Zika Virus-Associated Birth Defects, Costa Rica, 2016-2018.

Adriana Benavides-Lara,Cynthia A Moore,Melissa Ramírez-Rojas,Nereida Arjona-Ortegón,Marcela Hernández-Demezerville,Helena Brenes-Chacón,María De La Paz Barboza-Arguello,Mauricio González-Elizondo,Diana Valencia,Shana Godfred-Cato,Catalina Ramírez-Hernández,Alejandra Soriano-Fallas

doi:10.3201/eid2702.202047

Abstract

After Zika virus (ZIKV) infection in Costa Rica was confirmed in January 2016, the national surveillance system was enhanced to monitor associated birth defects. To characterize the ZIKV outbreak among live-born infants during March 2016–March 2018, we conducted a descriptive analysis. Prevalence of ZIKV-associated birth defects was 15.3 cases/100,000 live births. Among 22 infants with ZIKV-associated birth defects, 11 were designated as confirmed (positive for ZIKV) and 11 were designated as probable cases (negative for ZIKV or not tested, but mother was expsed to ZIKV during pregnancy). A total of 91% had microcephaly (head circumference >2 SDs below mean for age and sex), 64% severe microcephaly (head circumference > 3 SDs below mean for age and sex), 95% neurodevelopmental abnormalities, 82% brain anomalies, 41% eye abnormalities, and 9% hearing loss. Monitoring children for > 1 year can increase identification of ZIKV-associated abnormalities in addition to microcephaly.

Highlights

In support of improving patient care, this activity has been planned and implemented by Medscape, LLC and Emerging Infectious Diseases
Similar findings have been observed in Brazil, Colombia, and the United States, where the peak incidence was observed ≈6 months after the Zika virus (ZIKV) epidemic, corroborating a temporal link between ZIKV infection and associated birth defects [7,23,24]
Most infants with Zika-related birth defects (ZBD) were born to mothers who reported symptoms in the first and second trimesters of pregnancy (64%), consistent with other reports [25,26,27,28,29]; because 36% were born to mothers who were asymptomatic, the proportion of infections in early to mid-pregnancy is probably greater

Summary

Introduction

In support of improving patient care, this activity has been planned and implemented by Medscape, LLC and Emerging Infectious Diseases. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Describe epidemiologic features and prevalence of Zika-related birth defects (ZBD) and microcephaly among live-born infants in Costa Rica, March 2016 to March 2018, according to a descriptive analysis

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Results

Conclusion