Emerging MCH Issues

CityMatCH acts as a national voice in communicating urban MCH issues to local MCH leaders, members, and partners at the local, state, and national levels. This page will highlight emerging MCH issues in the field, providing timely resources and information on the most pressing MCH issues.

 

Zika Information and Resources

New! CityMatCH Learning Module 

Visit CityMatCH’s new Local MCH Responds to Zika: A Look, Listen, & Learn MCH Mini-Module to find out critical federal information, webinar podcasts outlining local health department responses to Zika, and the latest Zika research.

·     Look: Review Information, resources, and advocacy efforts from the MCH community and access the CDC Zika Portal

·     Listen: Check out 5-minute segments from CityMatCH’s Learning Network Zika webinar

·     Learn: Find current research from the field and what social media is saying about Zika

New CDC Resources - August 2017

Travel Counseling Guide for Pregnant Women: This guide provides recommendations for providers counseling pregnant women who are considering travel to areas with risk of Zika. It includes recommendations from CDC’s updated interim guidance and talking points to cover during discussions with patients.

Features from the Frontline: The following stories share some of the critical work that state and local health agencies have conducted to protect pregnant women, infants, and the community at large form the threat of Zika. View the links below to learn more.

Updated Resources - August 2017

The following resources have been updated to reflect the changes from the MMWR  Update: Interim Guidance for Healthcare Providers Caring for Pregnant Women with Possible Zika Virus Exposure—United States, July 2017

MMWR Interim Guidance for Healthcare Providers Caring for Pregnant Women with Possible Zika Virus Exposure--United States, July 2017This current guidance ensures that clinicians are provided the most current available evidence and has been updated to incorporate what has been learned over the past year and reduce misinterpretation of Zika test results for pregnant women. CDC’s updated interim guidance presents the updated recommendations in two algorithms—one for pregnant women with Zika symptoms and one for pregnant women without Zika symptoms.

New and Updated Web Resources (July 31, 2017):

MMWR: Pregnancy Outcomes After Maternal Zika Virus Infection During Pregnancy-U.S. Territories, January 1, 2016-April 25, 2017: CDC analysis of data from U.S. territories finds serious birth defections in about 1 in 12 fetusus or infants of pregant women with Zika infection in the first trimester. Among pregnant women in U.S. territories with confirmed Zika virus infection, the proportion affected by Zika-associated birth defects varied by trimester of diagnosis of Zika infection: 8 percent in first trimester, 5 percent in second trimester, and 4 percent in third trimester. 

 

New Web Resources for Parents

For Parents: Roadmap for Parents of Babies with Congenital Zika Syndrome: Babies with congenital Zika syndrome may experience different health problems as they develop, but it’s difficult to know how Zika virus infection will affect each baby. This newly developed roadmap is designed as a guide to help parents of babies with birth defects related to congenital Zika infection navigate the series of screenings and tests recommended during their baby’s first year of life. By using this roadmap, parents can actively keep track of their baby’s medical appointments and stay in tune with their healthcare needs. 

For Parents: Roadmap for Parents of Babies Infected with Zika Before Birth Who Appear Healthy: This roadmap is meant to help parents whose babies were infected with Zika before birth and appear healthy with navigating the series of screenings and tests recommended during their baby’s first year of life. By using this roadmap, parents can actively keep track of their baby’s medical appointments and healthcare needs and help ensure that they receive the care they need.

Updated Web Resource 

Travel Counseling Guide: This tool, meant to counsel travelers who are considering travel to areas with risk of Zika, has been updated to reflect CDC’s new travel guidance. This guide provides recommendations for providers counseling women and men of reproductive age who are considering travel to areas with risk of Zika. This material includes recommendations from CDC’s interim guidance and talking points to cover while discussing recommendations.

Zika Care Connect

Zika Care Connect (ZCC) aims to improve access to specialty healthcare services for the management of Zika virus infection during pregnancy and outcomes in infants caused by Zika. The program will target the most important and removable barriers to care, as identified by maternal and pediatric care experts. ZCC focuses on women infected with Zika during pregnancy, as well as infants born to mothers with laboratory evidence of Zika.  Developed by CDC and maintained in collaboration with March of Dimes, ZCC establishes a network of specialized healthcare providers who can care for patients and families affected by Zika virus. 

The ZCC website will be hosted by the March of Dimes as a micro-site. The website will have its own URL - www.zikacareconnect.org

 

Enhanced Epilepsy Surveillance and Awareness Encouraged in the Age of Zika
Recent studies show that seizures and epilepsy are being reported in some infants with congenital Zika virus infection, according to a commentary co-authored by CDC in JAMA Neurology. The effects Zika virus can have on a developing brain are similar to those of other congenital central nervous system infections associated with epilepsy. Seizure symptoms in infants and young children are difficult to recognize. This means that cases of Zika virus-associated epilepsy may be misdiagnosed or underreported. Caregivers’ and healthcare providers’ ability to recognize seizures and increase epilepsy monitoring and reporting is critical for early recognition and treatment. Better recognition, diagnosis, and reporting of seizures and epilepsy in infants and young children will help guide interventions to make sure families receive the right support and treatment. 

 

CDC Vital Signs-- Protecting Pregnant Women and Babies

  • Forty-four states reported pregnant women with evidence of Zika in 2016
    • Most of these women acquired Zika virus infection during travel to an area with Zika.
  • ​Nearly 1,300 pregnant women with evidence of possible Zika infection were reported to the U.S. Zika Pregnancy Registry.
    • Of the almost 1,000 pregnancies that were completed by the end of the year, more than 50 of those babies were born with birth defects
  • Among pregnant women with confirmed Zika infection, about 1 in 10 had a fetus or baby with birth defects.
    • Confirmed infections in the first trimester posed the highest risk – with about 15% having Zika-related birth defects.
  • About 1 in 3 babies with possible congenital Zika infection were not reported to have been tested for Zika at birth.
  • Only 1 in 4 babies with possible congenital Zika infection were reported to have received brain imaging after birth.
​***These findings underscore the importance of protecting pregnant women from Zika virus infection and among affected babies and the need for continued care and follow-up. Please visit this website to learn more: https://www.cdc.gov/vitalsigns/zika-babies

 

Additional Considerations for the Evaluation and Management of Infants with Possible Congenital Zika Virus Infection: CDC has also recently released additional considerations for the evaluation and management of infants with possible congenital Zika virus infection. The information is available at: https://www.cdc.gov/zika/hc-providers/infants-children/evaluation-and-management.html

 

CDC's Morbidity and Mortality Weekly Report: Prevalence of Microcephaly and Other Birth Defects Associated with Congenital Zika Virus Infection — Massachusetts, North Carolina, and Atlanta, Georgia, 2013–2014

Using data from three birth defects surveillance systems in the United States—Massachusetts, North Carolina, and Atlanta, Georgia—scientists identified the number of births with evidence of defects like those seen in infants born to women with Zika infection during pregnancy to see how common these birth defects were before the introduction of Zika virus into the Americas. These types of birth defects —including brain abnormalities and/or microcephaly, neural tube defects and other early brain malformations, eye defects, and other central nervous system (CNS) problems—were seen in about 3 out of every 1,000 births in 2013-2014. In contrast, 2016 data from the US Zika Pregnancy Registry (USZPR) indicate that these birth defects were 20 times more common in pregnancies with possible Zika virus infection— affecting about 6% or nearly 60 out of every 1,000 completed pregnancies with Zika infection. This new report provides a reference to help interpret the effect of Zika on the occurrence of birth defects in the United States and demonstrates the importance of having monitoring systems that collect data on birth defects.

CDC continues to recommend that pregnant women not travel to areas with Zika. If a pregnant woman must travel to or lives in an area with Zika, she should talk with her healthcare provider and strictly follow steps to prevent mosquito bites and sexual transmission of Zika virus. Pregnant women with possible exposure to Zika virus should be tested for Zika infection even if they do not have symptoms. For more information, please visit www.cdc.gov/zika/pregnancy/.

 

CityLights - Local Responses: Zika Prevention (September 2016 Issue)

CityMatCH's Learning Network Webinar - Local MCH Response to Zika (Recording Available)

Additional Information from the webinar:

Karen Thomas, MD, MPH
Epidemiology Program Manager
Florida Department of Health Palm Beach
 
Dr. Lorraine Boyd, MD, MPH
Medical Director
Bureau of Maternal, Infant and Reproductive Health
New York City Department of Health and Mental Hygiene

These presenters spoke about how health departments are preventing and mitigating the effects of Zika, how they're communicating about Zika, and how they're using data to have the most impact with their programming

 

CDC Updated Resources

The Centers for Disease Control and Prevention continue to provide updated guidance and information on Zika virus infection. Here are links to the latest resources related to local MCH:

For more information, please visit:

CDC Zika Virus Home Page

CDC Travel Alert

CDC Zika Virus Information for Healthcare Providers

 

Other MCH Zika Resources

Office of Population Affairs: Providing Family Planning Care for Non-Pregnant Women and Men of Reproductive Age in the Context of Zika: A Toolkit for Healthcare Providers

  • This toolkit was developed to help providers of family planning services in a variety of settings educate their non-pregnant clients about the risk of Zika infection. It is based on CDC guidance and is composed of the following components: core information about Zika virus and its implications for women’s and men’s family planning needs; guidance for healthcare providers; job aids and client handouts; and community outreach materials.

National Center for Fatality Review and Prevention: Guidance for Reviews of Zika-Related Fatalities

  • The National Center for Fatality Review and Prevention announces the availability of a new guidance document on Zika.  This document is intended to inform Child Death Review (CDR) and Fetal and Infant Mortality Review (FIMR) teams’ reviews of fetal, infant, and child deaths known to be related, or potentially related to Zika virus infection.  Not all mother-to-child transmissions of Zika will result in death, so teams may want to consider also using this guidance for “sentinel event” reviews and not limiting themselves to review of cases where fetal, infant, or child death is the final outcome.   

American College of Obstetricians and Gynecologists (ACOG): Zika Toolkit

  • ACOG's Zika Toolkit contains several resources to assist providers in their clinical decision making regarding Zika Virus.

 

CityMatCH continues to partner with CDC as the Zika public health emergency evolves. If you have questions or want to share resources with other local MCH programs, please email us:citymch@unmc.edu

 

 

Project Status: 
Active

CityMatCH.org. All rights reserved©