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CDC offers updated guidance on screening, caring for newborns exposed to Zika
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The CDC recently updated its interim clinical guidance for infants born to mothers with possible Zika virus exposure, emphasizing the importance of a team-based approach, with close communication between obstetrical and pediatric care providers.
This updated guidance provides instruction for three scenarios of potential maternal Zika exposure: Infants with clinical findings consistent with congenital Zika syndrome born to mothers possibly exposed to Zika; infants without clinical findings of Zika syndrome born to mothers with laboratory evidence of Zika infection; infants without clinical findings of Zika syndrome born to mothers with no laboratory evidence of Zika infection.
“There’s still a lot we don’t know about Zika, so it’s very important for us to keep a close eye on these babies as they develop,” Brenda Fitzgerald, MD, director of the CDC, said in a press release. “Learning how best to support them will require a team approach between health care providers and families.”
In the report, Tolulope Adebanjo, MD, from the Epidemic Intelligence Service and the division of bacterial diseases in the National Center for Immunization and Respiratory Diseases at the CDC, and colleagues also offer new information regarding laboratory test results and follow-up infant care. The CDC now recommends that:
- Vision screening should be conducted in accordance with the AAP policy statement “Visual System Assessment in Infants, Children and Young Adults by Pediatricians,” as well as newborn hearing screening at birth;
- Infants born with birth defects related to Zika infection should be assessed for additional problems, including breathing and swallowing difficulties, as well as hydrocephaly after birth;
- Post-birth and follow-up care should be given regardless of laboratory results if the child has birth defects related to Zika virus;
- Eye examinations performed by an ophthalmologist should be given to infants without birth defects born to mothers with exposure to Zika without evidence of infection;
- Testing for Zika in infants without birth defects born to mothers with exposure but no evidence of infection, as well as clinical evaluation that goes above standard assessment and procedures, should not be used in all cases.
The CDC no longer recommends:
- Previously recommended thyroid screening and hearing screening at 4 to 6 months, due to lack of data on whether these screenings are necessary.
“Communication regarding possible maternal exposures between pediatric health care providers and obstetric care providers is critical, and strategies to enhance coordination of care and communication of health information are being developed,” Adebanjo and colleagues wrote. “The long-term prognosis for infants with congenital Zika virus infection is not yet known; health care providers should strive to address families’ concerns, facilitate early identification of abnormal findings, and refer infants for neurodevelopmental follow-up and therapy when indicated.” – by Katherine Bortz
Disclosure: The author reports no relevant financial disclosures.
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