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CDC updates guidance on caring for children who may have Zika :

February 19, 2016

The Centers for Disease Control and Prevention (CDC) has expanded guidelines on caring for children with possible Zika virus infection to include those up to 18 years of age.

Officials also updated an algorithm on caring for infants whose mother traveled to areas where the mosquito-borne virus is circulating. The guidance was published in a Feb. 19 Morbidity and Mortality Weekly Report as researchers continue to study possible links between Zika in pregnant women and microcephaly in their babies.

“The Academy has been working alongside the Centers for Disease Control and Prevention to expeditiously identify the risks of Zika disease to infants and children,” said AAP Executive Director/CEO Karen Remley, M.D., M.B.A., M.P.H., FAAP. “With our combined expertise, we will continue to develop optimal recommendations to protect against infection and care for those who may have been exposed.”

The CDC’s updated guidelines say infants should receive routine well-child preventive care if they are not born with microcephaly or intracranial calcifications and their mother tested negative for Zika or was not tested.

Symptoms of Zika typically include fever, rash, joint pain and conjunctivitis. If children display at least two of those within two weeks of traveling to an affected area in Latin America or the Caribbean, pediatricians should suspect Zika.

Zika also should be suspected in infants with two of these symptoms in their first two weeks of life if their mother traveled to one of the affected areas within two weeks of delivery.

Mothers diagnosed with Zika virus who live in an area with active transmission should continue to breastfeed, according to the CDC.

“Zika virus RNA has been identified in breast milk, but attempts to culture the virus have been unsuccessful,” the CDC report said. “No cases of Zika virus infection associated with breastfeeding have been reported.”

For infants and children who contract Zika through mosquitoes, the disease typically is mild just as it is for adults, and treatment involves supportive care, according to the CDC. The infection is a nationally notifiable disease and should be reported to local, state or territorial health departments for purposes of research and testing.

Health officials continue to recommend that pregnant women avoid travel to areas where Zika virus is spreading as there are no vaccines available. People who do travel to areas where Zika is being transmitted should take steps to avoid mosquito bites.

The World Health Organization (WHO) has declared Zika to be a public health emergency due to its possible ties to birth defects. This week it released a strategic plan to combat the virus and dispelled rumors that microcephaly is caused by vaccines or larvicide. In addition, the WHO said there is no evidence genetically modified mosquitoes played a role in the Zika outbreak or the increase of microcephaly cases in Brazil.

In addition to collaborating with the CDC on the revised guidelines, Academy leaders are actively involved in other national initiatives involving Zika. Dr. Remley and AAP Committee on Infectious Diseases Vice Chair Yvonne A. Maldonado, M.D., FAAP, recently participated in a National Academies of Sciences, Engineering, and Medicine rapid research workshop on Zika virus that brought experts together to discuss research priorities, clinical management and public health interventions.

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