CHA News Article

CDC Updates Guidance for Pregnant Women Exposed to Zika Virus

The Centers for Disease Control and Prevention (CDC) has released updated guidance for treating pregnant women who have been exposed to Zika virus. The updates reflect declining prevalence of the virus in the Americas as well as emerging evidence indicating prolonged detection of Zika virus immunoglobulin M (IgM) antibodies. According to CDC, as the prevalence of Zika virus disease declines, the likelihood of false-positive test results increases. In addition, emerging data indicate that Zika virus IgM antibodies can persist beyond 12 weeks after infection. Therefore, IgM test results cannot always reliably distinguish whether an infection occurred during or prior to the current pregnancy.

Key recommendations include:

  • All pregnant women in the U.S. and U.S. territories should be asked about possible Zika virus exposure before and during the current pregnancy, at every prenatal care visit.
  • Pregnant women with recent possible Zika virus exposure and symptoms of Zika virus disease should be tested to diagnose the cause of their symptoms.
  • Asymptomatic pregnant women with ongoing possible Zika virus exposure should be offered Zika virus nucleic acid testing three times during pregnancy.
  • Asymptomatic pregnant women who have recent possible Zika virus exposure (i.e., through travel or sexual exposure) but without ongoing possible exposure are not recommended to routinely have Zika virus testing.
  • Pregnant women who have recent possible Zika virus exposure and who have a fetus with prenatal ultrasound findings consistent with congenital Zika virus syndrome should receive Zika virus testing to assist in establishing the etiology of the birth defects.
  • Zika virus IgM testing as part of preconception counseling to establish baseline IgM results for nonpregnant women with ongoing possible Zika virus exposure is not warranted.