At least 21 travelers returning to the U.S. from Cuba have contracted Oropouche virus, and health officials are providing guidance on caring for newborns who may be exposed in utero as cases rise.
The virus, which is spread by biting midges and certain mosquitoes, has been increasing in the Americas. Evidence suggests it can cause severe outcomes if passed from a pregnant person to a fetus.
More than 8,000 locally acquired cases have been reported in Bolivia, Brazil, Colombia, Cuba and Peru this year, and two people have died. The Centers for Disease Control and Prevention (CDC) on Tuesday detailed cases in 20 Florida residents and one New York resident returning from Cuba.
The U.S. patients ranged in age from 15-94 years. The most common symptoms were fever, muscle pain, headache, fatigue and joint stiffness. Some also had diarrhea, abdominal pain, nausea/vomiting or rash. Three of the patients were hospitalized, but none died.
In the days and weeks after their illness, at least three patients experienced a return of their symptoms, which is common with Oropouche, according to the report.
The report did not include whether any of the patients were pregnant. However, in Brazil, there have been reports of stillbirths and congenital abnormalities, including microcephaly, among infants exposed in utero.
The CDC has released new guidance for evaluating and managing infants born to people with confirmed or probable Oropouche during pregnancy. These infants should undergo a standard evaluation, including documentation of their gestational parent’s exposure and testing, a comprehensive newborn physical exam, standard newborn hearing screening at birth and AAP-recommended developmental monitoring, surveillance and screening.
Infants with congenital anomalies or signs of congenital infection should undergo routine evaluation for other infectious and non-infectious causes. Oropouche virus testing by real-time reverse transcription-polymerase chain reaction is expected to be available in September and can be considered in consultation with the state or local health department and CDC. These infants also may need care from a variety of specialists.
Health officials continue to encourage breastfeeding even if the gestational parent was infected or spent time in an area with Oropouche.
The CDC said it is working on a plan for rapid detection of the virus and is helping health departments test suspected cases. It released a health advisory on Aug. 16 with recommendations for clinicians on diagnosing and managing people who may have been infected.
People should protect themselves from insect bites during travel and for three weeks after, according to the CDC. Pregnant people should reconsider non-essential travel to areas with outbreaks. No vaccines or treatments are available for Oropouche.
Resources
- CDC advisory on Oropouche
- Information from the CDC for clinicians about Oropouche
- CDC interim guidance for evaluating and managing infants born to pregnant people who may have Oropouche disease
- CDC interim clinical considerations for pregnant people with Oropouche disease
- Information for parents from HealthyChildren.org on preventing infections in pregnancy
