Pregnant women with suspected or confirmed Zika virus infection should have regular fetal ultrasounds (e.g., every 3-4 weeks) to assess the fetus for the presence of microcephaly or other abnormalities. All pregnant women should be encouraged to attend scheduled prenatal visits. Abnormalities may be detected anywhere from 2 to 29 weeks after onset of symptoms, and brain abnormalities have been identified in the second and third trimesters.[14]Pan American Health Organization; World Health Organization. Provisional remarks on Zika virus infection in pregnant women: document for health care professionals. Jan 2016 [internet publication].
http://iris.paho.org/xmlui/handle/123456789/18600
[175]Centers for Disease Control and Prevention. Zika virus: clinical considerations for pregnant persons with possible Zika virus infection. May 2024 [internet publication].
https://www.cdc.gov/zika/hcp/clinical-pregnant/index.html
Fetal magnetic resonance imaging (MRI) should not be used as a screening tool. It requires specialized expertise and has limited availability in some countries.[175]Centers for Disease Control and Prevention. Zika virus: clinical considerations for pregnant persons with possible Zika virus infection. May 2024 [internet publication].
https://www.cdc.gov/zika/hcp/clinical-pregnant/index.html
Infants with congenital Zika syndrome should be followed up at 1, 3, 6, 9, 12, 18, and 24 months of age. Additional follow-up may be required if there are other complications. Follow-up beyond 24 months will depend on the child’s individual needs.[176]World Health Organization. Screening, assessment and management of neonates and infants with complications associated with Zika virus exposure in utero. Aug 2016 [internet publication].
https://www.who.int/publications/i/item/WHO-ZIKV-MOC-16.3-Rev.1
Assessment should include:[2]Adebanjo T, Godfred-Cato S, Viens L, et al. Update: interim guidance for the diagnosis, evaluation, and management of infants with possible congenital Zika virus infection - United States, October 2017. MMWR Morb Mortal Wkly Rep. 2017 Oct 20;66(41):1089-99.
https://www.cdc.gov/mmwr/volumes/66/wr/mm6641a1.htm?s_cid=mm6641a1_w
http://www.ncbi.nlm.nih.gov/pubmed/29049277?tool=bestpractice.com
[176]World Health Organization. Screening, assessment and management of neonates and infants with complications associated with Zika virus exposure in utero. Aug 2016 [internet publication].
https://www.who.int/publications/i/item/WHO-ZIKV-MOC-16.3-Rev.1
Head circumference measurement
Neurodevelopmental assessment
Hearing screen
Ophthalmologic assessment
Feeding and growth
Endocrine assessment
Psychological well-being of families and caregivers.
Infants with laboratory evidence of congenital infection who do not have any apparent abnormalities consistent with congenital infection should have ongoing developmental monitoring and screening, including hearing tests, by a primary care physician.[2]Adebanjo T, Godfred-Cato S, Viens L, et al. Update: interim guidance for the diagnosis, evaluation, and management of infants with possible congenital Zika virus infection - United States, October 2017. MMWR Morb Mortal Wkly Rep. 2017 Oct 20;66(41):1089-99.
https://www.cdc.gov/mmwr/volumes/66/wr/mm6641a1.htm?s_cid=mm6641a1_w
http://www.ncbi.nlm.nih.gov/pubmed/29049277?tool=bestpractice.com
The World Health Organization offers specific guidance for the screening, assessment, and management of neonates and infants with congenital Zika infection.
WHO: screening, assessment and management of neonates and infants with complications associated with Zika virus exposure in utero
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Patients with Guillain-Barre syndrome should be followed up for sequelae and multidisciplinary rehabilitation therapy.[143]World Health Organization. Assesssment and management of Guillain-Barré syndrome in the context of Zika virus: interim guidance update. Aug 2016 [internet publication].
https://www.who.int/publications/i/item/WHO-ZIKV-MOC-16.4-Rev.1