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The CDC Updates Guidelines for Congenital Zika

Stockwell, Serena

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AJN, American Journal of Nursing: February 2018 - Volume 118 - Issue 2 - p 14
doi: 10.1097/01.NAJ.0000530232.22909.7c
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An infant with microcephaly is examined by a neurologist at Hospital Pedro I in Campina Grande, Paraiba, Brazil. Photo by Felipe Dana / Associated Press.

The Centers for Disease Control and Prevention (CDC) has updated its clinical guidance for health professionals caring for infants whose mothers may have been exposed to the Zika virus during pregnancy. This information replaces the agency's August 2016 guidance. “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 Brenda Fitzgerald said in a news release. “Learning how best to support them will require a team approach between health care providers and families.”

The guidelines focus on the interpretation of recommended laboratory tests and follow-up care for three groups: infants with clinical findings consistent with congenital Zika syndrome regardless of the results of maternal tests; infants without clinical evidence of congenital Zika syndrome who were born to mothers with laboratory evidence of possible infection; and infants without clinical findings consistent with congenital Zika syndrome who were born to mothers without laboratory evidence of possible infection.

The CDC emphasizes the importance of having a multidisciplinary team, an individualized shared decision-making approach, and an established medical home to coordinate care and ensure that abnormal findings are addressed.

In addition, a new study gives insight into the epidemiology of childhood Zika, with researchers examining both locally acquired and travel-associated cases in a July 2016 outbreak in Florida. Among the 478 confirmed Zika virus infections in Miami-Dade County, 33 (7%) occurred in children ages one to 17—which is fewer than in concurrent outbreaks in Brazil and Puerto Rico. In the Florida outbreak, 27 of the 33 pediatric cases (82%) were travel associated, and most of the children presented with only two of the four main symptoms (maculopapular rash and fever—not conjunctivitis and arthralgia).

The researchers cautioned that although the Florida infections peaked in summer 2016, the climate there remains conducive year-round for mosquito breeding and thus transmission of disease. The team also urged clinicians to remind families to take mosquito bite prevention measures when traveling to areas of active Zika virus transmission.—Serena Stockwell


Adebanjo T, et al. MMWR Morb Mortal Wkly Rep 2017;66(41):1089-99; Griffin I, et al. Pediatrics 2017;140(6): e20172044.
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