The Centers for Disease Control and Prevention (CDC) has updated its interim guidance for US health care providers caring for pregnant women with possible Zika virus exposure, to include emerging data indicating that Zika virus RNA can be detected for prolonged periods in some pregnant women. In order to increase the proportion of pregnant women with Zika virus infection who receive a definitive diagnosis, CDC recommends expanding real-time reverse transcription-polymerase chain-reaction (rRT-PCR) testing. Other recommendations include:
• Symptomatic pregnant women who are evaluated <2 weeks after symptom onset should receive serum and urine Zika virus rRT-PCR testing.
• Symptomatic pregnant women who are evaluated 2 to 12 weeks after symptom onset should first receive a Zika virus immunoglobulin (IgM) antibody test; if result is positive or equivocal, serum and urine rRT-PCR testing should be performed.
• For asymptomatic pregnant women who live in areas without active Zika virus transmission and who are evaluated <2 weeks after last possible exposure, rRT-PCR testing should be performed; if result is negative, a Zika virus IgM antibody test should be performed 2 to 12 weeks after the exposure.
• Asymptomatic pregnant women who do not live in an area with active Zika virus transmission, who are first evaluated 2 to 12 weeks after their last possible exposure, should first receive a Zika virus IgM antibody test; if result is positive or equivocal, serum and urine rRT-PCR should be performed.
• For symptomatic and asymptomatic pregnant women with possible Zika virus exposure who seek care >12 weeks after symptom onset or possible exposure, IgM antibody testing may be considered.
• Asymptomatic pregnant women with ongoing risk for exposure to Zika virus should receive Zika virus IgM antibody testing as part of routine obstetric care during the first and second trimesters.
Oduyebo T, Igbinosa I, Petersen EE, et al. Update: Interim guidance for health care providers caring for pregnant women with possible Zika virus exposure—United States, July 2016. [Published online ahead of print July 25, 2016]. MMWR Morb Mortal Wkly Rep. doi:10.15585/mmwr.mm6529e1.
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