BACKGROUND: Zika virus infection during pregnancy has been linked to adverse pregnancy outcomes. To better understand the burden of Zika in pregnancy, the Texas Department of State Health Services (DSHS) established enhanced surveillance to identify pregnancy outcomes with congenital anomalies among women with laboratory evidence of Zika virus infection during pregnancy since January 1, 2016.
METHODS: As part of routine surveillance, arboviral disease case investigation forms, laboratory testing results, and other relevant epidemiologic information are collected and reviewed by the DSHS Zoonosis Control Branch. As part of the enhanced surveillance, data on pregnant women with laboratory evidence of Zika virus infection and their offspring are shared with the DSHS Birth Defects Epidemiology and Surveillance Branch (BDESB). BDESB staff then review neonatal medical records for documented congenital anomalies. Additionally, within 3 months of delivery, BDESB staff review hospital discharge data using International Classification of Diseases, Tenth Revision codes to identify neonates with birth defects consistent with Zika virus infection during pregnancy (e.g. brain abnormalities with and without microcephaly, neural tube defects, and arthrogryposis).
RESULTS: Between January 1 and November 30, 2016, 103 pregnant women with laboratory evidence of Zika virus infection were identified. All infections were travel-associated. Of the 30 pregnancies where delivery outcomes are known, 2 neonates presented with microcephaly and additional congenital anomalies; one with intraventricular hemorrhage and the other with holoprosencephaly and severe lower limb deformities. Both had laboratory evidence of Zika virus infection at delivery.
CONCLUSIONS: Through surveillance, we identified 2 neonates with Zika-related congenital anomalies and laboratory confirmed Zika virus infection. To assist in targeting resources for neonates affected by Zika virus infection and their families, continued enhanced surveillance is needed.