Dengue virus infection in late pregnancy and transmission to the infants,new treatment of herpes,herpes simplex genitalis behandlung - Good Point

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CDC has developed interim guidelines for health care providers in the United States who are caring for infants born to mothers who traveled to or resided in an area with Zika virus transmission during pregnancy. Zika virus is a mosquito-borne flavivirus primarily transmitted by Aedes aegypti mosquitoes (2,3). Zika virus RT-PCR testing should be performed on serum specimens collected from the umbilical cord or directly from the infant within 2 days of birth (12).
An infant is considered congenitally infected if Zika virus RNA or viral antigen is identified in any of the samples submitted, including testing of amniotic fluid and testing of the placenta or umbilical cord. When an infant is born with microcephaly or intracranial calcifications to a mother who was potentially infected with Zika virus during pregnancy, the infant should be tested for Zika virus infection (Figure 1) (Box 1). For infants with any positive or inconclusive test findings for Zika virus infection, health care providers should report the case to the state, territorial, or local health department and assess the infant for possible long-term sequelae (Box 3).
For infants with microcephaly or intracranial calcifications who have negative results on all Zika virus tests performed, health care providers should evaluate for other possible etiologies and treat as indicated.
For an infant without microcephaly or intracranial calcifications born to a mother who was potentially infected with Zika virus during pregnancy, subsequent evaluation is dependent on results from maternal Zika virus testing (Figure 2). If the mother has not undergone any previous testing for Zika virus infection during pregnancy, CDC recommends that she receive testing only if she reported symptoms consistent with Zika virus disease during or within 2 weeks of any time spent in an area with ongoing Zika virus transmission while she was pregnant (1,15). No specific antiviral treatment is available for Zika virus infections and no vaccine against Zika virus is available (2). The only way to prevent congenital Zika virus infection is to prevent maternal infection, either by avoiding areas where Zika virus transmission is ongoing or strictly following steps to avoid mosquito bites (15,18). Oliveira Melo AS, Malinger G, Ximenes R, Szejnfeld PO, Alves Sampaio S, Bispo de Filippis AM. Test infant serum for Zika virus RNA, Zika virus immunoglobulin (Ig) M and neutralizing antibodies, and dengue virus IgM and neutralizing antibodies. If cerebrospinal fluid is obtained for other studies, test for Zika virus RNA, Zika virus IgM and neutralizing antibodies, and dengue virus IgM and neutralizing antibodies. Consider histopathologic evaluation of the placenta and umbilical cord with Zika virus immunohistochemical staining on fixed tissue and Zika virus RT-PCR on fixed and frozen tissue. If not already performed during pregnancy, test mothera€™s serum for Zika virus IgM and neutralizing antibodies, and dengue virus IgM and neutralizing antibodies. A§ Laboratory evidence of Zika virus infection includes 1) detectable Zika virus, Zika virus RNA, or Zika virus antigen in any clinical sample, or 2) positive Zika virus immunoglobulin M with confirmatory neutralizing antibody titers that are a‰?4-fold higher than dengue virus neutralizing antibody titers in serum or cerebrospinal fluid. Comprehensive physical examination, including careful measurement of the occipitofrontal circumference, length, weight, and assessment of gestational age.
Evaluation for neurologic abnormalities, dysmorphic features, splenomegaly, hepatomegaly, and rash or other skin lesions. Cranial ultrasound, unless prenatal ultrasound results from third trimester demonstrated no abnormalities of the brain.
Evaluation of hearing by evoked otoacoustic emissions testing or auditory brainstem response testing, either before discharge from the hospital or within 1 month after birth.
Ophthalmologic evaluation, including examination of the retina, either before discharge from the hospital or within 1 month after birth.
Testing for other congenital infections such as syphilis, toxoplasmosis, rubella, cytomegalovirus infection, lymphocytic choriomeningitis virus infection, and herpes simplex virus infections. Complete blood count, platelet count, and liver function and enzyme tests, including alanine aminotransferase, aspartate aminotransferase, and bilirubin. Consideration of genetic and other teratogenic causes based on additional congenital anomalies that are identified through clinical examination and imaging studies. Report case to state, territorial, or local health department and monitor for additional guidance as it is released. Conduct additional hearing screen at age 6 months, plus any appropriate follow-up of hearing abnormalities detected through newborn hearing screening. A§ Laboratory evidence of a Zika virus infection includes 1) detectable Zika virus, Zika virus RNA, or Zika virus antigen in any clinical sample, or 2) positive Zika virus Immunoglobulin M (IgM) with confirmatory neutralizing antibody titers that are a‰?4-fold higher than dengue virus neutralizing antibody titers in serum or cerebrospinal fluid.
A¶ If mother reported clinical illness consistent with Zika virus disease during pregnancy and testing is indicated, perform Zika virus reverse transcription-polymerase chain reaction testing on serum specimen collected a‰¤7 days after illness onset when possible. Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. All HTML versions of MMWR articles are generated from final proofs through an automated process. This conversion might result in character translation or format errors in the HTML version. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S.
Antiviral treatment is not currently available for Zika virus disease; treatment is supportive and includes rest, fluids, and analgesic and antipyretic medications. Recommendations for Zika virus testing of pregnant women who have a clinical illness consistent with Zika virus disease during or within 2 weeks of travel to areas with ongoing Zika virus transmission are unchanged from CDC recommendations released January 19, 2016 (1).
Serologic testing for Zika virus can be offered to asymptomatic pregnant women who traveled to an area with ongoing Zika virus transmission (Figure 1); however, interpretation of results is complex. Pregnant women who reside in areas with ongoing Zika virus transmission should be evaluated for symptoms of Zika virus disease.
A false positive IgM result is more likely among women residing in areas with ongoing Zika virus transmission than among travelers because of a higher likelihood of previous exposure to a related flavivirus. Pregnant women with negative Zika virus IgM testing should receive routine prenatal care, including an assessment of pregnancy dating and an ultrasound at 18a€“20 weeks of gestation to assess fetal anatomy (15). Findings of fetal microcephaly or intracranial calcifications on prenatal ultrasound should prompt health care providers to repeat maternal IgM testing and consider amniocentesis, depending on gestational age. Serial fetal ultrasounds should be considered to monitor fetal anatomy and growth every 3a€“4 weeks in pregnant women with positive or inconclusive Zika virus test results, and referral to a maternal-fetal medicine specialist is recommended.
Sexual transmission of Zika virus can occur, although there is limited data about the risk (20). CDC recommends that health care providers discuss pregnancy intention and reproductive options with women of reproductive age. Health care providers should discuss strategies to prevent unintended pregnancy with women who do not want to become pregnant; these strategies should include counseling on family planning and use of contraceptive methods. Strategies to prevent mosquito bites should be emphasized for women living in areas with ongoing Zika virus transmission who want to become pregnant. Women of reproductive age with current or previous laboratory-confirmed Zika virus infection should be counseled that there is no evidence that prior Zika virus infection poses a risk for birth defects in future pregnancies (7).
A¶ Fetal ultrasounds might not detect microcephaly or intracranial calcifications until the late second or early third trimester of pregnancy. 2011: [AJHP] Stability of extemporaneously prepared acetylcysteine 1% and 10% solutions for treatment of meconium ileus. Tico Times In January of 2016, a Virginia man returned to the United States from travel abroad.
Meanwhile, the Arkansas Department of Health has confirmed a second case of Zika infection. Health insurance is a type of insurance coverage that covers the  cost of an insured individual's medical and surgical expenses.
3,114 ContributionsIn my prior life, I practiced insurance and trial law, taught insurance and civil trial law, and consulted for a major publisher on the development of insurance books and online products.
Even deep rivers and lakes are home to enormous fish that no sane human being wants swimming anywhere near their feet.
The fear of the unknown can be just as scary as a harmless fish twice the size of your body simply brushing up against your leg.
We've all seen crazy people catching catfish with their bare hands, but the following 10 fish would probably make even the toughest fisherman think twice before taking a dip into unknown waters.
This species of anglerfish—made famous in "Finding Nemo" after failing to eat Dory and Marlin—has finally been spotted alive in the ocean.
Some call it a "living fossil," but we just call it another reason never to swim in Australian waters.
This catch off the coast of Japan sparked an online debate about whether this odd-looking goliath fish was the effect of the Fukushima nuclear disaster back in 2011. A snorkeler made a shocking discovery when the corpse of a giant oarfish washed ashore off the coast of California last year.
This includes reverse transcription-polymerase chain reaction (RT-PCR) for viral RNA, and immunoglobulin (Ig) M ELISA and plaque reduction neutralization test (PRNT) for Zika virus antibodies. In addition, cerebrospinal fluid (CSF) obtained for other studies, and frozen and fixed placenta obtained at delivery, should also be tested by RT-PCR. In addition, Zika virus IgM antibodies with confirmatory neutralizing antibody titers that are ≥4-fold higher than dengue virus neutralizing antibody titers in the infant serum or CSF constitute evidence of a congenital Zika virus infection.
In addition, further clinical evaluation and laboratory testing is recommended for the infant (Box 2). This includes a repeat hearing screen at age 6 months, even if the initial hearing screening test was normal, because of the potential for delayed hearing loss as has been described with other infections such as cytomegalovirus (14). If the mother has any positive or inconclusive findings from tests for Zika virus infection, then the infant should undergo testing for evidence of a congenital Zika virus infection (Box 1). Mosquito-bite prevention includes using air conditioning or window and door screens when indoors, wearing long sleeves and pants, using permethrin-treated clothing and gear, and using insect repellents.
Chikungunya virus: surveillance and control of Aedes aegypti and Aedes albopictus in the United States.
Evidence of perinatal transmission of Zika virus, French Polynesia, December 2013 and February 2014.


Zika virus intrauterine infection causes fetal brain abnormality and microcephaly: tip of the iceberg? Genetic and serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007.
Longitudinal investigation of hearing disorders in children with congenital cytomegalovirus. The initial sample should be collected either from the umbilical cord or directly from the infant within 2 days of birth, if possible. Testing would be considered inconclusive if Zika virus neutralizing antibody titers are <4-fold higher than dengue virus neutralizing antibody titers.
Full body photographs and any rash, skin lesions, or dysmorphic features should be documented.
Infants with abnormal initial hearing screens should be referred to an audiologist for further evaluation.
Infants with abnormal initial eye evaluation should be referred to a pediatric ophthalmologist for further evaluation. Perform Zika and dengue virus IgM and neutralizing antibodies on serum specimens collected a‰?4 days after illness onset. Aspirin and other nonsteroidal anti-inflammatory medications should be avoided until dengue virus infection can be ruled out (8). Zika virus testing of maternal serum includes reverse transcription-polymerase chain reaction (RT-PCR) testing for symptomatic patients with onset of symptoms during the previous week; immunoglobulin M (IgM) and plaque-reduction neutralizing antibody testing should be performed on specimens collected a‰?4 days after onset of symptoms (Figure 1) (1,10). Because of cross-reactivity among related flaviviruses, such as dengue, yellow fever, and West Nile viruses, a positive IgM result can be difficult to interpret.
For women who report clinical illness consistent with Zika virus disease, testing by RT-PCR should be performed on serum collected within 7 days of symptom onset. Pregnant women who do not report clinical illness consistent with Zika virus disease can be offered IgM testing upon initiation of prenatal care; among women with negative IgM results, repeat testing can be considered in the mid-second trimester because of the ongoing risk for Zika virus exposure and infection throughout pregnancy (Figure 2). The ultrasound should include careful evaluation of the fetus for brain anomalies, including microcephaly and intracranial calcifications.
Zika virus testing can be performed on amniotic fluid using RT-PCR to inform clinical management (5). Testing is recommended at the time of delivery, including histopathologic examination of the placenta and umbilical cord, testing of frozen placental tissue and cord tissue for Zika virus RNA, and testing of cord serum (1,19).
The risk for sexual transmission of Zika virus can be eliminated by abstinence and reduced by correct and consistent use of condoms (21).
Decisions regarding the timing of pregnancies are personal and complex; reproductive life plans can assist in making these decisions (22). Safety, effectiveness, availability, and acceptability should be considered when selecting a contraceptive method (23). These strategies, including wearing pants and long-sleeved shirts, using FDA-approved insect repellents, ensuring that windows and doors have screens, and staying inside air conditioned spaces when possible, can reduce the risk for Zika virus infection and other vector-borne diseases. This is because the viremia is expected to last approximately 1 week in patients with clinical illness (2,25).
If performed, testing should include Zika virus IgM, and if IgM test result is positive or indeterminate, neutralizing antibodies on serum specimens.
Testing is considered inconclusive if Zika virus neutralizing antibody titers are <4-fold higher than dengue virus neutralizing antibody titers. Because of the overlap of symptoms and areas where other viral illnesses are endemic, evaluation for dengue or chikungunya virus infection is also recommended. Testing is considered inconclusive if Zika virus neutralizing antibody titers are <4-fold higher than dengue virus neutralizing antibody titer. Detection of anti-yellow fever virus immunoglobulin m antibodies at 3a€“4 years following yellow fever vaccination.
Persistence of virus-reactive serum immunoglobulin m antibody in confirmed west nile virus encephalitis cases.
Cytomegalovirus (CMV) glycoprotein B genotype and CMV DNA load in the amniotic fluid of infected fetuses. Interim guidelines for the evaluation and testing of infants with possible congenital Zika virus infectiona€”United States, 2016.
Interim guidelines for prevention of sexual transmission of Zika virusa€”United States, 2016. The person affected had also traveled outside of the country, where the infection almost certainly occurred. A brain tumor required me to stop practicing, but I have a store of knowledge that I wish to share.
That is, it does not provide primary benefits that are tied, for example, to the amount of a m…edical expense.
Australian waters in particular are home to fish that eat reptiles, prehistoric sharks that have been swallowing things whole for 80 million years, and something called a goblin shark.
After reeling in a decent sized cod, he noticed a bonus discovery in the fish's mouth.
After catching the 5-foot nurse shark, Gimbb14 noticed the goliath grouper was inspecting his catch.
In what sounds like a sci-fi movie plot, numerous reports emerged last summer of creepy-looking fish being found in multiple people's yards. Anglerfish are extremely rare, and are hardly ever seen long enough to be photographed, making this a special discovery.
Scientists recently filmed the black seadevil anglerfish in what is a huge milestone for marine biology.
Its ancestors have been fueling nightmares for more than 80 million years, and when local fishermen caught it they didn't know if it was an eel or a shark.
Mystifying locals and tourists alike with its sheer size, it reportedly took 15 people to drag the monster off the beach. This small goblin shark is a mini version of what scours the ocean's floors looking for something to devour, like a crab, fish, or octopus. After a long battle lasting nearly an hour, Italian fishermen Dino and Dario Ferrari managed to catch the fish and snap a few trophy photos before releasing it back into the water. Symptomatic disease generally is mild and characterized by acute onset of fever, maculopapular rash, arthralgia, or nonpurulent conjunctivitis.
Because it is currently not known which type of testing most reliably establishes the diagnosis of congenital infection, CDC recommends both molecular and serologic testing of infants who are being evaluated for evidence of a congenital Zika virus infection (Box 1). IgM ELISA for Zika virus and dengue virus should be performed on infant serum, infant CSF, and maternal serum; however, results of these assays can be falsely positive because of cross-reacting antibodies (9,12).
If Zika virus neutralizing antibody titers are <4-fold higher than dengue, results are considered inconclusive.
If an infant’s occipitofrontal circumference is equal to or greater than the third percentile but is notably disproportionate to the length of the infant, or if the infant has deficits that are related to the central nervous system, additional evaluation for Zika virus infection might be considered.
The mother should also be tested for a Zika virus infection, if this testing has not already been performed during pregnancy. If the mother received positive or inconclusive results of tests for Zika virus infection, the infant should be tested for a possible congenital Zika virus infection (Box 1).
If the mother has not received any previous testing for Zika virus, and did not report clinical illness consistent with Zika virus disease during pregnancy, no further testing of the mother or infant is recommended (Figure 2). Mothers are encouraged to breastfeed infants even in areas where Zika virus is found, as available evidence indicates the benefits of breastfeeding outweigh any theoretical risks associated with Zika virus infection transmission through breast milk (5,17). Updated guidelines include a new recommendation to offer serologic testing to asymptomatic pregnant women (women who do not report clinical illness consistent with Zika virus disease) who have traveled to areas with ongoing Zika virus transmission. Prevention of mosquito bites includes wearing long-sleeved shirts, pants, permethrin-treated clothing, and using United States Environmental Protection Agency (EPA)-registered insect repellents.
Dengue virus infection can cause serious complications, including hemorrhage and death, which might be substantially reduced by early recognition and supportive treatment (4,8). Plaque-reduction neutralization testing (PRNT) can be performed to measure virus-specific neutralizing antibodies to Zika virus and other flaviviruses. Because viremia decreases over time, a negative RT-PCR result from serum collected 5a€“7 days after symptom onset does not exclude Zika virus infection, and serologic testing should be performed.
Because fetal microcephaly is most easily detected in the late second and early third trimesters of pregnancy (16), and because of ongoing potential exposure to Zika virus, health care providers might consider an additional fetal ultrasound later in pregnancy. Based on experience with other congenital infections and a small number of prenatally-diagnosed fetal Zika virus infections (5,17), amniocentesis can be used to diagnose intrauterine infections (18). Guidelines for infants whose mothers have possible Zika virus infection are available (19). Given the potential risks of maternal Zika virus infection, pregnant women whose male partners have or are at risk for Zika virus infection should consider using condoms or abstaining from sexual intercourse (21). Patient age, fertility, reproductive and medical history, as well as the values and preferences of the woman and her partner should be considered during discussions regarding pregnancy intentions and timing. During preconception counseling visits, the potential risks of Zika virus infection acquired during pregnancy should be discussed.
There is no current evidence to suggest that a fetus conceived after maternal viremia has resolved would be at risk for fetal infection (7).
If chikungunya or dengue virus RNA is detected, treat in accordance with existing guidelines. Preparing for influenza after 2009 H1N1: special considerations for pregnant women and newborns. Updated diagnostic testing for Zika, chikungunya, and dengue viruses in US Public Health Laboratories.


The virus is transmitted by mosquitoes and has much in common with the more familiar dengue fever. The spread of Zika virus is likely to increase in the Americas even if it disappears in the United States. Instead, it pays a fixed daily amount if a covered occurrence renders one unable to work, hospitalized, or some other risk specified in the policy. Considering what we already know, whatever's swimming in the remaining 95 percent at this very moment is a terrifying thought. Although the image is an optical illusion that makes the fish look deceptively large, the fish with grandpa-like facial features is still an impressive catch.
This species of shark's mouth expands to an enormous size allowing it to swallow large fish. If this 9-foot-long monster catfish wanted to swallow a human whole, it could, but it's really just a gentle giant that feeds on smaller fish.
No commercial tests for Zika virus are available; Zika virus testing is performed at CDC and some state and territorial health departments. An ophthalmologic evaluation, including retinal examination, should occur during the first month of life, given reports of abnormal eye findings in infants with possible congenital Zika virus infection (11). If the results of all of the infant’s tests are negative for evidence of Zika virus infection, then no further Zika virus testing and evaluation is recommended. Environmental Protection Agency-registered insect repellents are safe for pregnant women (18).
Insect repellents containing ingredients such as DEET, picaridin, and IR3535 are safe for use during pregnancy when used in accordance with the product label (6). The levels of neutralizing antibodies can then be compared between flaviviruses, but these tests might also be difficult to interpret in persons who were previously infected with or vaccinated against flaviviruses.
However, the performance of RT-PCR testing of amniotic fluid for Zika virus infection has not been evaluated.
If a pregnant woman with Zika virus disease experiences a fetal loss, Zika virus RT-PCR and immunohistochemical staining should be performed on fetal tissues, including umbilical cord and placenta (1). Additional studies are needed to characterize the risk for sexual transmission of Zika virus; recommendations will be updated as more information becomes available. In the context of the ongoing Zika virus transmission, preconception care should include a discussion of the signs and symptoms and the potential risks associated with Zika virus infection. Timely recognition and supportive treatment for dengue virus infections can substantially lower the risk of medical complications and death.
Selected Practice Recommendations for Contraceptive Use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. Still, Zika infection can increase the risk of birth defects when pregnant women become ill.
The World Health Organization predicts that every country in the Americas will see cases of Zika except for Chile and Canada.
Aflac is available to individuals to purchase on their own, but it is often offered by employers to employees during periods of "open enrollment" for group major medical coverage.
It survives in the desolate depths by luring in squid and other sea life with a luminous apparatus at the tip of its fishing pole–like appendage, hence the name angler.
This 6-foot-long shark swallows its prey whole, so try not to remember this when visiting Australia. Bering wolffish are not uncommon off the coast of Hokkaido, the northernmost island of Japan, but they are difficult to catch. It also has a long snout covered in pores that help it sense the location of animals swimming in the distance. The Ferrari brothers estimated it to be around 30 years old, noting that these giant catfish can live for about 50 years and grow much bigger. Zika virus testing is recommended for 1) infants with microcephaly or intracranial calcifications born to women who traveled to or resided in an area with Zika virus transmission while pregnant; or 2) infants born to mothers with positive or inconclusive test results for Zika virus infection.
Based on information from previous outbreaks, severe disease requiring hospitalization is uncommon and fatalities are rare (6,7). Health care providers should contact their state or territorial health department to facilitate testing. Finally, immunohistochemical staining to detect Zika virus antigen on fixed placenta and umbilical cord tissues can be considered. If any of the infant’s samples test positive or inconclusive, then the infant should undergo further clinical evaluation (Box 2). This update also expands guidance to women who reside in areas with ongoing Zika virus transmission, and includes recommendations for screening, testing, and management of pregnant women and recommendations for counseling women of reproductive age (15a€“44 years).
To prevent human-to-mosquito-to-human transmission, persons infected with Zika, dengue, or chikungunya virus should protect themselves from mosquito exposure during the first week of illness. However, a negative IgM result obtained 2a€“12 weeks after travel would suggest that a recent infection did not occur and could obviate the need for serial ultrasounds. Furthermore, the risk for microcephaly or other anomalies when Zika virus RNA is detected in amniotic fluid is not known. Repeat Zika virus testing during pregnancy is warranted if clinical illness consistent with Zika virus disease develops later in pregnancy.
In an effort to keep the virus out of the United States, the CDC issued a travel alert for people visiting countries where Zika is prevalent.
Even in those instances, the employee pays the entire premium for the coverage, which supplements and stands separately from any other coverage that the employee has. The fish, complete with a mouthful of teeth, are called Arctic lampreys and are commonly found in waters near Fairbanks, Alaska. For infants with laboratory evidence of a possible congenital Zika virus infection, additional clinical evaluation and follow-up is recommended.
Zika virus infections have also been documented through both intrauterine transmission resulting in congenital infection and intrapartum transmission from a viremic mother to her newborn (5,6). The infant should also be followed to assess for possible long-term sequelae (Box 3), and the infant’s case should be reported to the state, territorial, or local health department. Pregnant women who reside in areas with ongoing Zika virus transmission have an ongoing risk for infection throughout their pregnancy. The number of mosquitoes in and around homes can be reduced by emptying standing water from containers, installing or repairing screens on windows and doors, and using air conditioning if available. Based on experience with other flaviviruses, IgM antibodies will be expected to be present at least 2 weeks after virus exposure and persist for up to 12 weeks (11a€“14). When choosing a contraceptive method, the risk for sexually transmitted infections should also be considered; correct and consistent use of condoms reduces the risk for sexually transmitted infections.
Centers for Disease Control and Prevention advise those who are pregnant or may become pregnant to avoid areas in which the virus is common, including parts of South and Central America.
The Level 2 alert asks travelers to "practice enhanced precautions" when visiting Zika-affected areas, which include Samoa, the Caribbean, and Burma as well as Central and South America.
The land down under is home to some of the nastiest spiders and immense wildlife you'll ever see, and finding a fish with a snake inside must be just another day in the Australian wild. Zika virus RNA has been detected in breast milk, but Zika virus transmission through breastfeeding has not been documented (5).
The Brazil Ministry of Health has reported a marked increase from previous years in the number of infants born with microcephaly and intracranial calcifications in 2015, although it is not known how many of these cases are associated with Zika virus infection (6,8a€“11). Infant follow-up should include a cranial ultrasound to assess for subclinical findings, unless prenatal ultrasound results from the third trimester demonstrated no abnormalities of the brain. For pregnant women with clinical illness consistent with Zika virus disease,* testing is recommended during the first week of illness. Information about the performance of serologic testing of asymptomatic persons is limited; a negative serologic test result obtained 2a€“12 weeks after travel cannot definitively rule out Zika virus infection.
Because it isn't mosquito season in Virginia, the risk of transmission in the United States is quite rare.
Ophthalmologic examination and a repeat hearing screen are also recommended, as previously described for infants with microcephaly or intracranial calcifications.
For asymptomatic pregnant women residing in areas with ongoing Zika virus transmission, testing is recommended at the initiation of prenatal care with follow-up testing mid-second trimester.
Given these challenges in interpreting serologic test results, health care providers should contact their state, local, or territorial health department for assistance with arranging testing and interpreting results. Developmental monitoring and screening during the first year of life is recommended for all children with congenital Zika virus infection.
Local health officials should determine when to implement testing of asymptomatic pregnant women based on information about levels of Zika virus transmission and laboratory capacity. CDC is working with health departments and other organizations to rapidly increase the availability of testing for Zika virus. Health care providers should discuss reproductive life plans, including pregnancy intention and timing, with women of reproductive age in the context of the potential risks associated with Zika virus infection. However, Levine's statement echoed the CDC's advice that pregnant women avoid countries in which Zika transmission is possible.



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