<i>Notes from the Field</i>: Zika Virus-Associated Neonatal Birth Defects Surveillance — Texas, January 2016–July 2017

Hall, Noémi B.; Broussard, Kelly; Evert, Nicole; Canfield, Mark A.

doi:10.15585/mmwr.mm6631a5

Cited by 15 publications

(19 citation statements)

References 3 publications

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“…Even in the United States, a high loss-to-follow-up for pregnant women at risk for travel-acquired ZIKV infections has been documented in several studies. (29, 30) Second, ZIKV infections are often asymptomatic and when symptoms occur, they may be vague (headache, conjunctivitis) and insufficient to trigger contact with a health care provider. Furthermore, other viruses co-circulating with ZIKV (e.g.…”

Section: Congenital Zika Syndrome and Diagnostic Challengesmentioning

confidence: 99%

Zika virus and the nonmicrocephalic fetus: why we should still worry

Walker

Little²,

Roby

et al. 2019

American Journal of Obstetrics and Gynecology

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Zika virus (ZIKV) is a mosquito-transmitted flavivirus and was first linked to congenital microcephaly due to a large outbreak in Northeastern Brazil. Although the ZIKV epidemic is now in decline, pregnancies in large parts of the Americas remain at risk due to ongoing transmission and the potential for new outbreaks. This review presents why Zika virus is still a complex and worrisome public health problem with an expanding spectrum of birth defects and why ZIKV and related viruses may evade the immune response to injure the fetus. Recent reports indicate that the spectrum of fetal brain and other anomalies associated with ZIKV exposure is broader and more complex than microcephaly alone and includes subtle fetal brain and ocular injuries; thus, the ability to prenatally diagnose fetal injury associated with ZIKV infection remains limited. New studies indicate that ZIKV imparts disproportionate effects on fetal growth with an unusual femur-sparing profile, potentially providing a new approach to identify viral injury to the fetus. Studies to determine the limitations of prenatal and postnatal testing for detection of ZIKV-associated birth defects and long-term neurocognitive deficits are needed to better guide counseling for women with a possible infectious exposure. It is also imperative that we investigate why ZIKV is so adept at infecting the placenta and the fetal brain to better predict other viruses with similar capabilities that may give rise to new epidemics. The efficiency with which ZIKV evades the early immune response to enable infection of the mother, placenta and fetus is likely critical for understanding why the infection may either be fulminant or limited. Furthermore, studies suggest that several emerging and related viruses may also cause birth defects, including West Nile virus, which is endemic in many parts of the United States. With mosquito-borne diseases increasing worldwide, there remains an urgent need to better understand the pathogenesis of ZIKV and related viruses to protect pregnancies and child health.

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Section: Congenital Zika Syndrome and Diagnostic Challengesmentioning

confidence: 99%

Zika virus and the nonmicrocephalic fetus: why we should still worry

Walker

Little²,

Roby

et al. 2019

American Journal of Obstetrics and Gynecology

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“…albopictus, which were considered nuisance mosquitoes in most of Texas at the time (Yakob and Walker 2016). The 1st reports of local Zika mosquito transmission in Texas occurred in November of 2016 in Brownsville, TX, on the Texas-Mexico border (Hall et al 2017). Prior to Zika, the majority of mosquito control entities in Texas used either Centers for Disease Control and Prevention (CDC) light traps or gravid traps and were focused on WNV surveillance.…”

Section: Integrated Mosquito Management-a Comprehensive Strategymentioning

confidence: 99%

Integrating Vector and Nuisance Mosquito Control for Severe Weather Response

Ward

Qualls

2020

Journal of the American Mosquito Control Association

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Ideally, all mosquito control programs would have public health–driven and nuisance population–focused components in their mosquito control plan. However, due to resource limitations many mosquito control programs focus attention on one specific component of integrated mosquito control, i.e., adulticiding only. Programs run by public health departments with limited resources are frequently heavily focused on vector control, targeting a few mosquito species that are locally medically relevant in human and animal disease cycles. Focusing their mosquito management on these specific vector species can result in inefficiencies after hurricanes and severe flooding events that create a need for nuisance mosquito control. Floodwater nuisance species that emerge are not routinely a public health threat, but hinder operations related to response efforts and can negatively affect the lives of people in areas recovering from these disaster events. Staff, training, equipment, and facilities, when aimed at public health vector control, may not have the experience, knowledge, or tools to effectively respond to postdisaster, floodwater mosquito populations. As such, all mosquito management programs should have plans in place to handle not only known vectors of public health concern in response to mosquito-borne disease, but also to manage floodwater mosquito populations after natural disasters to safeguard public health and facilitate recovery operations. The current paper discusses the severe weather events in South Texas in 2018 and the resulting integrated nuisance floodwater mosquito control guidance developed by the Texas Department of State Health Services.

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“…ZIKV can infect many cell types [9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32], but in adult human and non-human primates it primarily targets ocular and reproductive tissues [33] (i.e., germ and somatic cells in the testes [9] in men and uterine fibroblasts [10] in women) and has been isolated from body fluids, such as blood [11], tears [12], sperm [13], and vaginal fluids [14]. In pregnant women, Hofbauer, trophoblast, and endothelial cells in the placenta have also been shown to be susceptible to ZIKV infection and serve as a reservoir [24,28,31,32,34,35,36,37,38].…”

Section: Introductionmentioning

confidence: 99%

“…Although the WHO and CDC note decreasing prevalence of Zika virus (ZIKV) infection cases in the Americas (inclusive of North American, Central American, and South American countries and territories; [17]), it remains an ongoing clinical problem of significant magnitude for women and their providers in endemic and non-endemic, but nearby, regions. For example, in Texas, the second largest birth populous in the U.S. and the only state with ongoing local transmission, 219 pregnant women with laboratory evidence of possible recent ZIKV infection were reported from January 2016 to July 2017 [18]. Due to limitations and underutilization of current laboratory testing strategies for ZIKV, this number likely underestimates the number of cases with ZIKV infection in pregnancy by 57% or more [18].…”

Section: Introductionmentioning

confidence: 99%

“…For example, in Texas, the second largest birth populous in the U.S. and the only state with ongoing local transmission, 219 pregnant women with laboratory evidence of possible recent ZIKV infection were reported from January 2016 to July 2017 [18]. Due to limitations and underutilization of current laboratory testing strategies for ZIKV, this number likely underestimates the number of cases with ZIKV infection in pregnancy by 57% or more [18]. For example, given the transient nature of ZIKV RNA, laboratory based nucleic acid testing (NAT) of serum, urine, and amniotic fluid does not exclude prior infection.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Importance of Placental Testing among Suspected Cases of Congenital Zika Syndrome

Seferovic

Turley

Valentine

et al. 2019

IJMS

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Contemporaneous Zika virus (ZIKV) strains can cause congenital Zika syndrome (CZS). Current ZIKV clinical laboratory testing strategies are limited and include IgM serology (which may wane 12 weeks after initial exposure) and nucleic acid testing (NAT) of maternal serum, urine, and placenta for (+) strand ZIKV RNA (which is often transient). The objectives of this study were to determine if use of additional molecular tools, such as quantitative PCR and microscopy, would add to the diagnostic value of current standard placental ZIKV testing in cases with maternal endemic exposure and indeterminate testing. ZIKV RNA was quantified from dissected sections of placental villi, chorioamnion sections, and full cross-sections of umbilical cord in all cases examined. Quantitation with high-resolution automated electrophoresis determined relative amounts of precisely verified ZIKV (74-nt amplicons). In order to localize and visualize stable and actively replicating placental ZIKV in situ, labeling of flaviviridae glycoprotein, RNA ISH against both (+) and (–) ZIKV-specific ssRNA strands, and independent histologic examination for significant pathologic changes were employed. We demonstrate that the use of these molecular tools added to the diagnostic value of placental ZIKV testing among suspected cases of congenital Zika syndrome with poorly ascribed maternal endemic exposure.

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Notes from the Field: Zika Virus-Associated Neonatal Birth Defects Surveillance — Texas, January 2016–July 2017

Cited by 15 publications

References 3 publications

Zika virus and the nonmicrocephalic fetus: why we should still worry

Zika virus and the nonmicrocephalic fetus: why we should still worry

Integrating Vector and Nuisance Mosquito Control for Severe Weather Response

Clinical Importance of Placental Testing among Suspected Cases of Congenital Zika Syndrome

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