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Follow-Up Care

Following CDC guidance on the follow-up care for infants born to women with possible Zika virus exposure during pregnancy can help ensure that affected infants receive the care and services they need.

The long-term prognosis for infants with congenital Zika virus infection is currently unknown. CDC’s infant guidance includes recommendations for testing infants for congenital Zika infection and clinical management recommendations for infants with evidence of Zika virus infection, both with and without apparent birth defects, to ensure careful screening and monitoring of infant development. For infants with congenital Zika virus infection, care is focused on diagnosing and managing conditions that are present and addressing problems as they arise.

Overall, families and caregivers of infants with congenital Zika virus infection will require ongoing psychosocial assessment and support. As a critical component of patient care and to facilitate early identification of developmental delays, families should be empowered to be active participants in their child’s monitoring and care.

Follow-Up Care for Infants Born to Women with Possible Zika Virus Exposure during Pregnancy

Infants with birth defects consistent with congenital Zika syndrome (e.g., microcephaly, intracranial calcifications or other brain or eye abnormalities) who are born to mothers with possible Zika virus exposure during pregnancy (regardless of maternal test results) require a multidisciplinary team and established medical home to facilitate the coordination of care. Follow-up care for these infants include the following:

  • A standard evaluation with routine preventive pediatric care and immunizations at each subsequent well-child visit
  • Additional eye exams should be as recommended by ophthalmologists
  • Referral for automated auditory brainstem response (ABR) testing by 1 month, if infant passed the newborn hearing screen using only the otoacoustic emissions (OAE) method
  • Referral to specialists for management of clinical abnormalities

Infants without birth defects consistent with congenital Zika syndrome but who were born to mothers with laboratory evidence of possible Zika virus infection during pregnancy should receive the following care:

  • A standard evaluation with routine preventive pediatric care (including growth parameters) and immunizations at each subsequent well-child visit
  • Additional eye exams should be as recommended by ophthalmologists
  • Referral for automated auditory brainstem response (ABR) testing by 1 month, if infant passed the newborn hearing screen using only the otoacoustic emissions (OAE) method
  • Refer to specialists for any signs associated with congenital Zika virus infection (e.g., impaired visual acuity/function, hearing problems, developmental delay, delay of head growth)

For infants in this group who test positive for Zika virus infection, healthcare providers should follow recommendations for infants with clinical findings even in the absence of clinically apparent abnormalities.

For infants in this group who have adequate laboratory testing but without laboratory evidence of congenital infection and a normal clinical evaluation, congenital Zika virus infection is unlikely. Healthcare providers should continue routine pediatric care but remain alert for any new findings of possible congenital Zika virus infection.

Infants without birth defects consistent with congenital Zika syndrome but who were born to mothers with possible Zika virus exposure but without laboratory evidence of possible Zika virus infection during pregnancy should receive the following care:

  • A standard evaluation with routine preventive pediatric care and immunizations at each subsequent well-child visit

Further evaluation beyond the initial evaluation and preventive care is not routinely indicated unless abnormalities are noted at any time. If findings are identified, referral to appropriate specialists should occur and the infant should receive further evaluation, including testing and evaluation for congenital Zika virus infection.

Patient Materials

What to Know if Your Baby Was Born with Congenital Zika Syndrome

What to Know if Your Baby May Have Been Affected by Zika but has No Related Health Conditions at Birth

Zika Clinical Summary Card

Clinician Resources

Evaluation and Management for Infants with Possible Congenital Zika Infection

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