The Centers for Disease Control and Prevention issued new clinical guidance Thursday for health care providers caring for infants born to mothers with possible Zika virus infection during pregnancy.
The updated guidelines include new information that has become available in the year since the August 2016 release of the CDC’s previous guidelines, according to CDC.
The Zika virus continues to be a public health threat to pregnant women and their infants. The illness has existed for years, but a mutation has made it more dangerous to infants in the womb.
Zika infection during pregnancy can cause serious damage to the brain of the developing fetus. It can lead to congenital Zika syndrome in babies, a pattern of birth defects that includes brain abnormalities, vision problems, hearing loss, and problems moving limbs. Babies with congenital infection may also appear healthy at birth but have underlying brain defects or other Zika-related health problems.
The Virgin Islands saw an outbreak of Zika in 2016 that has largely tapered off in 2017. But the current standing water and potential increase in mosquito populations in the wake of two hurricanes and weeks of torrential rains since, raises the possibility of more cases appearing.
“There’s a lot we still don’t know about Zika, so it’s very important for us to keep a close eye on these babies as they develop,” CDC Director Dr. Brenda Fitzgerald said in a statement from the CDC.
“Learning how best to support them will require a team approach between healthcare providers and families,” Fitzgerald said.
The updated recommendations emphasize that it is important for pediatric health care providers to assess risk of congenital Zika virus infection, to communicate closely with obstetrical providers, and to remain alert for any problems that may develop in infants without birth defects born to mothers with possible Zika virus exposure during pregnancy.
For infants with birth defects consistent with congenital Zika syndrome, healthcare providers should monitor for an expanded list of potential problems. These include difficulty breathing, difficulty swallowing, and hydrocephaly, also called “water on the brain,” after birth. Care and follow-up of these infants no longer depends on the infants’ Zika virus testing results.
Infants without birth defects consistent with congenital Zika syndrome but born to mothers with laboratory evidence of possible Zika virus infection during pregnancy should receive an eye examination by an ophthalmologist.
For infants without birth defects consistent with congenital Zika syndrome born to mothers with exposure to Zika virus but no laboratory evidence, Zika testing and clinical evaluation beyond the standard evaluation and routine preventive care are not routinely recommended.
The updated guidance also removes the recommendation for thyroid and hearing screenings due to a lack of clinical evidence showing it is useful.
Because the types of services needed to care for infants with congenital Zika syndrome are complex, CDC recommends coordinated care by a multidisciplinary team and an established medical home, which they say helps ensure care is coordinated and infants receive appropriate services.
The most current information about Zika virus is online at http://www.cdc.gov/zika/. A searchable database of specialists in several states, the U.S. Virgin Islands, and Puerto Rico is available at http://www.zikacareconnect.org/.