Kayleigh Sandhu

Georgia Department of Public Health

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Catherine Brown

Massachusetts Department of Public Health

Taryn Stevens

Indiana State Department of Health

Andrea Morrison

Florida Department of Health

Judie Hyun

New York State Department of Health

Wendy Jilek

University of California, Berkeley

Emily Potts

Western Sydney University

Sean Simonson

Louisiana State Department of Health and Hospitals

K. J. Worthington

University of Liverpool

Charsey Cole Porse

California Department of Public Health

Julius Tonzel

Louisiana State Department of Health and Hospitals

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Centers for Disease Control and Prevention

149

New York State Department of Health

Center for Surveillance, Epidemiology, and Laboratory Services

National Center for Emerging and Zoonotic Infectious Diseases

New York City Department of Health and Mental Hygiene

National Center on Birth Defects and Developmental Disabilities

Epidemic Intelligence Service

Florida Department of Health

Wadsworth Center

The Centers

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381: Indications for preterm birth in an Urban safety net hospital

American Journal of Obstetrics and Gynecology (2016)

Lisa Carroll Qiu Zi Yang Kayleigh Sandhu Olivera Vragovic Jodi Abbott

Medical record

10.1016/j.ajog.2016.11.639

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Citations (0)

Case Series of Laboratory-Associated Zika Virus Disease, United States, 2016–2019

Emerging infectious diseases (2021)

Susan L. Hills Andrea Morrison Shawna Stuck Kayleigh Sandhu Krystal Mason

Abstract Zika virus diagnostic testing and laboratory research increased considerably when Zika virus began spreading through the Americas in 2015, increasing the risk for potential Zika virus exposure of laboratory workers and biomedical researchers. We report 4 cases of laboratory-associated Zika virus disease in the United States during 2016–2019. Of these, 2 were associated with needlestick injuries; for the other 2 cases, the route of transmission was undetermined. In laboratories in which work with Zika virus is performed, good laboratory biosafety practices must be implemented and practiced to reduce the risk for infection among laboratory personnel.

Zika Virus

Biosafety

10.3201/eid2705.203602

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Citations (11)

Evaluation of Placental and Fetal Tissue Specimens for Zika Virus Infection — 50 States and District of Columbia, January–December, 2016

MMWR Morbidity and Mortality Weekly Report (2017)

Sarah Reagan-Steiner Regina M. Simeone Elizabeth L. Simon Julu Bhatnagar Titilope Oduyebo

Zika virus infection during pregnancy can cause congenital microcephaly and brain abnormalities (1), and detection of Zika virus RNA in clinical and tissue specimens can provide definitive laboratory evidence of recent Zika virus infection. Whereas duration of viremia is typically short, prolonged detection of Zika virus RNA in placental, fetal, and neonatal brain tissue has been reported and can provide key diagnostic information by confirming recent Zika virus infection (2). In accordance with recent guidance (3,4), CDC provides Zika virus testing of placental and fetal tissues in clinical situations where this information could add diagnostic value. This report describes the evaluation of formalin-fixed paraffin-embedded (FFPE) tissue specimens tested for Zika virus infection in 2016 and the contribution of this testing to the public health response. Among 546 live births with possible maternal Zika virus exposure, for which placental tissues were submitted by the 50 states and District of Columbia (DC), 60 (11%) were positive by Zika virus reverse transcription-polymerase chain reaction (RT-PCR). Among 81 pregnancy losses for which placental and/or fetal tissues were submitted, 18 (22%) were positive by Zika virus RT-PCR. Zika virus RT-PCR was positive on placental tissues from 38/363 (10%) live births with maternal serologic evidence of recent unspecified flavivirus infection and from 9/86 (10%) with negative maternal Zika virus immunoglobulin M (IgM) where possible maternal exposure occurred >12 weeks before serum collection. These results demonstrate that Zika virus RT-PCR testing of tissue specimens can provide a confirmed diagnosis of recent maternal Zika virus infection.

Zika Virus

Microcephaly

Flavivirus

Viremia

10.15585/mmwr.mm6624a3

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Citations (45)

Vital Signs: Update on Zika Virus–Associated Birth Defects and Evaluation of All U.S. Infants with Congenital Zika Virus Exposure — U.S. Zika Pregnancy Registry, 2016

MMWR Morbidity and Mortality Weekly Report (2017)

Megan R. Reynolds Abbey M. Jones Emily E. Petersen Ellen H. Lee Marion E. Rice

In collaboration with state, tribal, local, and territorial health departments, CDC established the U.S. Zika Pregnancy Registry (USZPR) in early 2016 to monitor pregnant women with laboratory evidence of possible recent Zika virus infection and their infants.This report includes an analysis of completed pregnancies (which include live births and pregnancy losses, regardless of gestational age) in the 50 U.S. states and the District of Columbia (DC) with laboratory evidence of possible recent Zika virus infection reported to the USZPR from January 15 to December 27, 2016. Birth defects potentially associated with Zika virus infection during pregnancy include brain abnormalities and/or microcephaly, eye abnormalities, other consequences of central nervous system dysfunction, and neural tube defects and other early brain malformations.During the analysis period, 1,297 pregnant women in 44 states were reported to the USZPR. Zika virus-associated birth defects were reported for 51 (5%) of the 972 fetuses/infants from completed pregnancies with laboratory evidence of possible recent Zika virus infection (95% confidence interval [CI] = 4%-7%); the proportion was higher when restricted to pregnancies with laboratory-confirmed Zika virus infection (24/250 completed pregnancies [10%, 95% CI = 7%-14%]). Birth defects were reported in 15% (95% CI = 8%-26%) of fetuses/infants of completed pregnancies with confirmed Zika virus infection in the first trimester. Among 895 liveborn infants from pregnancies with possible recent Zika virus infection, postnatal neuroimaging was reported for 221 (25%), and Zika virus testing of at least one infant specimen was reported for 585 (65%).These findings highlight why pregnant women should avoid Zika virus exposure. Because the full clinical spectrum of congenital Zika virus infection is not yet known, all infants born to women with laboratory evidence of possible recent Zika virus infection during pregnancy should receive postnatal neuroimaging and Zika virus testing in addition to a comprehensive newborn physical exam and hearing screen. Identification and follow-up care of infants born to women with laboratory evidence of possible recent Zika virus infection during pregnancy and infants with possible congenital Zika virus infection can ensure that appropriate clinical services are available.

Zika Virus

Microcephaly

10.15585/mmwr.mm6613e1

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Citations (284)

Postnatally Acquired Zika Virus Disease Among Children, United States, 2016–2017

Clinical Infectious Diseases (2019)

Nicole P. Lindsey Charsey Cole Porse Emily Potts Judie Hyun Kayleigh Sandhu

Abstract Background The clinical findings among children with postnatally acquired Zika virus disease are not well characterized. We describe and compare clinical signs and symptoms for children aged <18 years. Methods Zika virus disease cases were included if they met the national surveillance case definition, had illness onset in 2016 or 2017, resided in a participating state, and were reported to the Centers for Disease Control and Prevention. Pediatric cases were aged <18 years; congenital and perinatal infections were excluded. Pediatric cases were matched to adult cases (18‒49 years). Clinical information was compared between younger and older pediatric cases and between children and adults. Results A total of 141 pediatric Zika virus disease cases were identified; none experienced neurologic disease. Overall, 28 (20%) were treated in an emergency department, 1 (<1%) was hospitalized; none died. Of the 4 primary clinical signs and symptoms associated with Zika virus disease, 133 (94%) children had rash, 104 (74%) fever, 67 (48%) arthralgia, and 51 (36%) conjunctivitis. Fever, arthralgia, and myalgia were more common in older children (12‒17 years) than younger children (1‒11 years). Arthralgia, arthritis, edema, and myalgia were more common in adults compared to children. Conclusions This report supports previous findings that Zika virus disease is generally mild in children. The most common symptoms are similar to other childhood infections, and clinical findings and outcomes are similar to those in adults. Healthcare providers should consider a diagnosis of Zika virus infection in children with fever, rash, arthralgia, or conjunctivitis, who reside in or have traveled to an area where Zika virus transmission is occurring.

myalgia

Zika Virus

10.1093/cid/ciz195

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Citations (13)