Abstract
Zika virus infection during pregnancy can lead to congenital Zika syndrome. Implementation of screening programs and interpretation of test results can be particularly challenging during ongoing local mosquitoborne transmission. We conducted a retrospective chart review of 2,327 pregnant women screened for Zika virus in Miami–Dade County, Florida, USA, during 2016. Of these, 86 had laboratory evidence of Zika virus infection; we describe 2 infants with probable congenital Zika syndrome. Delays in receipt of laboratory test results (median 42 days) occurred during the first month of local transmission. Odds of screening positive for Zika virus were higher for women without health insurance or who did not speak English. Our findings indicate the increase in screening for Zika virus can overwhelm hospital and public health systems, resulting in delayed receipt of results of screening and confirmatory tests and the potential to miss cases or delay diagnoses.
Highlights
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Demographic and laboratory data recorded for pregnant women tested for Zika virus consisted of age, patientreported ethnic group, language preference, insurance status, screening test date, result receipt date, test result, number of tests performed per patient, and timing of test and result relative to delivery date
During 2016, a total of 2,327 pregnant women were tested for Zika virus (Table 1)
Summary
We retrospectively reviewed charts of all 2,327 pregnant women who were tested for Zika virus during January 1, 2016–December 31, 2016, at 2 tertiary care hospitals in Miami–Dade County, Florida, USA: University of Miami Miller School of Medicine and Jackson Memorial Hospital. Women were triaged to consultation with the high-risk obstetrics team and the pediatric infectious disease team if Zika virus RNA was detected by rRT-PCR or if Zika virus IgM was detected by IgM antibody-capture ELISA (MACELISA) in maternal serum This change in care was done as part of clinical management. Women with negative serum and urine rRT-PCR results and any nonnegative Zika virus IgM and with a PRNT titer for Zika virus
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