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CDC: 158 U.S. children contracted Zika postnatally :

September 30, 2016

At least 158 children in the U.S. have contracted Zika virus from mosquitoes while traveling abroad, but nearly all cases have been mild, according to a new report.

The Centers for Disease Control and Prevention (CDC) study details demographics, symptoms and most common origins of the infection when contracted postnatally. Much of the previous research has focused on children with congenital Zika infection, which can cause microcephaly and other neurologic conditions.

“We appreciate the CDC’s diligence in researching how Zika affects children whether they contract the virus before or after birth,” said AAP CEO/Executive Director Karen Remley, M.D., M.B.A., M.P.H., FAAP. “Pediatricians need to be vigilant for either type of infection and prepared to care for children accordingly.”

This week before adjourning for recess, Congress approved $1.1 billion in funding to combat Zika. Those dollars will go toward efforts like developing a vaccine, improving diagnostics and controlling mosquitoes.

The latest study shows the 158 U.S. children infected with Zika postnatally ranged in age from 1 month to 17 years with a median age of 14 years. Just over half were female and five were pregnant.

Roughly 82% of infected children had a rash, 55% had a fever, 29% had conjunctivitis and 28% had arthralgia, according to the report, which is published in today’s Morbidity and Mortality Weekly Report. Two of the children were hospitalized — a 4-year-old with fever, cough and poor oral intake and a 1-year-old with a cough and rash. No cases of Guillain-Barré syndrome and no deaths were reported. The CDC noted there have been two Zika-related pediatric deaths in other countries — a Brazilian girl with possible hemorrhage and a Colombian girl with sickle cell disease.

All cases in U.S. children have been travel-associated, and the most commonly visited places with local transmission were the Dominican Republic, Puerto Rico, Honduras, Nicaragua and Jamaica.

The CDC recommends considering Zika as a possibility in children who display symptoms and have a history of travel to areas where the virus is spreading. It previously released guidelines for collecting blood and urine samples.

There is no treatment for Zika virus infection, but symptoms can be managed with antipyretics and supportive care, according to the report. Children should not be given aspirin because of the risk of Reye syndrome. They also should not take nonsteroidal anti-inflammatory drugs until dengue virus is ruled out.

For infants with congenital Zika infection, CDC guidance recommends an array of tests and follow up with appropriate specialists. Fan Tait, M.D., FAAP, AAP associate executive director and director of the Department of Child Health and Wellness, stressed the importance of monitoring all children who may have contracted Zika virus regardless of the source or timing.

“It is critically important these children and others who have been exposed to Zika are not lost to follow-up and that they are screened for development and other issues as per the CDC and Bright Futures guidelines,” Dr. Tait said.

Doctors also should continue to advise patients to avoid mosquito bites and provide age-appropriate guidance for preventing sexual transmission.

The CDC asks that health care professionals report all suspected Zika cases to their state, local, tribal or territorial health officials whether congenital or postnatal. For congenital cases, they also should provide clinical information to the U.S. Zika Pregnancy Registry or Puerto Rico Zika Active Pregnancy Surveillance System through age 1 year so the CDC can monitor outcomes and adjust recommendations accordingly.

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