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
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.
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/.
CityMatCH's Learning Network Webinar - Local MCH Response to Zika (Recording Available)
Additional Information from the webinar:
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:
- Updated: CDC Interim Zika Response Plan - revised guidance including information on sexual transmission, guidance around locally acquired Zika virus infection, revised Zika laboratory testing, enhanced case identification, and information on reporting birth defects to state-based birth defects surveillance systems
- Updated: Women & Their Partners webpage - provides information on pregnancy, pregnancy timing, and exposure to Zika
- Contraception to Prevent Unintended Pregnancy during the Zika Virus Outbreak - provides contraceptive guidence for healthcare providers
MMWR Publication: Contraceptive Use among non-Pregnant and Postpartum Women at Risk for Unintended Pregnancy and Female High School Students, in the Context of Zika Preparedness--United States, 2011-2013 and 2015. Main findings:
- About 1 in 3 women at risk for unintended pregnancy are not using any birth control method.
- Use of long-acting reversible contraception (LARC including intrauterine devices and implants)—the most effective method to prevent unintended pregnancy—remains lower than use of moderately and less effective reversible contraceptives such as pills and condoms.
- Moderately effective and less effective contraceptive methods, including pills, patches, rings, injections, condoms and other barrier methods, were used more frequently than highly effective methods across all age groups and race/ethnicity.
- What to know: If your baby may have been affected by Zika but has no related health conditions at birth
- What to know: If your baby was born with congenital Zika syndrome
- What to know: If your doctor suspects microcephaly during pregnancy
- Counseling Pregnant Women on Zika Virus Test Results
For more information, please visit:
Other MCH Zika Resources
- 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:firstname.lastname@example.org
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