Tuesday, January 26, 2016

MMWR: Evaluation and Testing of Infants with Possible Congenital Zika Virus Infection













#10,932


As the Zika virus continues to spread across the Americas it is inevitable that U.S. doctors will be called upon to evaluate and test pregnant women and infants for (congenital) Zika virus infection. 

While a conclusive link between maternal Zika virus infections and microcephaly has yet to be established, the CDC views the risks as too great to ignore and has already produced a good deal of guidance. 

Ten days ago the CDC released a HAN advisory for clinicians on Recognizing, Managing & Reporting ZIka Virus Infections In Travelers, while last week the CDC's MMWR published Interim Guidelines For Pregnant Women During A Zika Outbreak, along with reports on Zika's Spread & Its Possible Association With Microcephaly.
The word `interim' features prominently in nearly all of these documents as the threa from Zika infection is still poorly understood, and our understanding of how to best handle its challenges may change over time.

Today, another major MMWR Early Release that provides interim guidance to clinicians on evaluating and dealing with possible maternal Zika virus infection. First the description from the CDC of this release, followed by a link to the report (which is too large to excerpt properly).


Interim Guidelines for the Evaluation and Testing of Infants with Possible Congenital Zika Virus Infection

The CDC has developed, in consultation with the American Academy of Pediatrics, interim guidance for the evaluation, testing, and management of infants born to mothers who traveled to or resided in an area with Zika virus transmission during pregnancy.
The document provides guidance to healthcare providers caring for 1) infants with microcephaly or intracranial calcifications detected prenatally or at birth or 2) infants without these findings whose risk is based on maternal exposure and testing for Zika virus infection.

Briefly, pediatric healthcare providers should ask mothers of newborns with microcephaly or intracranial calcifications about their residence and travel while pregnant as well as symptoms of illness compatible with Zika virus disease (acute onset of fever, maculopapular rash, arthralgia, and conjunctivitis). In addition, results of any Zika virus testing performed prior to delivery should be obtained.  Interim guidance includes consideration of clinical issues that might be encountered in caring for infants who might have been infected with Zika virus infection. Certain actions (e.g., cranial ultrasound and ophthalmologic examination) are recommended for all infants being tested for Zika virus infection, and other actions (e.g., repeat hearing screening, developmental monitoring) are recommended for all infants with Zika virus infection, regardless of the presence or absence of symptoms.


Interim Guidelines for the Evaluation and Testing of Infants with Possible Congenital Zika Virus Infection — United States, 2016
 
JANUARY 26, 2016
 
CDC has developed interim guidelines for health care providers in the United States who are caring for infants born to mothers who traveled to or resided in an area with Zika virus transmission during pregnancy.

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