Increase in Birth Defects Prompts CDC to Award Zika Surveillance Funding

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The need for continued surveillance to provide estimates on the rate at which the virus has impacted the incidence of birth defects has prompted the Centers for Disease Control and Prevention (CDC) to award funding to five jurisdictions.

The Centers for Disease Control and Prevention (CDC) has just released a new study estimating that there has been an increase in the number of birth defects documented within the United States since the Zika virus was identified in the Americas. As a result, the CDC has granted additional funding to help with birth defect surveillance efforts.

Much progress is being made to understand a virus that has shown to be a life-changing threat to women of childbearing age. Researchers have found that congenital infection with the Zika virus can cause neurological harm in developing fetuses, such as microcephaly, and more recently, progressive and delayed hearing loss. Furthermore, infection in adults can potentially result in Guillain-barré syndrome, which causes the immune system to attack the nerves. Recent studies have also shown that Zika virus and Chikungunya co-infection can result in more prolonged infection. Additional research is required in order to fully understand the full scope of infection.

The recent study, which will be published in the March 3, 2017 issue of the CDC's Morbidity and Mortality Weekly Report, reports that there has been a “20-fold increase” in birth defects identified in the United States in 2016 compared to those identified between 2013 and 2014. These defects include, “brain abnormalities and/or microcephaly, neural tube defects and other early brain malformations, eye defects, and other central nervous system (CNS) problems,” according to a press release the CDC released on the study. Between 2013 and 2014, birth defects were identified in 0.3% of total births (2.86 of 1,000 births). However, in 2016, this number grew to a staggering 6% of births (58.8 of 1,000 births).

These findings are based on data from surveillance programs from Massachusetts, North Carolina, and Georgia. The researchers examined data submitted to these programs between 2013 and 2014 in order to create a reference point. From the surveillance programs, the team identified a total of 747 infants and fetuses who presented with one or more of the identified birth defects. According to the research, brain abnormalities and microcephaly remain at the top of the list of detected complications as a result of congenital Zika virus infection (1.5 of 1,000 births). These figures were compared to data collected in 2016 by the US Zika Pregnancy Registry, which documents cases of women who were infected while pregnant with the Zika virus either locally in the United States or abroad.

The Zika registry included information on 442 completed pregnancies in women with possible Zika virus infection from January 2016 to September 2016 in the United States. The data revealed that between January and September 2016, 26 infants were identified to have similar birth defects to those identified before the Zika virus started circulating in the Americas.

“The birth defects observed are not unique to congenital Zika [virus] infection, and the full range of effects of congenital Zika [virus] infection is not known,” the study authors concluded. These findings stress the importance of the data that continued surveillance can provide.

To that end, the CDC announced today that it will provide additional funding to five jurisdictions to help them continually monitor birth defects and collect data for the surveillance programs: Arkansas, Nebraska, Nevada, the Federated State of Micronesia, and the Republic of the Marshall Islands. The addition of these jurisdictions brings surveillance funding to a total of $27 million divided between 50 jurisdictions for the 2016 and 2017 fiscal year.

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Paul Tambyah, MD, president of ISID
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