Update: Interim Guidelines for Health Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure — United States, 2016

Oduyebo, Titilope; Petersen, Emily E.; Rasmussen, Sonja A.; Mead, Paul S.; Meaney‐Delman, Dana; Renquist, Christina M.; Ellington, Sascha; Fischer, M. L.; Staples, J. Erin; Powers, Ann M.; Villanueva, Julie; Galang, Romeo R.; Dieke, Ada; Muñoz, Jorge L.; Honein, Margaret A.; Jamieson, Denise J.

doi:10.15585/mmwr.mm6505e2er

Cited by 51 publications

(106 citation statements)

References 15 publications

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“…As no vaccine exists against Zika virus, following prevention and control measures can be taken 32 like avoiding mosquito bites, reducing sexual transmission and controlling the mosquito vector. Potentially effective methods of prevention that are focused on reducing infections among pregnant women include i) avoiding unnecessary travel to areas of ongoing Zika virus transmission, ii) avoiding unprotected sexual contact with partners who are at risk for Zika virus infection, iii) and using mosquito repellent treatment for clothing, bed nets, window screens and air conditioning.…”

Section: Preventionmentioning

confidence: 99%

Epidemiology, Diagnosis and Preventive Measures of Zika Virus Infection: A Review Update

Parveen

Begum

Sharmin

et al. 2017

Bangladesh J. Infect. Dis.

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The relation between ZIKV infection during pregnancy and microcephaly in neonate has been established by the Brazillian Ministry of Health. Therefore, more attention regarding control of Aedes mosquito is required. Since it transmits this disease, which has more disastrous consequences than dengue viral infection. Potentially effective methods of prevention that are focused on reducing infections among pregnant women include avoiding unnecessary travel to areas of ongoing Zika virus transmission, avoiding unprotected sexual contact with partners who are at risk for Zika virus infection. According to Institute of Epidemiology Disease Control and Reseaech (IEDCR) there is nothing to panic at this moment for Bangladesh, but they stressed on mosquito control, which is the only tool to prevent and fight off Zika virus. They however, could not mention how the virus came to Bangladesh. May be somebody brought it while travelling. There is good survillence and testing system to detect the disease in Bangladesh.

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Section: Preventionmentioning

confidence: 99%

Epidemiology, Diagnosis and Preventive Measures of Zika Virus Infection: A Review Update

Parveen

Begum

Sharmin

et al. 2017

Bangladesh J. Infect. Dis.

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“…The US Centers for Disease Control and Prevention recommends that pregnant women who do not reside in areas with Zika virus should avoid travel to affected countries. 13 Until the role of sexual transmission is fully elucidated, pregnant women should abstain from or have protected sexual intercourse with partners who have recently travelled to countries with Zika virus. Travellers to and residents of affected countries should use universally recommended barriers to mosquito biting (e.g., mosquito repellant, long-sleeved shirts and long pants, bed nets and staying indoors in air-conditioned and/or screened-in rooms).…”

Section: Key Pointsmentioning

confidence: 99%

“…Travellers to and residents of affected countries should use universally recommended barriers to mosquito biting (e.g., mosquito repellant, long-sleeved shirts and long pants, bed nets and staying indoors in air-conditioned and/or screened-in rooms). 13 Women of child-bearing age who are not pregnant should use contraceptive methods to delay pregnancy until the outbreak ends or until they are immune.…”

Section: Key Pointsmentioning

confidence: 99%

“…Zika virus reverse transcription-polymerase chain reaction is an excellent diagnostic test in acute illness but is limited by a short window of detection. 13 The turnaround time for national testing (14 d) may be delayed if exposure to other flaviviruses has occurred. Asymptomatic pregnant women with potential exposure to the virus should also be tested.…”

Section: Key Pointsmentioning

confidence: 99%

“…If abnormalities are detected, amniocentesis may be offered beyond 15 weeks gestation to aid diagnosis. 13 If ongoing studies confirm a causal association between congenital Zika virus infection and irregularities in fetal development, the virus' potential for devastating impact on fetal survival and infant neurodevelopmental health will become clearer. Development of a Zika virus vaccine is currently a high priority.…”

Section: Key Pointsmentioning

confidence: 99%

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Zika virus and microcephaly

Barton

Salvadori

2016

CMAJ

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Birth Defects Among Fetuses and Infants of US Women With Evidence of Possible Zika Virus Infection During Pregnancy

Honein

Dawson

Petersen

et al. 2017

JAMA

Self Cite

718

435

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; for the US Zika Pregnancy Registry Collaboration IMPORTANCE Understanding the risk of birth defects associated with Zika virus infection during pregnancy may help guide communication, prevention, and planning efforts. In the absence of Zika virus, microcephaly occurs in approximately 7 per 10 000 live births. OBJECTIVE To estimate the preliminary proportion of fetuses or infants with birth defects after maternal Zika virus infection by trimester of infection and maternal symptoms. DESIGN, SETTING, AND PARTICIPANTS Completed pregnancies with maternal, fetal, or infant laboratory evidence of possible recent Zika virus infection and outcomes reported in the continental United States and Hawaii from January 15 to September 22, 2016, in the US Zika Pregnancy Registry, a collaboration between the CDC and state and local health departments. EXPOSURES Laboratory evidence of possible recent Zika virus infection in a maternal, placental, fetal, or infant sample. MAIN OUTCOMES AND MEASURES Birth defects potentially Zika associated: brain abnormalities with or without microcephaly, neural tube defects and other early brain malformations, eye abnormalities, and other central nervous system consequences. RESULTS Among 442 completed pregnancies in women (median age, 28 years; range, 15-50 years) with laboratory evidence of possible recent Zika virus infection, birth defects potentially related to Zika virus were identified in 26 (6%; 95% CI, 4%-8%) fetuses or infants. There were 21 infants with birth defects among 395 live births and 5 fetuses with birth defects among 47 pregnancy losses. Birth defects were reported for 16 of 271 (6%; 95% CI, 4%-9%) pregnant asymptomatic women and 10 of 167 (6%; 95% CI, 3%-11%) symptomatic pregnant women. Of the 26 affected fetuses or infants, 4 had microcephaly and no reported neuroimaging, 14 had microcephaly and brain abnormalities, and 4 had brain abnormalities without microcephaly; reported brain abnormalities included intracranial calcifications, corpus callosum abnormalities, abnormal cortical formation, cerebral atrophy, ventriculomegaly, hydrocephaly, and cerebellar abnormalities. Infants with microcephaly (18/442) represent 4% of completed pregnancies. Birth defects were reported in 9 of 85 (11%; 95% CI, 6%-19%) completed pregnancies with maternal symptoms or exposure exclusively in the first trimester (or first trimester and periconceptional period), with no reports of birth defects among fetuses or infants with prenatal exposure to Zika virus infection only in the second or third trimesters. CONCLUSIONS AND RELEVANCE Among pregnant women in the United States with completed pregnancies and laboratory evidence of possible recent Zika infection, 6% of fetuses or infants had evidence of Zika-associated birth defects, primarily brain abnormalities and microcephaly, whereas among women with first-trimester Zika infection, 11% of fetuses or infants had evidence of Zika-associated birth defects. These findings support the importance of screening pregnant women for Zika virus exposure.

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Update: Interim Guidelines for Health Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure — United States, 2016

Cited by 51 publications

References 15 publications

Epidemiology, Diagnosis and Preventive Measures of Zika Virus Infection: A Review Update

Epidemiology, Diagnosis and Preventive Measures of Zika Virus Infection: A Review Update

Zika virus and microcephaly

Birth Defects Among Fetuses and Infants of US Women With Evidence of Possible Zika Virus Infection During Pregnancy

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