Zika Virus in a Non-Endemic Urban Population: Patient Characteristics and Ultrasound Findings [12M

Abstract

INTRODUCTION: The global Zika virus (ZIKV) outbreak has led to pregnant women seeking consultation, testing and ultrasound surveillance. We describe patient characteristics and ultrasound findings in a high-risk non-endemic Southern U.S. urban cohort. METHODS: This is a retrospective cohort study of women referred to our Obstetrics Infectious Disease Clinic for potential ZIKV exposure between February and September 2016 and tested accordance to Center for Disease Control (CDC) criteria. Patient characteristics, ultrasound findings and testing outcomes were recorded. RESULTS: A total of 105 gravidas were evaluated for ZIKV. Mean gestational age at last exposure and testing was 20+9.8 wks and 26.3 +8.9 wks, respectively. Geographic exposure was more common than sexual contact alone (90% vs 10%), though 61 (58%) reported partner co-travel. 95 (90%) were Hispanic and Mexico was the country most often traveled (50%). 21 (20%) women were symptomatic and 8 (11%) had positive test results (1 serum PCR and 7 with IgM and PRNT >10). There were 17 (18%) patients with ultrasound abnormalities; including microcephaly 12 (12%), intracranial abnormalities 3 (3%) and 11 (11%) with fetal growth restriction and/or oligohydramnios. There were 2 (2%) first trimester miscarriages and one stillbirth at 33 weeks. No congenital infection of ZIKV was confirmed either on amniocentesis or at delivery in the 48 (46%) of women delivered thus far. CONCLUSION: The prevalence of ultrasound abnormalities was higher than previously reported for as the baseline prevalence in the United States (3-5%). Further research is needed to determine if our findings are related to risk factors independent or dependent on ZIKV exposure or infection.