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Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure - United States, July 2016.

Abstract CDC has updated its interim guidance for U.S. health care providers caring for pregnant women with possible Zika virus exposure, to include the emerging data indicating that Zika virus RNA can be detected for prolonged periods in some pregnant women. 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. Possible exposures to Zika virus include travel to or residence in an area with active Zika virus transmission, or sex* with a partner who has traveled to or resides in an area with active Zika virus transmission without using condoms or other barrier methods to prevent infection.(?) Testing recommendations for pregnant women with possible Zika virus exposure who report clinical illness consistent with Zika virus disease(?) (symptomatic pregnant women) are the same, regardless of their level of exposure (i.e., women with ongoing risk for possible exposure, including residence in or frequent travel to an area with active Zika virus transmission, as well as women living in areas without Zika virus transmission who travel to an area with active Zika virus transmission, or have unprotected sex with a partner who traveled to or resides in an area with active Zika virus transmission). 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 2-12 weeks after symptom onset should first receive a Zika virus immunoglobulin (IgM) antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR testing should be performed. Testing recommendations for pregnant women with possible Zika virus exposure who do not report clinical illness consistent with Zika virus disease (asymptomatic pregnant women) differ based on the circumstances of possible exposure. 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 the rRT-PCR result is negative, a Zika virus IgM antibody test should be performed 2-12 weeks after the exposure. Asymptomatic pregnant women who do not live in an area with active Zika virus transmission, who are first evaluated 2-12 weeks after their last possible exposure should first receive a Zika virus IgM antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR should be performed. 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; immediate rRT-PCR testing should be performed when IgM antibody test results are positive or equivocal. This guidance also provides updated recommendations for the clinical management of pregnant women with confirmed or possible Zika virus infection. These recommendations will be updated when additional data become available.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title mmwr. morbidity and mortality weekly report
Publication Year Start
%A Oduyebo, Titilope; Igbinosa, Irogue; Petersen, Emily E.; Polen, Kara N. D.; Pillai, Satish K.; Ailes, Elizabeth C.; Villanueva, Julie M.; Newsome, Kim; Fischer, Marc; Gupta, Priya M.; Powers, Ann M.; Lampe, Margaret; Hills, Susan; Arnold, Kathryn E.; Rose, Laura E.; Shapiro-Mendoza, Carrie K.; Beard, Charles B.; Mu?oz, Jorge L.; Rao, Carol Y.; Meaney-Delman, Dana; Jamieson, Denise J.; Honein, Margaret A.
%T Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure - United States, July 2016.
%J MMWR. Morbidity and mortality weekly report, vol. 65, no. 29, pp. 739-744
%D 07/2016
%V 65
%N 29
%M eng
%B CDC has updated its interim guidance for U.S. health care providers caring for pregnant women with possible Zika virus exposure, to include the emerging data indicating that Zika virus RNA can be detected for prolonged periods in some pregnant women. 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. Possible exposures to Zika virus include travel to or residence in an area with active Zika virus transmission, or sex* with a partner who has traveled to or resides in an area with active Zika virus transmission without using condoms or other barrier methods to prevent infection.(?) Testing recommendations for pregnant women with possible Zika virus exposure who report clinical illness consistent with Zika virus disease(?) (symptomatic pregnant women) are the same, regardless of their level of exposure (i.e., women with ongoing risk for possible exposure, including residence in or frequent travel to an area with active Zika virus transmission, as well as women living in areas without Zika virus transmission who travel to an area with active Zika virus transmission, or have unprotected sex with a partner who traveled to or resides in an area with active Zika virus transmission). 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 2-12 weeks after symptom onset should first receive a Zika virus immunoglobulin (IgM) antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR testing should be performed. Testing recommendations for pregnant women with possible Zika virus exposure who do not report clinical illness consistent with Zika virus disease (asymptomatic pregnant women) differ based on the circumstances of possible exposure. 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 the rRT-PCR result is negative, a Zika virus IgM antibody test should be performed 2-12 weeks after the exposure. Asymptomatic pregnant women who do not live in an area with active Zika virus transmission, who are first evaluated 2-12 weeks after their last possible exposure should first receive a Zika virus IgM antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR should be performed. 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; immediate rRT-PCR testing should be performed when IgM antibody test results are positive or equivocal. This guidance also provides updated recommendations for the clinical management of pregnant women with confirmed or possible Zika virus infection. These recommendations will be updated when additional data become available.
%P 739
%L 744
%Y 10.15585/mmwr.mm6529e1
%W PHY
%G AUTHOR
%R 2016.......65..739O

@Article{Oduyebo2016,
author="Oduyebo, Titilope
and Igbinosa, Irogue
and Petersen, Emily E.
and Polen, Kara N. D.
and Pillai, Satish K.
and Ailes, Elizabeth C.
and Villanueva, Julie M.
and Newsome, Kim
and Fischer, Marc
and Gupta, Priya M.
and Powers, Ann M.
and Lampe, Margaret
and Hills, Susan
and Arnold, Kathryn E.
and Rose, Laura E.
and Shapiro-Mendoza, Carrie K.
and Beard, Charles B.
and Mu{\~n}oz, Jorge L.
and Rao, Carol Y.
and Meaney-Delman, Dana
and Jamieson, Denise J.
and Honein, Margaret A.",
title="Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure - United States, July 2016.",
journal="MMWR. Morbidity and mortality weekly report",
year="2016",
month="Jul",
day="25",
volume="65",
number="29",
pages="739--744",
abstract="CDC has updated its interim guidance for U.S. health care providers caring for pregnant women with possible Zika virus exposure, to include the emerging data indicating that Zika virus RNA can be detected for prolonged periods in some pregnant women. 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. Possible exposures to Zika virus include travel to or residence in an area with active Zika virus transmission, or sex* with a partner who has traveled to or resides in an area with active Zika virus transmission without using condoms or other barrier methods to prevent infection.({\textdagger}) Testing recommendations for pregnant women with possible Zika virus exposure who report clinical illness consistent with Zika virus disease({\textsection}) (symptomatic pregnant women) are the same, regardless of their level of exposure (i.e., women with ongoing risk for possible exposure, including residence in or frequent travel to an area with active Zika virus transmission, as well as women living in areas without Zika virus transmission who travel to an area with active Zika virus transmission, or have unprotected sex with a partner who traveled to or resides in an area with active Zika virus transmission). 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 2-12 weeks after symptom onset should first receive a Zika virus immunoglobulin (IgM) antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR testing should be performed. Testing recommendations for pregnant women with possible Zika virus exposure who do not report clinical illness consistent with Zika virus disease (asymptomatic pregnant women) differ based on the circumstances of possible exposure. 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 the rRT-PCR result is negative, a Zika virus IgM antibody test should be performed 2-12 weeks after the exposure. Asymptomatic pregnant women who do not live in an area with active Zika virus transmission, who are first evaluated 2-12 weeks after their last possible exposure should first receive a Zika virus IgM antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR should be performed. 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; immediate rRT-PCR testing should be performed when IgM antibody test results are positive or equivocal. This guidance also provides updated recommendations for the clinical management of pregnant women with confirmed or possible Zika virus infection. These recommendations will be updated when additional data become available.",
issn="1545-861X",
doi="10.15585/mmwr.mm6529e1",
url="http://www.ncbi.nlm.nih.gov/pubmed/27467820",
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%0 Journal Article
%T Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure - United States, July 2016.
%A Oduyebo, Titilope
%A Igbinosa, Irogue
%A Petersen, Emily E.
%A Polen, Kara N. D.
%A Pillai, Satish K.
%A Ailes, Elizabeth C.
%A Villanueva, Julie M.
%A Newsome, Kim
%A Fischer, Marc
%A Gupta, Priya M.
%A Powers, Ann M.
%A Lampe, Margaret
%A Hills, Susan
%A Arnold, Kathryn E.
%A Rose, Laura E.
%A Shapiro-Mendoza, Carrie K.
%A Beard, Charles B.
%A Mu?oz, Jorge L.
%A Rao, Carol Y.
%A Meaney-Delman, Dana
%A Jamieson, Denise J.
%A Honein, Margaret A.
%J MMWR. Morbidity and mortality weekly report
%D 2016
%8 July 25
%V 65
%N 29
%@ 1545-861X
%G eng
%F Oduyebo2016
%X CDC has updated its interim guidance for U.S. health care providers caring for pregnant women with possible Zika virus exposure, to include the emerging data indicating that Zika virus RNA can be detected for prolonged periods in some pregnant women. 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. Possible exposures to Zika virus include travel to or residence in an area with active Zika virus transmission, or sex* with a partner who has traveled to or resides in an area with active Zika virus transmission without using condoms or other barrier methods to prevent infection.(?) Testing recommendations for pregnant women with possible Zika virus exposure who report clinical illness consistent with Zika virus disease(?) (symptomatic pregnant women) are the same, regardless of their level of exposure (i.e., women with ongoing risk for possible exposure, including residence in or frequent travel to an area with active Zika virus transmission, as well as women living in areas without Zika virus transmission who travel to an area with active Zika virus transmission, or have unprotected sex with a partner who traveled to or resides in an area with active Zika virus transmission). 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 2-12 weeks after symptom onset should first receive a Zika virus immunoglobulin (IgM) antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR testing should be performed. Testing recommendations for pregnant women with possible Zika virus exposure who do not report clinical illness consistent with Zika virus disease (asymptomatic pregnant women) differ based on the circumstances of possible exposure. 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 the rRT-PCR result is negative, a Zika virus IgM antibody test should be performed 2-12 weeks after the exposure. Asymptomatic pregnant women who do not live in an area with active Zika virus transmission, who are first evaluated 2-12 weeks after their last possible exposure should first receive a Zika virus IgM antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR should be performed. 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; immediate rRT-PCR testing should be performed when IgM antibody test results are positive or equivocal. This guidance also provides updated recommendations for the clinical management of pregnant women with confirmed or possible Zika virus infection. These recommendations will be updated when additional data become available.
%U http://dx.doi.org/10.15585/mmwr.mm6529e1
%U http://www.ncbi.nlm.nih.gov/pubmed/27467820
%P 739-744

PT Journal
AU Oduyebo, T
   Igbinosa, I
   Petersen, EE
   Polen, KND
   Pillai, SK
   Ailes, EC
   Villanueva, JM
   Newsome, K
   Fischer, M
   Gupta, PM
   Powers, AM
   Lampe, M
   Hills, S
   Arnold, KE
   Rose, LE
   Shapiro-Mendoza, CK
   Beard, CB
   Mu?oz, JL
   Rao, CY
   Meaney-Delman, D
   Jamieson, DJ
   Honein, MA
TI Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure - United States, July 2016.
SO MMWR. Morbidity and mortality weekly report
JI MMWR Morb. Mortal. Wkly. Rep.
PD 07
PY 2016
BP 739
EP 744
VL 65
IS 29
DI 10.15585/mmwr.mm6529e1
LA eng
AB CDC has updated its interim guidance for U.S. health care providers caring for pregnant women with possible Zika virus exposure, to include the emerging data indicating that Zika virus RNA can be detected for prolonged periods in some pregnant women. 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. Possible exposures to Zika virus include travel to or residence in an area with active Zika virus transmission, or sex* with a partner who has traveled to or resides in an area with active Zika virus transmission without using condoms or other barrier methods to prevent infection.(?) Testing recommendations for pregnant women with possible Zika virus exposure who report clinical illness consistent with Zika virus disease(?) (symptomatic pregnant women) are the same, regardless of their level of exposure (i.e., women with ongoing risk for possible exposure, including residence in or frequent travel to an area with active Zika virus transmission, as well as women living in areas without Zika virus transmission who travel to an area with active Zika virus transmission, or have unprotected sex with a partner who traveled to or resides in an area with active Zika virus transmission). 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 2-12 weeks after symptom onset should first receive a Zika virus immunoglobulin (IgM) antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR testing should be performed. Testing recommendations for pregnant women with possible Zika virus exposure who do not report clinical illness consistent with Zika virus disease (asymptomatic pregnant women) differ based on the circumstances of possible exposure. 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 the rRT-PCR result is negative, a Zika virus IgM antibody test should be performed 2-12 weeks after the exposure. Asymptomatic pregnant women who do not live in an area with active Zika virus transmission, who are first evaluated 2-12 weeks after their last possible exposure should first receive a Zika virus IgM antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR should be performed. 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; immediate rRT-PCR testing should be performed when IgM antibody test results are positive or equivocal. This guidance also provides updated recommendations for the clinical management of pregnant women with confirmed or possible Zika virus infection. These recommendations will be updated when additional data become available.
ER

PMID- 27467820
OWN - NLM
STAT- In-Data-Review
DA  - 20160729
IS  - 1545-861X (Electronic)
IS  - 0149-2195 (Linking)
VI  - 65
IP  - 29
DP  - 2016
TI  - Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with
      Possible Zika Virus Exposure - United States, July 2016.
PG  - 739-44
LID - 10.15585/mmwr.mm6529e1 [doi]
AB  - CDC has updated its interim guidance for U.S. health care providers caring for
      pregnant women with possible Zika virus exposure, to include the emerging data
      indicating that Zika virus RNA can be detected for prolonged periods in some
      pregnant women. 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. Possible
      exposures to Zika virus include travel to or residence in an area with active
      Zika virus transmission, or sex* with a partner who has traveled to or resides in
      an area with active Zika virus transmission without using condoms or other
      barrier methods to prevent infection.(dagger) Testing recommendations for
      pregnant women with possible Zika virus exposure who report clinical illness
      consistent with Zika virus disease( section sign) (symptomatic pregnant women)
      are the same, regardless of their level of exposure (i.e., women with ongoing
      risk for possible exposure, including residence in or frequent travel to an area 
      with active Zika virus transmission, as well as women living in areas without
      Zika virus transmission who travel to an area with active Zika virus
      transmission, or have unprotected sex with a partner who traveled to or resides
      in an area with active Zika virus transmission). Symptomatic pregnant women who
      are evaluated &lt;2 weeks after symptom onset should receive serum and urine Zika
      virus rRT-PCR testing. Symptomatic pregnant women who are evaluated 2-12 weeks
      after symptom onset should first receive a Zika virus immunoglobulin (IgM)
      antibody test; if the IgM antibody test result is positive or equivocal, serum
      and urine rRT-PCR testing should be performed. Testing recommendations for
      pregnant women with possible Zika virus exposure who do not report clinical
      illness consistent with Zika virus disease (asymptomatic pregnant women) differ
      based on the circumstances of possible exposure. For asymptomatic pregnant women 
      who live in areas without active Zika virus transmission and who are evaluated &lt;2
      weeks after last possible exposure, rRT-PCR testing should be performed. If the
      rRT-PCR result is negative, a Zika virus IgM antibody test should be performed
      2-12 weeks after the exposure. Asymptomatic pregnant women who do not live in an 
      area with active Zika virus transmission, who are first evaluated 2-12 weeks
      after their last possible exposure should first receive a Zika virus IgM antibody
      test; if the IgM antibody test result is positive or equivocal, serum and urine
      rRT-PCR should be performed. 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; immediate rRT-PCR 
      testing should be performed when IgM antibody test results are positive or
      equivocal. This guidance also provides updated recommendations for the clinical
      management of pregnant women with confirmed or possible Zika virus infection.
      These recommendations will be updated when additional data become available.
FAU - Oduyebo, Titilope
AU  - Oduyebo T
FAU - Igbinosa, Irogue
AU  - Igbinosa I
FAU - Petersen, Emily E
AU  - Petersen EE
FAU - Polen, Kara N D
AU  - Polen KN
FAU - Pillai, Satish K
AU  - Pillai SK
FAU - Ailes, Elizabeth C
AU  - Ailes EC
FAU - Villanueva, Julie M
AU  - Villanueva JM
FAU - Newsome, Kim
AU  - Newsome K
FAU - Fischer, Marc
AU  - Fischer M
FAU - Gupta, Priya M
AU  - Gupta PM
FAU - Powers, Ann M
AU  - Powers AM
FAU - Lampe, Margaret
AU  - Lampe M
FAU - Hills, Susan
AU  - Hills S
FAU - Arnold, Kathryn E
AU  - Arnold KE
FAU - Rose, Laura E
AU  - Rose LE
FAU - Shapiro-Mendoza, Carrie K
AU  - Shapiro-Mendoza CK
FAU - Beard, Charles B
AU  - Beard CB
FAU - Munoz, Jorge L
AU  - Munoz JL
FAU - Rao, Carol Y
AU  - Rao CY
FAU - Meaney-Delman, Dana
AU  - Meaney-Delman D
FAU - Jamieson, Denise J
AU  - Jamieson DJ
FAU - Honein, Margaret A
AU  - Honein MA
LA  - eng
PT  - Journal Article
DEP - 20160725
PL  - United States
TA  - MMWR Morb Mortal Wkly Rep
JT  - MMWR. Morbidity and mortality weekly report
JID - 7802429
SB  - IM
EDAT- 2016/07/29 06:00
MHDA- 2016/07/29 06:00
CRDT- 2016/07/29 06:00
AID - 10.15585/mmwr.mm6529e1 [doi]
PST - epublish
SO  - MMWR Morb Mortal Wkly Rep. 2016 Jul 25;65(29):739-44. doi:
      10.15585/mmwr.mm6529e1.
TY  - JOUR
AU  - Oduyebo, Titilope
AU  - Igbinosa, Irogue
AU  - Petersen, Emily E.
AU  - Polen, Kara N. D.
AU  - Pillai, Satish K.
AU  - Ailes, Elizabeth C.
AU  - Villanueva, Julie M.
AU  - Newsome, Kim
AU  - Fischer, Marc
AU  - Gupta, Priya M.
AU  - Powers, Ann M.
AU  - Lampe, Margaret
AU  - Hills, Susan
AU  - Arnold, Kathryn E.
AU  - Rose, Laura E.
AU  - Shapiro-Mendoza, Carrie K.
AU  - Beard, Charles B.
AU  - Mu?oz, Jorge L.
AU  - Rao, Carol Y.
AU  - Meaney-Delman, Dana
AU  - Jamieson, Denise J.
AU  - Honein, Margaret A.
PY  - 2016/07/25
TI  - Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure - United States, July 2016.
T2  - MMWR Morb. Mortal. Wkly. Rep.
JO  - MMWR. Morbidity and mortality weekly report
SP  - 739
EP  - 744
VL  - 65
IS  - 29
N2  - CDC has updated its interim guidance for U.S. health care providers caring for pregnant women with possible Zika virus exposure, to include the emerging data indicating that Zika virus RNA can be detected for prolonged periods in some pregnant women. 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. Possible exposures to Zika virus include travel to or residence in an area with active Zika virus transmission, or sex* with a partner who has traveled to or resides in an area with active Zika virus transmission without using condoms or other barrier methods to prevent infection.(?) Testing recommendations for pregnant women with possible Zika virus exposure who report clinical illness consistent with Zika virus disease(?) (symptomatic pregnant women) are the same, regardless of their level of exposure (i.e., women with ongoing risk for possible exposure, including residence in or frequent travel to an area with active Zika virus transmission, as well as women living in areas without Zika virus transmission who travel to an area with active Zika virus transmission, or have unprotected sex with a partner who traveled to or resides in an area with active Zika virus transmission). 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 2-12 weeks after symptom onset should first receive a Zika virus immunoglobulin (IgM) antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR testing should be performed. Testing recommendations for pregnant women with possible Zika virus exposure who do not report clinical illness consistent with Zika virus disease (asymptomatic pregnant women) differ based on the circumstances of possible exposure. 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 the rRT-PCR result is negative, a Zika virus IgM antibody test should be performed 2-12 weeks after the exposure. Asymptomatic pregnant women who do not live in an area with active Zika virus transmission, who are first evaluated 2-12 weeks after their last possible exposure should first receive a Zika virus IgM antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR should be performed. 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; immediate rRT-PCR testing should be performed when IgM antibody test results are positive or equivocal. This guidance also provides updated recommendations for the clinical management of pregnant women with confirmed or possible Zika virus infection. These recommendations will be updated when additional data become available.
SN  - 1545-861X
UR  - http://dx.doi.org/10.15585/mmwr.mm6529e1
UR  - http://www.ncbi.nlm.nih.gov/pubmed/27467820
ID  - Oduyebo2016
ER  - 
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<b:Person><b:Last>Meaney-Delman</b:Last><b:First>Dana</b:First></b:Person>
<b:Person><b:Last>Jamieson</b:Last><b:First>Denise</b:First><b:Middle>J</b:Middle></b:Person>
<b:Person><b:Last>Honein</b:Last><b:First>Margaret</b:First><b:Middle>A</b:Middle></b:Person>
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<b:Title>Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure - United States, July 2016.</b:Title>
 <b:ShortTitle>MMWR Morb. Mortal. Wkly. Rep.</b:ShortTitle>
<b:Comments>CDC has updated its interim guidance for U.S. health care providers caring for pregnant women with possible Zika virus exposure, to include the emerging data indicating that Zika virus RNA can be detected for prolonged periods in some pregnant women. 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. Possible exposures to Zika virus include travel to or residence in an area with active Zika virus transmission, or sex* with a partner who has traveled to or resides in an area with active Zika virus transmission without using condoms or other barrier methods to prevent infection.(&#8224;) Testing recommendations for pregnant women with possible Zika virus exposure who report clinical illness consistent with Zika virus disease(&#167;) (symptomatic pregnant women) are the same, regardless of their level of exposure (i.e., women with ongoing risk for possible exposure, including residence in or frequent travel to an area with active Zika virus transmission, as well as women living in areas without Zika virus transmission who travel to an area with active Zika virus transmission, or have unprotected sex with a partner who traveled to or resides in an area with active Zika virus transmission). Symptomatic pregnant women who are evaluated &lt;2 weeks after symptom onset should receive serum and urine Zika virus rRT-PCR testing. Symptomatic pregnant women who are evaluated 2-12 weeks after symptom onset should first receive a Zika virus immunoglobulin (IgM) antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR testing should be performed. Testing recommendations for pregnant women with possible Zika virus exposure who do not report clinical illness consistent with Zika virus disease (asymptomatic pregnant women) differ based on the circumstances of possible exposure. For asymptomatic pregnant women who live in areas without active Zika virus transmission and who are evaluated &lt;2 weeks after last possible exposure, rRT-PCR testing should be performed. If the rRT-PCR result is negative, a Zika virus IgM antibody test should be performed 2-12 weeks after the exposure. Asymptomatic pregnant women who do not live in an area with active Zika virus transmission, who are first evaluated 2-12 weeks after their last possible exposure should first receive a Zika virus IgM antibody test; if the IgM antibody test result is positive or equivocal, serum and urine rRT-PCR should be performed. 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; immediate rRT-PCR testing should be performed when IgM antibody test results are positive or equivocal. This guidance also provides updated recommendations for the clinical management of pregnant women with confirmed or possible Zika virus infection. These recommendations will be updated when additional data become available.</b:Comments>
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