Zika virus is a mosquito-transmitted virus that generally causes no symptoms or mild illness, but is associated with microcephaly in infants whose mothers contract it during pregnancy. In January 2016, the US Centers for Disease Control and Prevention (CDC) issued a health advisory, travel alert and MMWR urging women who are pregnant to avoid countries where Zika virus transmission is ongoing. Women trying to become pregnant should consult with their healthcare providers before traveling to these areas and strictly follow steps to avoid mosquito bites during the trip. Information on this webpage, including recommendations for management, will be updated periodically to reflect changing evidence and emerging consensus.
ACOG Practice Advisory
The ACOG-SMFM Practice Advisory: Updated Interim Guidance for Care of Women of Reproductive Age During a Zika Virus Outbreak has been modified to include CDC's update on submitting urine samples with blood samples for PCR testing. June 13, 2016
ACOG Zika Update: Interpreting Tests released 6/13/16
Interpretation of Zika Virus Antibody Test Results
On June 3, 2016, the Centers for Disease Control and Prevention (CDC) issued their Interim Guidance for Interpretation of Zika Virus Antibody Test Results.
Of particular importance for obstetrician-gynecologists and other obstetric providers, for persons with suspected Zika virus disease, a positive rRT-PCR result confirms Zika virus infection, and no antibody testing is indicated. However, because of the decline in the level of viremia over time and possible inaccuracy in reporting of dates of illness onset, a negative rRT-PCR result does not exclude Zika virus infection. Therefore, serum IgM antibody testing for Zika and dengue virus infections should be performed if rRT-PCR is negative. For serum specimens collected <7 days after onset of symptoms, the combination of a negative rRT-PCR result and negative IgM antibody testing suggests that there was no recent infection. However, a negative IgM antibody test, in the absence of rRT-PCR testing, might reflect specimen collection before development of detectable antibodies and does not rule out infection with the viruses for which testing was performed. For specimens collected from 7 days to 12 weeks after onset of symptoms, a negative IgM antibody result to both Zika and dengue viruses rules out recent infection with
ACOG Special Zika Update released via email blast 5/27/16
US Zika Pregnancy Registry
Obstetrician–gynecologists will need to report pregnant women with any laboratory evidence of Zika virus infection (positive or equivocal test results, regardless of whether or not they have symptoms) to the state health department. ACOG strongly encourages all members to support the US Zika Pregnancy Registry, established by CDC in collaboration with state, tribal, local, and territorial health departments to track cases of Zika virus by reporting eligible cases. Each new data point collected through these surveillance systems contributes to what we know about Zika virus, which will improve the care we provide to patients affected by the virus. Obstetricians and gynecologists and other obstetric providers can support the registry by designating staff who can assist in the completion of pregnancy data collection forms and who will be responsible for reporting pregnant women with Zika virus to their health department. To better facilitate reporting, the CDC has provided a contact list (ACOG members only) of US Zika Pregnancy Registry contacts for each state. Click here for CDC’s Provider and Patient fact sheets on the Zika registry reporting requirements. For additional questions about the registry please e-mail: ZikaPregnancy@cdc.gov or call 770-488-7100
To better facilitate reporting, the CDC has provided a contact list (ACOG members only) of US Zika Pregnancy Registry contacts for each state.
Zika Testing on Urine
On May 13, 2016, the Centers for Disease Control and Prevention (CDC) issued interim guidance that recommends Zika virus rRT-PCR testing of urine collected less than 14 days after symptom onset, along with testing of patient-matched serum samples, for the diagnosis of suspected Zika infection. If the PCR result is negative, serologic (IgM) testing should be performed. CDC recommendations for Zika virus testing of serum and other clinical specimens remain unchanged at this time. Learn more.
ACOG Annual Clinical and Scientific Meeting: Late Breaking Lecture – The Latest on the Zika Virus: Ob/Gyn Response in This World of Uncertainty Laura E. Riley, MD and Denise Jamieson, MD presented on Sunday, May 15, 2016
Click here to watch the late-breaking presentation on Zika Virus (ACOG members only) This session presented an overview of what is known about Zika virus with particular attention paid to pregnancy implications. This lecture also reviewed what is not known about the pathogenesis of the virus. In this time of uncertainty, guidance on prevention, screening, and treatment will be discussed as well.
CDC Zika Pregnancy Hotline for Healthcare Providers
Ob-gyns can contact the CDC Zika Pregnancy Hotline at 770-488-7100 or email ZikaPregnancy@cdc.gov for any concerns related to clinical management or the US Zika Pregnancy Registry
For more information please see CDC fact sheets on US Zika Pregnancy Registry for obstetric healthcare providers and pregnant women.
Diagnostic Testing on CDC.gov
Zika virus disease can often be diagnosed by performing reverse transcriptase-polymerase chain reaction (RT-PCR) on serum. Testing is performed at the CDC Arbovirus Diagnostic Laboratory and a few state health departments.
Contact your state health department for local direction on handling specimens for testing. To find your state contact refer to the Zika state contact list from CDC (members-only PDF).
CDC Reporting Data: Pregnant Women with Any Lab Evidence of Zika Virus Infection
Click Here For Cases in Pregnancy
Click here For Pregnancy Outcomes
CDC Communication Toolkit – US Zika Pregnancy Registry Adverse Outcomes reporting
Urge Congress to Fund Zika Prevention: Our patients can't wait!
We don’t know how to treat or cure Zika, but we do know how to prevent it. Our Nation needs to act immediately to stop Zika from spreading here in the U.S. With the right measures, we can slow the spread of Zika until a treatment or vaccine can be developed.
The White House has redirected available federal funds, but we need Congress to do much more. Tell Congress to ACT NOW, pass an emergency spending bill to prevent Zika from causing devastating birth defects among babies here in the U.S. We can’t afford to wait much longer –mosquito season is nearly here.
Write to your elected officials here
CDC Confirms that Prenatal Zika Virus Causes Microcephaly and other Fetal Brain Anomalies
Scientists at the Centers for Disease Control and Prevention (CDC) have concluded, after careful review of existing evidence, that Zika virus is a cause of microcephaly and other severe fetal brain defects. In the report published in the New England Journal of Medicine, the CDC authors describe a rigorous weighing of evidence using established scientific criteria. Access the article here: Zika Virus and Birth Defects- Reviewing the Evidence for Causality
Rasmussen SA, Jamieson DJ, Honein MA, Petersen LR. Zika Virus and Birth Defects - Reviewing the Evidence for Causality. N Engl J Med. 2016 Apr 13. e-published ahead of print. Read the ACOG Statement on the CDC Update and Zika Virus for more information.
The American Academy of Neurology is collaborating with the Centers for Disease Control and Prevention (CDC) to develop educational materials for health care providers on the diagnosis, management, and treatment of Guillain-Barré syndrome (GBS). With the widespread outbreak of Zika virus infections, there have been reports of an increased number of people who have been infected with Zika virus who also have GBS.
A free webinar on this topic, presented by neurologist Ted M. Burns, MD, with the University of Virginia, will be held on Friday, June 17, at 12:00 p.m. ET.
Click here to Register—it’s free!
Learn more about the Zika virus and GBS.
ISUOG Congenital Zika Virus Syndrome: how to improve your diagnostic capabilities
As pregnant women and their fetuses are being diagnosed with Congenital Zika Virus Syndrome with increased frequency in Brazil as well as in other Latin American countries, it becomes crucial to educate regional practitioners on the way to make these diagnoses as early as possible. ISUOG Outreach has organised, in collaboration with the World Health Organization (WHO). a free webinar on the subject to provide participants with the necessary tools to differentiate between unaffected and affected fetuses.
Click Here to watch webinar on demand