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CIDRAP - 1 in 7 kids exposed to Zika in utero suffers defects, delays

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  • CIDRAP - 1 in 7 kids exposed to Zika in utero suffers defects, delays


    1 in 7 kids exposed to Zika in utero suffers defects, delays
    Filed Under:
    Stephanie Soucheray | News Reporter | CIDRAP News
    | Aug 07, 2018

    One in seven children born of a Zika-affected pregnancy could develop neurologic or cognitive disabilities likely connected to prenatal exposure to the flavivirus, according to the largest study yet conducted on children born in US territories to mothers who had Zika in pregnancy.
    The new study is published today in the Centers for Disease Control and Prevention's (CDC's) Morbidity and Mortality Weekly Report (MMWR), and included babies born inPuerto Rico, American Samoa, US Virgin Islands, Federated States of Micronesia, and Republic of the Marshall Islands.
    "This is the first study of its kind to track children who appeared healthy at birth through their first year of life," said Peggy Honein, PhD, MPH, an epidemiologist and chief of the CDC's Birth Defects Branch, in an interview. Children who appeared normal at birth developed motor delays, seizures, trouble swallowing, microcephaly (smaller-than-normal head and brain), vision problems, and other neurologic delays over a series of follow-up visits with pediatricians.
    "This report emphasizes that the Zika story is not over, especially for children," Hoenin said.
    "Zika is still a risk, especially for pregnant women and their developing babies," said CDC Director Robert Redfield, MD, in a teleconference today. "Infection during pregnancy can have devastating consequences."
    Birth defect rate: 6%

    CDC researchers looked at all pregnancies in the US Zika pregnancy Infant Registry that resulted in an infant aged at least 1 year by Feb 1, 2018. They identified 1,450 children with confirmed or suspected Zika in pregnancy who were seen in several follow-up appointments in the first year of life. The study did not take into account which trimester of pregnancy a mother was in when she contracted the virus
    Almost all babies (95%) had at least one physical 2 weeks after birth. Sixty percent of study participants had postnatal neuroimaging, 48% had automated auditory brainstem response-based hearing screen or evaluation, and 36% had an ophthalmologic evaluation, according to the report.
    Among evaluated children, 6% had at least one Zika-associated birth defect identified, 9% had at least one neurodevelopmental abnormality possibly associated with congenital Zika virus infection, and 1% had both. This adds up to 14% affected, or about one in seven children.
    The 6% birth defect rate aligns with previous CDC studies, Honein said.
    Follow-up care

    In a teleconference today, Honein said the study reaffirms the need for children to have several follow-ups through their first year of life if their mothers suspect they had Zika in pregnancy.
    The CDC said full physicals should be performed at 2, 4, 6, and 12 months, and that developmental screenings should be performed at 9, 18, and 30 months. Eye exams, hearing tests, and head measurements should also be taken throughout the first year of life.
    New sexual transmission guidance

    Honein also said the CDC will soon be releasing data on the 2,500 pregnancies in the United States affected by Zika, and today a separate MMWR report offers guidelines for preventing the sexual transmission of Zika.
    Men and who have contracted the virus or traveled to an area with active transmission are encouraged to wait 3 months before trying to conceive with their partner. Men should abstain from sex or use a condom with their pregnant partner for 3 months if they contract the disease or travel to a Zika-endemic area.
    The previous guidelines recommended a wait-time of 6 months.
    "Zika RNA can live in semen for a very long time, but the longest transmission we've seen in published reports is 69 days," Honein said.
    See also:
    Aug 7 MMWR report on affected children
    Aug 7 CDC Vital Signs report
    Aug 7 MMWR guidelines on sexual transmission