Zika Screening Beyond Brazil: Zika Madness and Cost of Reassurance? [15M

Abstract

INTRODUCTION: Zika infection during pregnancy can cause severe birth defects. We investigated patients concerns evaluated for Zika exposure in a perinatal center. METHODS: Following outbreak of Zika, patients presented to our fetal evaluation unit were prompted to provide information regarding exposure to the Zika Feb-July 2016. Information recorded included: travel to Zika areas, symptoms, mosquito bites, tests, ultrasound findings, partner exposure and use of barrier protection. Zika related visits and results were reviewed. RESULTS: A total of 13,769 ultrasounds were performed. Seventy two patients expressed concern regarding Zika exposure. One third of patients came solely for Zika screening for a total of 77 visits. Fifty four percent reported a mosquito bite, 10 % had Zika related symptom. Two patients had a fetal head circumference (HC) < 3%: one had craniosynostosis on MRI and the other was normal at birth. Fifty two patients had lab testing were negative. Two thirds of the patients' partners reported travel history only 1 had Zika testing. Thirty eight percent patients reported sexual activity after suspected exposure to Zika only 10% used a barrier method. CONCLUSION: Patient concerns regarding Zika exposure declined precipitously after peaking early in 2016 likely due to avoiding travel to Zika affected areas. Less than 1% of visits were solely for Zika concerns, none of which had a positive sonographic evidence of infection. The minimal cost of Zika screening appeared to provide reassurance with negligible impact on the flow of care. As Zika spreads to Florida and other states, the clinical burden of screening may increase.