Only 25% of infants with possible congenital Zika virus infection received recommended brain imaging, according to a new report.
Pediatricians need to be vigilant as the rate of brain abnormalities/microcephaly is 30 times higher for babies whose mothers had lab evidence of recent Zika infection, Centers for Disease Control and Prevention (CDC) officials said Tuesday.
“Health care providers have an important role, and we encourage them to ask about possible Zika exposure when caring for both pregnant women and their babies and to follow CDC guidance for evaluation and care of infants with possible Zika infection,” said Peggy Honein, Ph.D., co-lead, Pregnancy and Birth Defects Task Force, CDC Zika Response.
The CDC’s new Vital Signs report analyzes 1,297 completed pregnancies in 44 states where the mother tested positive for Zika infection and was reported to the U.S. Zika Pregnancy Registry last year.
Roughly 5% of the women with unconfirmed Zika virus infection and 10% of those with confirmed Zika infection had a fetus or baby with birth defects, according to the report. Babies born to women confirmed to have been infected in the first trimester of pregnancy were found to have the highest rates of birth defects (15%). Among these infants with Zika-associated birth defects, 84% had brain abnormalities and/or microcephaly.
The CDC found many infants who may have contracted Zika from their mothers did not undergo recommended testing after birth. Just 25% reported postnatal neuroimaging results, and 65% reported Zika virus testing, according to cases reported to the registry.
Infants whose mother had laboratory evidence of Zika virus infection during pregnancy should receive a comprehensive physical exam, head ultrasound, standard newborn hearing assessment and Zika virus laboratory testing. Infants with abnormal clinical findings and a mother who was exposed also need Zika testing regardless of their mother’s test results. The CDC has updated its guidance on evaluation of infants at http://bit.ly/2oS2amc.
Pediatricians are urged to stay up-to-date on CDC recommendations and ask new families about potential exposure to Zika virus so they can facilitate the proper tests. They also should report suspected congenital Zika cases to their state, local, tribal or territorial health officials and provide clinical information to the U.S. Zika Pregnancy Registry or Puerto Rico Zika Active Pregnancy Surveillance System.
“It is critically important that infants born to mothers with Zika virus infection during pregnancy receive appropriate studies and evaluation, including careful neurodevelopmental screening with referral and follow-up,” said AAP CEO/Executive Vice President Karen Remley, M.D., M.B.A., M.P.H., FAAP. “Appropriate intervention services can only be provided if these steps are taken in a timely fashion.”
Pediatricians can learn more about testing infants via an AAP webinar “Zika Virus, the Evolving Story: What You Need to Know” at 11 a.m. EDT on April 11. Registration is required. Visit https://cc.readytalk.com/r/clrdyj7l4iak&eom. Email questions ahead of time to [email protected] or live during the webinar.
The CDC will hold a Clinician Outreach and Communication Activity call on the Vital Signs findings at 2 p.m. EDT on April 27. Register at https://emergency.cdc.gov/coca/calls/index.asp.
