Update: Interim Guidance for the Diagnosis, Evaluation, and Management of Infants with Possible Congenital Zika Virus Infection — United States, October 2017

著者: Tolulope Adebanjo, Shana Godfred‐Cato, Laura Viens, Marc Fischer, J. Erin Staples, Wendi Kuhnert-Tallman, Henry Walke, Titilope Oduyebo, Kara D. Polen, Georgina Peacock, Dana Meaney‐Delman, Margaret A. Honein, Sonja A. Rasmussen, Cynthia A. Moore, Contributors, Contributors, Edna Alleyne, Martina L. Badell, James F. Bale, Wanda D. Barfield, Richard H. Beigi, Audina M. Berrocal, Carina Blackmore, Eric Blank, Jennifer Bolden Pitre, Coleen Boyle, Erin E. Conners, Christine L. Curry, Richard Danila, Alberto de la Vega, Roberta L. DeBiasi, Gail J. Demmler‐Harrison, Siobhan M. Dolan, Rita W. Driggers, Eric J. Dziuban, John Eichwald, Catherine Eppes, Nicole Fehrenbach, Meg Fisher, Kimberly B. Fortner, Elizabeth Garbarczyk, Francisco José Ferraro García, Stephanie L. Gaw, Valerie Godoshian, Iván González, Caitlin Green, Dixie D. Griffin, Manda Hall, Amy J. Houtrow, Mark L. Hudak, Lisa L. Hunter, David W. Kimberlin, Linda Lawrence, Ellen H. Lee, Rebecca T. Leeb, Deborah Levine, Claritsa Malave, Yvonne Maldonado, Lynne Mofenson, Sarah B. Mulkey, Flor M. Muñoz, Scott Needle, Chloe Oram, Cassandra G. Pasley, Maria P. Carlos, Alyssa Pensirikul, Emily E. Petersen, Lawrence Platt, S. Grace Prakalapakorn, Sarah Reagan-Steiner, Jeannie Rodriguez, Elizabeth Rosenblum, Pablo J. Sánchez, Magdalena Sanz Cortés, David J. Schonfeld, Carrie K. Shapiro‐Mendoza, Dean E. Sidelinger, V. Fan Tait, Miguel Valencia‐Prado, Lisa F. Waddell, Michael D. Warren, Susan Wiley, Eileen G. Yamada, Marshalyn Yeargin‐Allsopp, Fernando Ysern, Christopher M. Zahn - MMWR Morbidity and Mortality Weekly Report 2017 被引用: 218

without clinical findings consistent with congenital Zika syndrome who were born to mothers without laboratory evidence of possible Zika virus infection. Infants in the first two scenarios should receive further testing and evaluation for Zika virus, whereas for the third group, further testing and clinical evaluation for Zika virus are not recommended. Health care providers should remain alert for abnormal findings (e.g., postnatal-onset microcephaly and eye abnormalities without microcephaly) in infants with possible congenital Zika virus exposure without apparent abnormalities at birth. * Possible Zika virus exposure includes travel to, or residence in an area with mosquitoborne Zika virus transmission or sex without the use of condoms with a partner who has traveled to or resides in an area with mosquitoborne Zika virus transmission. Laboratory evidence of possible Zika virus infection during pregnancy is defined as 1) Zika virus infection detected by a Zika virus RNA nucleic acid test (NAT) on any maternal, placental, or fetal specimen (referred to as NAT-confirmed), or 2) diagnosis of Zika virus infection, timing of infection cannot be determined or unspecified flavivirus infection, timing of infection cannot be determined by serologic tests on a maternal specimen (i.e., positive/equivocal Zika virus immunoglobulin M [IgM] and Zika virus plaque reduction neutralization test [PRNT] titer 10, regardless of dengue virus PRNT value; or negative Zika virus IgM, and positive or equivocal dengue virus IgM, and Zika virus PRNT titer 10, regardless of dengue virus PRNT titer). The use of PRNT for confirmation of Zika virus infection, including in pregnant women, is not routinely recommended in Puerto Rico (https://www.cdc.gov/zika/laboratories/lab-guidance.html).