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CDC updates clinical guidance based on U.S. Zika Pregnancy Registry

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A total of 972 pregnant women with evidence of Zika completed pregnancies in 2016

CDC’s U.S. Zika Pregnancy Registry is helping inform recommendations and guidance on how health care providers and others can respond to Zika virus disease.

During a health care providers call hosted by CDC’s Clinician Outreach and Communication Activity (COCA), Emily Petersen, MD, from the Division of Reproductive Health at CDC, updated participants on the latest data from the U.S. Zika Pregnancy Registry.

“[This information is] critical to CDC’s efforts to understand Zika during pregnancy,” said Petersen. 

The registry represents the largest reported series of infant outcomes among pregnant women with laboratory evidence of possible Zika virus disease. Petersen said the information reinforces the need to prevent the virus in pregnant women.

Zika virus infection during pregnancy has been associated with birth defects, including microcephaly and other brain abnormalities. After analyzing registry data, researchers found that about 1 in 10 pregnant women with confirmed Zika virus disease had a fetus or baby with birth defects. Data came from 44 U.S. states that reported pregnant women with evidence of the virus in 2016. From those states, 972 pregnant women with evidence of Zika virus disease completed pregnancies in 2016, and some had babies with Zika-related birth defects.

Petersen urged health care providers to pass along CDC recommended prevention tips to pregnant women to avoid being infected with Zika virus disease, which is carried and spread through the Aedes aegypti mosquito, the same species that carry yellow fever, dengue, and chikungunya viruses.

Petersen said health care providers should advise pregnant women to protect themselves from mosquito bites, especially if they live in or are traveling to areas with Zika virus disease. Effective methods include using an EPA-registered insect repellent, wearing long-sleeved shirts and long pants, staying and sleeping in places with air conditioning or that use window and door screens, and regularly emptying or throwing out outdoor items that hold water. Scientists have also discovered that Zika virus disease can be transmitted sexually. CDC said pregnant women should use condoms during sex or not have sex if their partner lives in or has traveled to Zika virus disease-risk areas.

CDC also recommends that health care providers advise pregnant women not to travel to areas with risk of the disease. Currently there are 63 countries and territories worldwide with a CDC Zika Travel Notice. (CDC has an interactive map with more information.) In the United States, to date, only Florida and Texas have had local transmission. Officials from the Florida Department of Agriculture and Consumer Services recently said that no Zika virus disease has been detected in any mosquitoes tested this year in the state. If a pregnant women must travel to an infected area, CDC said they should talk with their health care provider before leaving, strictly follow steps to prevent mosquito bites during the trip, prevent sexual transmission, and speak with a health care provider after returning, even if there are no symptoms.

The COCA briefing also went into detail about testing pregnant women, as well as testing and evaluating infants with possible congenital Zika virus disease infection.

However, states may be up against funding challenges for prevention and testing going forward. Last year, Congress provided over a billion dollars to CDC for Zika virus disease efforts. Most of the money was passed to state public health departments, but CDC said recently that these funds were running out and additional money from the federal government was unlikely. 

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