Preventing Transmission of Zika Virus in Labor and Delivery Settings Through Implementation of Standard Precautions — United States, 2016

Olson, Christine K.; Iwamoto, Martha; Perkins, Kiran M.; Polen, Kara; Hageman, Jeffrey; Meaney‐Delman, Dana; Igbinosa, Irogue; Khan, Sumaiya; Honein, Margaret A.; Bell, Michael; Rasmussen, Sonja A.; Jamieson, Denise J.

doi:10.15585/mmwr.mm6511e3

Cited by 30 publications

(24 citation statements)

References 10 publications

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“…8 Nervous system diseases (embryonic, fetal and postnatal) resulting from ZIKV infection induced a considerable number of studies, pedagogical publications on the subject, and the creation of several care and surveillance protocols. [9][10][11][12][13][14][15][16] Microcephaly resulting from ZIKV infection is the epilogue of a vast process of diffuse involvement of the embryonic/fetal nervous system that manifests clinically with the reduction of the cephalic perimeter. Over time, other abnormalities have been identified, such as deafness, visual deficiencies of varying degrees, dysphagia and arthrogryposis, resulting in a complex of alterations currently called 'congenital Zika virus syndrome'.…”

Section: Palavras-chavementioning

confidence: 99%

Zika Virus Infection in Pregnant Women and Microcephaly

Duarte

Moron

Timerman³

et al. 2017

Rev Bras Ginecol Obstet

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From the discovery of the Zika virus (ZIKV) in 1947 in Uganda (Africa), until its arrival in South America, it was not known that it would affect human reproductive life so severely. Today, damage to the central nervous system is known to be multiple, and microcephaly is considered the tip of the iceberg. Microcephaly actually represents the epilogue of this infection's devastating process on the central nervous system of embryos and fetuses. As a result of central nervous system aggression by the ZIKV, this infection brings the possibility of arthrogryposis, dysphagia, deafness and visual impairment. All of these changes of varying severity directly or indirectly compromise the future life of these children, and are already considered a congenital syndrome linked to the ZIKV. Diagnosis is one of the main difficulties in the approach of this infection. Considering the clinical part, it has manifestations common to infections by the dengue virus and the chikungunya fever, varying only in subjective intensities. conjunctivitis and arthralgia, among others. In terms of laboratory resources, there are also limitations to the subsidiary diagnosis. Molecular biology tests are based on polymerase chain reaction (PCR) with reverse transcriptase (RT) action, since the ZIKV is a ribonucleic acid (RNA) virus. The RT-PCR shows serum or plasma positivity for a short period of time, no more than five days after the onset of the signs and symptoms. The ZIKV urine test is positive for a longer period, up to 14 days. There are still no reliable techniques for the serological diagnosis of this infection. If there are no complications (meningoencephalitis or Guillain-Barré syndrome), further examination is unnecessary to assess systemic impairment. However, evidence is needed to rule out other infections that also cause rashes, such as dengue, chikungunya, syphilis, toxoplasmosis, cytomegalovirus, rubella, and herpes. There is no specific antiviral therapy against ZIKV, and the therapeutic approach to infected pregnant women is limited to the use of antipyretics and analgesics. Anti-inflammatory drugs should be avoided until the diagnosis of dengue is discarded. There is no need to modify the schedule of prenatal visits for pregnant women infected by ZIKV, but it is necessary to guarantee three ultrasound examinations during pregnancy for low-risk pregnancies, and monthly for pregnant women with confirmed ZIKV infection. Vaginal delivery and natural breastfeeding are advised. ResumoDesde a descoberta do vírus Zika (VZIK) em 1947 em Uganda, na África, até sua chegada na América do Sul, não se tinha notícia de que ele seria capaz de comprometer a vida reprodutiva em humanos de forma tão severa. Hoje, sabe-se que os danos sobre o sistema nervoso central são múltiplos, e a microcefalia é considerada a ponta do iceberg, visto que na realidade ela representa o epílogo de um processo devastador desta infecção sobre o sistema nervoso central do embrião e do feto. Em decorrência da agressão do sistema nervoso central pelo VZIK, est...

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Section: Palavras-chavementioning

confidence: 99%

Zika Virus Infection in Pregnant Women and Microcephaly

Duarte

Moron

Timerman³

et al. 2017

Rev Bras Ginecol Obstet

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“…For example, the MHT’s work on infection control in Ebola built the foundation for recommendations to prevent transmission of Zika virus in obstetric settings through implementation of standard precautions. 13 With each emergency response and continued preparedness work, the MHT strives to advance the science around reproductive health and emergencies, and ultimately increase the health of women and infants.…”

Section: Resultsmentioning

confidence: 99%

Addressing Maternal Health During CDC's Ebola Response in the United States

Ellington

Perez

Morof

et al. 2017

Journal of Women's Health

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Previous outbreaks suggest that pregnant women with Ebola virus disease (EVD) are at increased risk for severe disease and death. Healthcare workers who treat pregnant women with EVD are at increased risk of body fluid exposure. Despite the absence of pregnant women with EVD in the United States, CDC activated the Maternal Health Team (MHT), a functional unit dedicated to emergency preparedness and response issues, on October 18, 2014. We describe major activities of the MHT. A high-priority MHT activity was to publish guiding principles early in the response. The MHT also prepared guidance documents, provided guidance and technical support for hospital preparedness, and addressed inquiries. We analyzed maternal health inquiries received through CDC-INFO, MHT, and CDC’s Medical Investigations Team from August 2014 to December 2015. Internal call logs used to capture, monitor, and track inquiries for the three data sources were merged. Inquiries not related to maternal health issues and duplicates were removed. Each inquiry was categorized by route (email/phone), inquirer type, and topic. In total, 201 inquiries were received from clinicians, public health professionals, and the public. The predominant topic was related to infection control for high-risk situations such as labor and delivery. During the Ebola response, most inquiries were received via email rather than telephone, a notable shift compared to the H1N1 emergency response. Lessons learned during the H1N1 and Ebola responses are currently informing CDC’s Zika Response, an unprecedented emergency response primarily focused on reproductive health issues.

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“…However, if there is concern about infant follow-up, head ultrasound, ophthalmologic assessment and infant Zika virus testing should be performed before hospital discharge. CDC recommends standard precautions in all health care settings to protect both health care personnel and patients from infection with blood-borne pathogens, including Zika virus (25).…”

Section: Updated Recommendations For the Initial Laboratory Testing Amentioning

confidence: 99%