The age of onset of symptoms is variable, with some individuals showing symptoms in childhood and others remaining relatively symptom-free into their fifties or sixties. The severity of symptoms varies among patients. Enzyme replacement therapy has been developed in recent years and has been highly effective in reversing some symptoms and reducing the severity of others. Type I Gaucher disease is the most common genetic disorder in the Ashkenazi Jewish population, with a carrier frequency of about 1 in 19. Analysis of common mutations allows a detection rate for carriers of about 95 percent. 

Cystic fibrosis (CF) is a progressive, lifelong condition in which the glands that produce mucus, sweat, and intestinal secretions do not function properly. This dysfunction results in thick mucus accumulation in the lungs, leading to breathing difficulty and infection. CF also causes poor digestion. Males with this disease are usually infertile. There is no cure for CF. Supportive treatments are available to help improve quality of life, and average life expectancy has improved over the years. While some babies with CF still die in infancy, many patients with CF live into their twenties and thirties. CF is found in all ethnic groups. It is most common among Caucasians, Jewish and non-Jewish alike, with a carrier frequency of about 1 in 25. By testing for some of the more common mutations, 96 percent of Ashkenazi Jewish CF carriers can be identified, as can 85 percent of non-Jewish Northern European CF carriers. 

Fanconi Anemia (Type C) is a chronic disease associated with short stature, bone marrow failure, congenital malformations, and a predisposition to leukemia. For some children, the condition may also involve learning disabilities or mental retardation. The carrier frequency in the Ashkenazi Jewish population is about 1 in 90. Testing for one common mutation provides a carrier detection rate of approximately 95 percent. 

Bloom syndrome is a condition in which children grow poorly, have frequent infections, and may have learning disabilities. As adolescents and young adults, individuals with Bloom syndrome are predisposed to develop common cancers such as breast cancer, colon cancer, and leukemia. The carrier frequency in the Ashkenazi Jewish population is approximately 1 in 100. Testing for one common mutation allows for a carrier detection rate that is greater than 95 percent.

Mucolipidosis Type IV (MLIV) is a severe neurodegenerative condition that is characterized by a variable degree of growth and psychomotor retardation. In addition, many patients have abnormalities of the cornea and retina. Most patients never develop the ability to speak or walk and remain at the developmental level of one to two years of age. The carrier frequency in the Ashkenazi population is approximately 1 in 125. Testing for two mutations provides a carrier detection rate of 96 percent.