BACKGROUND: The U.S. Virgin Islands (USVI) is experiencing an ongoing outbreak of Zika virus (ZIKV). The USVI sees around 1,600 births annually. Due to the potential for ZIKV related pregnancy complications and birth defects, the CDC has created the U.S. Zika Virus Pregnancy Registry (USZPR), which provides enhanced surveillance through collection of information about antenatal diagnostic testing, and clinical outcomes among ZIKV positive pregnant women and their infants through the first year of life, as well as all infants born with any birth defects.
METHODS: Free ZIKV testing has been offered to all pregnant women in the territory and community outreach has been performed territory-wide. Pregnant women who test positive or equivocal for ZIKV, or who give birth to an infant with suspected birth defects, have a maternal health history form completed and are entered into the USZPR. At birth, a neonatal assessment form is filled out, and the serum and urine from the infant, and the placenta are collected for ZIKV testing. The infant is entered into the USZPR and infant follow-up forms are completed at two, six, and twelve months after birth.
RESULTS: As of January 3, 2017 there are 130 pregnant women and 47 infants in the USVI USZPR. Five (4%) women are located on St. John, 20 (15%) are on St. Croix, and 105 (81%) are on St. Thomas. Among ZIKV positive pregnant women, there have been 4 miscarriages and 1 stillbirth. There have been 1,378 pregnant women tested for ZIKV, and it is estimated that over 80% of pregnant women in the USVI will receive at least one ZIKV test by the end of their third trimester. No infants have tested positive for ZIKV and no birth defects have been noted.
CONCLUSIONS: ZIKV testing has become part of routine prenatal care in the USVI, with most pregnant women being tested at least once during their pregnancy. Most ZIKV positive pregnant women reside in St. Thomas, which is where a majority of all ZIKV cases have been located. The high percentage of pregnant women tested for ZIKV highlights the successful efforts of health care providers and community outreach programs. The outbreak is ongoing and ZIKV positive pregnant women will continue to give birth after the outbreak ends. USZPR surveillance will help in further understanding ZIKV and will assist the USVI in providing the services needed by infants born with birth defects and to ZIKV positive pregnant women.