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Updated Guidance for Care of Newborns with Possible Congenital Zika Exposure

August 23, 2016

The Centers for Disease Control and Prevention (CDC) has released updated interim guidance for healthcare providers caring for infants born to mothers with possible Zika virus infection during pregnancy.

The guidance offers recommendations for evaluation and testing, management, and follow-up of infants with laboratory evidence of congenital Zika virus infection, with or without apparent associated birth defects.

The CDC recommends the following:

  • Laboratory testing is recommended for infants born to mothers with laboratory evidence of Zika virus infection and infants who have abnormal clinical or neuroimaging findings suggestive of congenital Zika syndrome and a maternal epidemiologic link suggesting possible transmission, regardless of maternal Zika virus test results.
  • Initial samples should be collected directly from the infant in the first 2 days of life, if possible; testing of cord blood is not recommended.
  • Initial evaluation of all infants born to mothers with laboratory evidence of Zika virus infection during pregnancy should include a comprehensive physical examination, including a neurologic examination, postnatal head ultrasound, and standard newborn hearing screen.
  • Infants with laboratory evidence of congenital Zika virus infection should have a comprehensive ophthalmologic exam and hearing assessment by auditory brainstem response testing before 1 month of age.
  • Infants with abnormalities consistent with congenital Zika syndrome should have a coordinated evaluation by multiple specialists within the first month of life; additional evaluations will be needed within the first year of life, including assessments of vision, hearing, feeding, growth, and neurodevelopmental and endocrine function.
  • Infants with laboratory evidence of congenital Zika virus infection without apparent abnormalities should have ongoing developmental monitoring and screening by the primary care provider; repeat hearing testing is recommended.

Recommendations were developed in collaboration with the American Academy of Pediatrics.

 

Centers for Disease Control and Prevention (CDC). CDC Updates Guidance for Care of Infants Born to Mothers with Possible Zika Virus Infection During Pregnancy [media statement]. August 19, 2016. Available at: click here. Accessed August 22, 2016.