Last reviewed: November 2017
Last updated: November  2017

Important updates

Updated CDC guidance on Zika infection in pregnancy

  • The Centers for Disease Control and Prevention (CDC) has updated its interim guidance on caring for pregnant women with possible Zika virus infection. Key recommendations include:

  • Pregnant women in the US and US territories should be asked about possible Zika virus exposure before and during their current pregnancy at every prenatal visit.

  • Pregnant women with recent Zika virus exposure and symptoms should undergo molecular testing (serum and urine) and serologic testing (serum) as soon as possible, up to 12 weeks after onset of symptoms.

  • Pregnant women without symptoms but with ongoing possible exposure to Zika virus should undergo molecular testing 3 times during pregnancy; serologic testing is no longer recommended in these patients.

  • Routine testing is no longer recommended in asymptomatic pregnant women with possible recent exposure to Zika virus, but may be considered.

See Diagnosis: approach

Original source of update

Summary

Definition

History and exam

Key diagnostic factors

  • residence in/travel from endemic area
  • fever
  • maculopapular rash
  • arthralgia
  • conjunctivitis
  • features of congenital Zika syndrome (infants)
  • features of Guillain-Barre syndrome

Other diagnostic factors

  • other constitutional symptoms
  • gastrointestinal symptoms
  • retro-orbital pain
  • edema of lower limbs
  • transient hearing loss in adults

Risk factors

  • residence in/travel from endemic area
  • mosquito bites in endemic area
  • unprotected sexual contact with infected individual
  • blood transfusion from infected individual
  • sperm donation from infected individual
  • exposure to other infected body fluids
  • exposure to infected human cells/tissues

Diagnostic investigations

1st investigations to order

  • reverse transcriptase-polymerase chain reaction (RT-PCR) on serum and urine
  • serology
  • testing for other arboviruses
Full details

Investigations to consider

  • prenatal ultrasound
  • amniocentesis
  • head circumference measurement (newborn)
  • newborn further evaluation
  • CT/MRI head (newborn)
  • cranial ultrasound (newborn)
  • tests for Guillain-Barre syndrome
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Clinical Director

Microcephaly Working Group

Instituto de Medicina Integral Professor Fernando Figueira (IMIP)

Recife

Brazil

Disclosures

GF declares that he has no competing interests.

Coordinator Obstetrics/Gynecology

Microcephaly Working Group

Instituto de Medicina Integral Professor Fernando Figueira (IMIP)

Recife

Brazil

Disclosures

AS declares that she has no competing interests.

Peer reviewers VIEW ALL

Chief

Division of Infectious Diseases and International Health

University of Virginia

Charlottesville

VA

Disclosures

WAP declares that he has no competing interests.

Director

Institute of Clinical Pathology and Medical Research

Pathology West

Westmead Hospital

Sydney

Australia

Disclosures

DD is a member of Advisory Boards for bioCSL and GSK in antivirals and vaccines.

Assistant Professor

Division of Infectious Diseases

Northwestern University Feinberg School of Medicine

Chicago

IL

Disclosures

CA declares that he has no competing interests.

Assistant Professor of Medicine

TravelWell Center

Division of Infectious Diseases

Atlanta

GA

Disclosures

HW declares that he has no competing interests.

Use of this content is subject to our disclaimer