Monitoring

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][175]​ 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]

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]

Assessment should include:[2]​​[176]

  • 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]​​

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 Opens in new window

Patients with Guillain-Barre syndrome should be followed up for sequelae and multidisciplinary rehabilitation therapy.​[143]

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