Possible Zika Virus Infection Among Pregnant Women - United States and Territories, May 2016.

Regina M. Simeone, Carrie K. Shapiro-Mendoza, Dana Meaney-Delman, Emily E. Petersen, Romeo R. Galang, Titilope Oduyebo, Brenda Rivera-Garcia, Miguel Valencia-Prado, Kimberly B. Newsome, Janice Pérez-Padilla, Tonya R. Williams, Matthew Biggerstaff, Denise J. Jamieson, Margaret A. Honein, Farah Ahmed, Scott Anesi, Kathryn E. Arnold, Danielle Barradas, Devra Barter, Jeanne Bertolli, Andrea M. Bingham, Jan Bollock, Trish Bosse, Kristy K. Bradley, Diane Brady, Catherine M. Brown, Katie Bryan, Victoria Buchanan, Ponce D. Bullard, Alice Carrigan, Monica Clouse, Sally Cook, Michael Cooper, Sherri Davidson, Ariana DeBarr, Thomas Dobbs, Tambra Dunams, Jeffrey Eason, Amanda Eckert, Paula Eggers, Sascha R. Ellington, Amanda Feldpausch, Carolyn R. Fredette, Julie Gabel, Maleeka Glover, Michael Gosciminski, Margarita Gay, Robert Haddock, Sheryl Hand, Jessica Hardy, Marie E. Bottomley Hartel, K. Hennenfent, Susan L. Hills, Jennifer House, Iro Igbinosa, Lucy Im, Hamik Jeff, Sumaiya Khan, Lon Kightlinger, Jean Y. Ko, Samir Koirala, Lauren Korhonen, Vikram Krishnasamy, Katie Kurkjian, Margaret Lampe, Sandra Larson, Ellen H. Lee, Leah Lind, Scott Lindquist, Jonah Long, Jennifer Macdonald, Jennifer MacFarquhar, Daniel P. Mackie, Miguella Mark-Carew, Brennan Martin, Alma Martinez-Quiñones, Janice Matthews-Greer, Sasha A. McGee, Joe McLaughlin, Valerie Mock, Esther Muna, Hanna Oltean, Josephine O’Mallan, H. Pamela Pagano, Sarah Y. Park, Dallin Peterson, Kara N.D. Polen, Charsey Cole Porse, Carol Y. Rao, Abubakar Ropri, Jessica Rinsky, Sara Robinson, Asher Y. Rosinger, Irene Ruberto, Elizabeth Schiffman, Christine Scott-Waldron, Shereen Semple, Tyler Sharp, Kirstin Short, Kimberly Signs, Sally A. Slavinski, Taryn Stevens, Joseph Sweatlock, Elizabeth A. Talbot, Julius Tonzel, Rita Traxler, Sheri Tubach, Clayton Van Houten, Elizabeth VinHatton, Melissa Viray, Daguise Virginie, Michael D. Warren, Catherine Waters, Paul White, Tanya Williams, Ann I. Winters, Shelley Wood, Ibrahim Zaganjor

Zika virus is a cause of microcephaly and brain abnormalities (1), and it is the first known mosquito-borne infection to cause congenital anomalies in humans. The establishment of a comprehensive surveillance system to monitor pregnant women with Zika virus infection will provide data to further elucidate the full range of potential outcomes for fetuses and infants of mothers with asymptomatic and symptomatic Zika virus infection during pregnancy. In February 2016, Zika virus disease and congenital Zika virus infections became nationally notifiable conditions in the United States (2). Cases in pregnant women with laboratory evidence of Zika virus infection who have either 1) symptomatic infection or 2) asymptomatic infection with diagnosed complications of pregnancy can be reported as cases of Zika virus disease to ArboNET* (2), CDC's national arboviral diseases surveillance system. Under existing interim guidelines from the Council for State and Territorial Epidemiologists (CSTE), asymptomatic Zika virus infections in pregnant women who do not have known pregnancy complications are not reportable. ArboNET does not currently include pregnancy surveillance information (e.g., gestational age or pregnancy exposures) or pregnancy outcomes. To understand the full impact of infection on the fetus and neonate, other systems are needed for reporting and active monitoring of pregnant women with laboratory evidence of possible Zika virus infection during pregnancy. Thus, in collaboration with state, local, tribal, and territorial health departments, CDC established two surveillance systems to monitor pregnancies and congenital outcomes among women with laboratory evidence of Zika virus infection(†) in the United States and territories: 1) the U.S. Zika Pregnancy Registry (USZPR),(§) which monitors pregnant women residing in U.S. states and all U.S. territories except Puerto Rico, and 2) the Zika Active Pregnancy Surveillance System (ZAPSS), which monitors pregnant women residing in Puerto Rico. As of May 12, 2016, the surveillance systems were monitoring 157 and 122 pregnant women with laboratory evidence of possible Zika virus infection from participating U.S. states and territories, respectively. Tracking and monitoring clinical presentation of Zika virus infection, all prenatal testing, and adverse consequences of Zika virus infection during pregnancy are critical to better characterize the risk for congenital infection, the performance of prenatal diagnostic testing, and the spectrum of adverse congenital outcomes. These data will improve clinical guidance, inform counseling messages for pregnant women, and facilitate planning for clinical and public health services for affected families.