Zika Update for Providers who Care for Pregnant Women
Due to the recent expansion of Zika-affected areas into Wynwood, a neighborhood in Miami, Florida, all pregnant women in West Virginia should now be assessed for Zika risk at every prenatal visit. In order to achieve this objective, obstetric providers should:
- Ask pregnant women about their personal travel and travel of their sexual partner(s) to Zika-affected areas.
- Inquire about signs and symptoms of the Zika virus disease (fever, rash, arthralgia, conjunctivitis) for both the pregnant woman and her sexual partner(s) if Zika exposure is possible.
Pregnant women can be exposed to Zika by travel to Zika-affected areas or by sexual contact with a partner who has travelled to Zika-affected areas. Providers can track Zika-affected areas by referring to www.zikawv.org (click on “Communities” and “Zika-affected Areas”). Symptomatic or asymptomatic pregnant women who may have been exposed to Zika should be tested for Zika infection. Testing algorithms are complex and can be accessed at www.zikawv.org (Click on “Health Care Workers” and “For Healthcare Providers”). Simultaneous serum and urine samples should always be collected for testing of pregnant patients for Zika. To arrange laboratory testing for Zika-exposed or symptomatic pregnant women through the West Virginia Office of Laboratory Services, please consult your local health department or the Division of Infectious Disease Epidemiology at 1 (800) 423-1271, extension 1 or the answering service at (304) 925-9946.
Obstetric providers should also familiarize themselves with the most recent guidelines for management of pregnancies potentially complicated by Zika infection at www.zikawv.org (Click on “Health Care Workers” and “Caring for Pregnant Women With Possible Zika Virus Exposure”). Mothers with Zika infection or mothers for whom Zika cannot be excluded should be followed with serial fetal ultrasounds every 3-4 weeks. Abnormalities associated with congenital Zika include microcephaly, intracranial calcifications, and other CNS and ocular malformations. Infants born to these mothers should undergo serological testing for Zika regardless of the presence of abnormalities. Pathological specimens, including placenta, cord or fetal remains can also be tested for the presence of the Zika virus.
In West Virginia, mothers with Zika infection and their infants will be enrolled in the Zika Pregnancy Registry by the Office of Maternal, Child and Family Health (OMCFH) and followed for the duration of the pregnancy and for a year after the birth. The purpose of the Registry is to monitor pregnancy and infant outcomes. Additionally, OMCFH will assure that the mother and child can access any needed services. At the national level, the data in the Registry will be used to advance the quality of clinical and prevention services for pregnant women. For information on the Zika Pregnancy Registry visit www.zikawv.org (Click on “Pregnant Women” and “CDC US Zika Pregnancy Registry”).
Wheeling-Ohio County Health Department
1500 Chapline Street, Room 106
Wheeling, WV 26003
Howard Gamble, MPH
Becky Beckett, RN
Lock Johnson, RS
William Mercer, M.D.
Threat Preparedness Director
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