The recent updates in Congenital Zika management in Infants

Centers for Disease Control and Prevention CDC

Zika virus testing is recommended for infants with clinical findings consistent with congenital Zika syndrome and possible maternal Zika virus exposure during pregnancy, regardless of maternal testing results. Testing CSF for Zika virus RNA and Zika virus IgM antibodies should be considered, especially if serum and urine testing are negative and another etiology has not been identified.

In addition to a standard evaluation, infants with clinical findings consistent with congenital Zika syndrome should have a head ult

rasound and a comprehensive ophthalmologic exam performed by age 1 month by an ophthalmologist experienced in assessment of and intervention in infants. Infants should be referred for automated auditory brainstem response (ABR) by age 1 month if the newborn hearing screen was passed using only otoacoustic emissions methodology. Zika virus testing is recommended for infants without clinical findings consistent with congenital Zika syndrome born to mothers with lab

oratory evidence of possible Zika virus infection during pregnancy. In addition to a standard evaluation, infants who do not have clinical findings consistent with congenital Zika syndrome born to mothers with laboratory evidence of possible Zika virus infection during pregnancy should have a head ultrasound and a comprehensive ophthalmologic exam performed by age 1 month to detect subclinical brain and eye findings. A diagnostic ABR at 4 to 6 months or behavioral audiology at age 9 months is no longer recommended if the initial hearing screen is passed by 

automated ABR, because of absence of data suggesting delayed-onset hearing loss in congenital Zika virus infection.

  • Kel­ly JC. New CDC guid­ance on car­ing for infants with con­gen­i­tal Zika. Med­scape News. Web­MD Inc. Octo­ber 20, 2017.
  • Update: Inter­im guid­ance for the diag­no­sis, eval­u­a­tion, and man­age­ment of infants with pos­si­ble con­gen­i­tal Zika virus infection—Unites States, Octo­ber 2017. MMWR Morb Mor­tal Wkly Rep. 2017 Oct 20;66(41):1089–99.