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Zika Virus Infection

A Vector-Borne Threat to Pregnant Women and Infants

Grazel, Regina, MSN, RN, BC, APN-C; Harris-Haman, Pamela, DNP, CRNP, NNP-BC

Section Editor(s): Newberry, Desi M.

doi: 10.1097/ANC.0000000000000557
Special Series: Congenital Infections

Background: Zika virus (ZIKV) is an emergent flavivirus, transmitted predominately by Aedes genus mosquitos that recently reached the Americas and was soon implicated in an increase in microcephaly and other serious birth defects.

Purpose: This report provides updated information and recommendations on testing, screening, and care for pregnant women and infants affected by ZIKV.

Methods: Current published recommendations from the Centers for Disease Control and Prevention, the World Health Organization, and the American Academy of Pediatrics were reviewed and included in this report.

Results: Although largely a self-limiting disease usually without symptoms, pregnant women and their fetuses are at greatest risk. Maternal transmission of ZIKV to the fetus can lead to congenital Zika infection with potentially devastating sequelae to the infant. The available evidence suggests that infection during the first trimester of pregnancy, in which the fetus' central nervous system is being formed, is associated with higher risk of brain abnormalities and perinatal loss.

Implications for Practice: Uncertainties remain about the course of the disease, and the full spectrum of effects of the virus on the developing infant is not yet understood. Infants with congenital Zika syndrome need coordinated follow-up and long-term specialty care, as well as support for the family.

Implications for Research: There is no known cure for ZIKV infection and no vaccine is currently available. The full spectrum of developmental disabilities and other adverse early childhood outcomes associated with congenital ZIKV infection needs to be studied.

New Jersey Chapter, American Academy of Pediatrics, East Windsor, and former consultant, New Jersey Department of Health Critical Congenital Heart Defects Screening Program and Zika Infant Surveillance, Trenton (Ms Grazel); and Thomas Jefferson School of Nursing, Philadelphia, Pennsylvania, and Duke-Johnson & Johnson Nurse Leadership, Division of Community Health, Durham, North Carolina, and Geisinger Holy Spirit Hospital, Middletown, Pennsylvania (Dr Harris-Haman).

Correspondence: Pamela Harris-Haman, DNP, CRNP, NNP-BC, 115 Providence Circle, Middletown, PA 17057 (pahhnnp@aol.com).

The authors declare no conflicts of interest.

© 2018 by The National Association of Neonatal Nurses