eNotes on Zika Virus
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Zika Virus: What It Is, Affected Countries, Symptoms, Treatment and More
New Medscape Slideshow: Zika in Babies in US Territories
Medscape recently announced a new online slide show, Zika in Babies in US Territories (November 2018) that highlights key data from the CDC's August 2018 Vital Signs Report and recommendations for screening infants possibly infected by Zika. The resource addresses the healthcare providers' important role in early identification of health and developmental issues related to congenital Zika virus infection.
More Zika Resources from the CDC
The CDC continues to provide helpful resources for all impacted by the Zika virus. Here are a couple of recently updated resources (August 2018) from their Zika and Pregnancy webpage:
Vital Signs: Zika-Associated Birth Defects & Neurodevelopmental Abnormalities
A recent CDC report (August 2018) states that 1 in 7 of the 1,450 children under age 1, reported to the USZPIR and born to mothers with lab evidence confirming possible Zika virus infection during pregnancy in the U.S., were identified during infancy or early childhood as having a Zika-associated birth defect, a neurodevelopmental abnormality possibly associated with congenital Zika virus infection, or both. Of the Zika-associated birth defects, 6% include brain and eye abnormalities, a large increase from previous statistics. The report also states that it is crucial for health care providers caring for children to have access to information concerning maternal exposure to Zika during pregnancy. For additional information on babies affected by Zika in the U.S., view the video and fact sheet on the CDC's Vital Signs page.
Zika and Pregnancy
The CDC has recently updated its Zika and Pregnancy website (May 2018) to include Zika Pregnancy and Infant Registry communication tools to encourage healthcare providers to securely send medical information to their local health department about infants born to mothers infected by Zika during pregnancy. It is crucial to monitor the health of these children until their second birthday. Some of these new materials include:
American Academy of Pediatrics (AAP) Special Supplement on Zika
The AAP has published a special supplement on Zika (February 2018) including articles that offer best practices for addressing the needs of children affected by the congenital syndrome, what to expect as affected infants develop, and extensive care coordination with health care professionals to provide the necessary supports and services for families.
More Birth Defects Seen in Parts of U.S. with Local Zika Spread
According to a recent press release from the CDC (January 2018), birth defects most strongly related to Zika virus infection during pregnancy have increased in areas of the U.S. reporting local transmission of Zika. Specifically, southern Florida, a section of south Texas, and Puerto Rico have seen a 21% increase in birth defects most strongly linked to Zika in the last half of 2016 as compared to numbers in the first half of that year. For more information, visit the full report.
Updated Guidance for Diagnosis, Evaluation, and Management of Infants with Congenital Zika Virus
Per recent clinical findings, the CDC updated its guidance for health care providers caring for infants with possible congenital Zika virus infection (October 2017). The guide provides updated recommendations for initial testing, evaluation and follow-up care for both pregnant women and infants at risk for infection or who have contracted the virus.
Measures Taken to Prevent Zika Virus Infection During Pregnancy
According to the CDC (June 2017), Puerto Rico reported the largest number of confirmed cases of Zika virus infections among pregnant women in the U.S. between Jan. 2016- Mar. 2017. "Most women (98.1%) reported using at least one measure to avoid mosquitos in their home environment. However, only 45.8% of women reported wearing mosquito repellent daily, and 11.5% reported wearing pants and shirts with long sleeves daily." See additional statistics below:
U.S. Infants with Congenital Zika Virus Exposure - Update
Vital Signs: Update on Zika Virus-Associated Birth Defects and Evaluation of All U.S. Infants with Congenital Zika Virus Exposure - U.S. Zika Pregnancy Registry, 2016 (Morbidity and Mortality Weekly Report, 66, Early Release - April 4, 2017) - This new report finds that in 2016 a total of 1,297 pregnancies with possible recent Zika virus infection were reported to the U.S. Zika Pregnancy Registry from 44 states. Approximately one in 10 pregnancies with Zika virus infection resulted in associated birth defects. Birth defects were highest among first trimester Zika virus infections - approximately 15 percent. Early identification can help to ensure that appropriate intervention and follow-up care are available to affected infants.
New Zika Virus Resources from CDC
The Centers for Disease Control and Prevention (CDC) recently released preliminary estimates of birth defects after Zika Virus infection during pregnancy based on data available as of September 22, 2016. CDC has also added the following new "What to Know" 2-page information sheets to their Zika Virus webpage. These information sheets were developed for practitioners to help answer questions from women who have been exposed to Zika or who have babies who were born after being exposed to the Zika virus.
See also, Zika Virus - 10 Public Health Achievements in 2016 and Future Priorities (Morbidity and Mortality Weekly Report - December 30, 2016).
Zika Virus Resources from the AAP
The American Academy of Pediatrics (AAP) has added a new Zika Virus page to its website, which includes: AAP Zika Response Activities, Latest News, Guidance Specific to Children, Psychosocial Support, Resources for Health Care Providers and Health Departments, State Level Actions, General Information on Zika, and more.
Preparedness for Zika Virus Disease - New York City, 2016
A new paper from the Centers for Disease Control and Prevention, Preparedness for Zika Virus Disease - New York City, 2016, reports that the rapid spread of Zika virus has had a direct effect on the U.S. health care delivery system. As of September 21, 2016, a total of 715 cases of laboratory-confirmed Zika virus disease had been diagnosed in New York state, representing the highest number of reported cases in any state to date. This underscores the importance of health care systems preparing to care for patients with possible Zika virus disease and the need for providers to educate patients, especially pregnant women, about avoiding infection with Zika virus. Zika virus infection during pregnancy can lead to adverse birth outcomes such as microcephaly, defects of the eye, hearing deficits, and impaired growth.
The Zika Virus: Implications for Collaboration across Human Services Agencies and State Action Plans
A new white paper, The Zika Virus: Implications for Collaboration across Human Services Agencies and State Action Plans (September 2016), is designed to help human service agencies, including early intervention, child care, early childhood, and public welfare agencies, start the process of coordinating and preparing to support children and families affected by the Zika virus. Research has documented a wide range of neurologic abnormalities in babies infected with Zika, including microcephaly, problems with vision, hearing loss, and impaired growth. The white paper provides information about the causes and costs of the Zika virus, state government and provider planning efforts, actionable suggestions for prevention and intervention, and a comprehensive list of state-by-state online resources for Zika action planning.
Zika Virus Disease Cases - 50 States and the District of Columbia
Zika virus infection during pregnancy can lead to adverse birth outcomes such as microcephaly, defects of the eye, hearing deficits, and impaired growth. A new report from the Centers for Disease Control and Prevention, Zika Virus Disease Cases - 50 States and the District of Columbia, January 1-July 31, 2016 finds that as of September 3, 2016, a total of 2,382 confirmed or probable cases of Zika virus disease during January 1-July 31, 2016 were reported from 48 of 50 states and the District of Columbia. Most cases were travel-associated.
Resources about Zika Virus for families and for healthcare providers can be found on CDC's Zika website. Health care providers are encouraged to educate patients, especially pregnant women, about avoiding infection with Zika virus, and all pregnant women should be assessed for possible Zika virus exposure at each prenatal visit.
Hearing Loss in Infants with Microcephaly and Evidence of Congenital Zika Virus
A new report, Hearing Loss in Infants with Microcephaly and Evidence of Congenital Zika Virus Infection - Brazil, November 2015-May 2016 (Morbidity and Mortality Weekly Report, Vol. 65, Early Release - August 30, 2016) finds that among 70 children with microcephaly and laboratory evidence of congenital Zika virus infection, four of 69 were found to have sensorineural hearing loss without other potential cause. Children with evidence of the virus infection who have normal initial screening tests should receive regular follow-up, because hearing loss can be delayed.
New Guidance and Data Related to Infants with Possible Congenital Zika Virus
The following two new reports related to infants with possible congenital Zika virus are now available online. Additional resources for families and for healthcare providers can be found on CDC's Zika website.
- Update: Interim Guidance for the Evaluation and Management of Infants with Possible Congenital Zika Virus Infection-United States, August 2016 (Morbidity and Mortality Weekly Report, 65(33), August 26, 2016) - This revised guidance updates recommendations for the initial evaluation and testing of infants with confirmed or possible congenital exposure to Zika infection, and establishes recommendations for the outpatient management and follow-up of infants with laboratory evidence of congenital Zika virus infection, with or without apparent associated birth defects. The guidance also emphasizes that families and caregivers will need ongoing psychosocial support and assistance with coordination of care.
- Estimating the number of infants that may be born with congenital Zika virus infection and microcephaly following the Zika outbreak in Puerto Rico, 2016 (Journal of the American Medical Association (JAMA) Pediatrics, Online First, August 19, 2016) - In this report, CDC scientists estimate that 5,900-10,300 pregnant women might be infected during the Zika virus outbreak in Puerto Rico in 2016, in the absence of effective interventions. Of these, they estimated that 100-270 infections might lead to microcephaly in infants between mid-2016 and mid-2017. These estimates underscore the importance of the urgent actions being taken in Puerto Rico to prevent Zika virus infection during pregnancy and the need to plan for medical and supportive services for families affected by Zika.