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Zika virus transmission & testing of pregnant women & infants

Today’s topic: Zika virus transmission & testing of pregnant women & infants

Action requested:  Be aware of updated guidance about Zika virus transmission & testing of pregnant women & infants.

Background: Florida Dept. of Health continues to investigate Zika virus transmission in Miami-Dade County and information about areas of Zika transmission is rapidly evolving. A new area of active transmission in a 1.5-square-mile section of Miami Beach has been identified in addition to the previously reported area of active transmission in the Wynwood neighborhood of Miami (http://www.cdc.gov/zika/intheus/florida-update.html). It is possible that other neighborhoods in Miami-Dade County have active Zika virus transmission that is not yet apparent, but other areas with active Zika virus transmission are likely to emerge.

The Centers for Disease Control & Prevention (CDC) has issued updated guidance for evaluation and management of infants with possible congenital Zika virus infection. See resources below for more details.

Recommendations:

  • Advise pregnant patients to avoid non-essential travel to all areas with active Zika virus transmission, including the specified areas of Miami-Dade County. Pregnant women and their partners who are concerned about being exposed to Zika should consider postponing nonessential travel to all parts of Miami-Dade County.
  • Assess all pregnant patients for possible Zika virus exposure during each prenatal care visit, including for signs and symptoms of Zika virus disease, a travel history, and their sexual partner’s potential exposure to Zika virus to determine whether Zika virus testing is indicated.
  • Test infants born to mothers with laboratory evidence of Zika virus infection during pregnancy and infants who have abnormal clinical or neuroimaging findings suggestive of congenital Zika syndrome (microcephaly, intracranial calcifications or other brain anomalies, or eye anomalies, among others) and a maternal epidemiologic link suggesting possible transmission, regardless of maternal Zika virus test results.
  • Collect serum and urine from infants in the first 2 days of life, if possible, for PCR and IgM testing; testing of cord blood is no longer recommended. A positive infant serum or urine rRT-PCR test result confirms congenital Zika virus infection. Positive Zika virus IgM testing, with a negative rRT-PCR result, indicates probable congenital Zika virus infection.
  • Report suspected cases by calling the Health District at 425-339-5278. Staff are available for consultation about testing of suspected Zika cases. A completed Zika intake form is required prior to approval of testing through Public Health.

Resources:

You can find my recent health alerts posted on the Provider pages of our website, at http://www.snohd.org/Providers/Health-Alerts.

 

Gary Goldbaum, MD, MPH | Health Officer & Director | Administration

3020 Rucker Avenue, Ste 306 | Everett, WA 98201 | 425.339.5210 | ggoldbaum@snohd.org

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