{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T10:50:38Z","timestamp":1771930238688,"version":"3.50.1"},"reference-count":46,"publisher":"Centers for Disease Control and Prevention (CDC)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Emerg. Infect. Dis."],"published-print":{"date-parts":[[2021,2]]},"DOI":"10.3201\/eid2702.202047","type":"journal-article","created":{"date-parts":[[2021,1,4]],"date-time":"2021-01-04T16:42:36Z","timestamp":1609778556000},"source":"Crossref","is-referenced-by-count":15,"title":["Zika Virus\u2013Associated Birth Defects, Costa Rica, 2016\u20132018"],"prefix":"10.3201","volume":"27","author":[{"given":"Adriana","family":"Benavides-Lara","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda de","family":"la Paz Barboza-Arguello","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauricio","family":"Gonz\u00e1lez-Elizondo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcela","family":"Hern\u00e1ndez-deMezerville","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Brenes-Chac\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Ram\u00edrez-Rojas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catalina","family":"Ram\u00edrez-Hern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nereida","family":"Arjona-Orteg\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shana","family":"Godfred-Cato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Valencia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia A.","family":"Moore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandra","family":"Soriano-Fallas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1822","reference":[{"key":"key-10.3201\/eid2702.202047-202101041140-R1","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1016\/0035-9203(52)90042-4","article-title":"Zika virus. I. Isolations and serological specificity.","volume":"46","author":"Dick","year":"1952","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"key-10.3201\/eid2702.202047-202101041140-R2","doi-asserted-by":"publisher","first-page":"1552","DOI":"10.1056\/NEJMra1602113","article-title":"Zika Virus.","volume":"374","author":"Petersen","year":"2016","journal-title":"N Engl J Med"},{"key":"key-10.3201\/eid2702.202047-202101041140-R3","doi-asserted-by":"publisher","first-page":"1232","DOI":"10.3201\/eid1408.080287","article-title":"Genetic and serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007.","volume":"14","author":"Lanciotti","year":"2008","journal-title":"Emerg Infect Dis"},{"key":"key-10.3201\/eid2702.202047-202101041140-R4","doi-asserted-by":"publisher","first-page":"669","DOI":"10.3201\/eid2304.161549","article-title":"Zika virus seroprevalence, French Polynesia, 2014\u20132015.","volume":"23","author":"Aubry","year":"2017","journal-title":"Emerg Infect Dis"},{"key":"key-10.3201\/eid2702.202047-202101041140-R5","doi-asserted-by":"publisher","first-page":"1885","DOI":"10.3201\/eid2110.150847","article-title":"Zika virus outbreak, Bahia, Brazil.","volume":"21","author":"Campos","year":"2015","journal-title":"Emerg Infect Dis"},{"key":"key-10.3201\/eid2702.202047-202101041140-R6","doi-asserted-by":"publisher","first-page":"59","DOI":"10.15585\/mmwr.mm6503e2","article-title":"Possible association between Zika virus infection and microcephaly\u2014Brazil, 2015.","volume":"65","author":"Schuler-Faccini","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"key-10.3201\/eid2702.202047-202101041140-R7","doi-asserted-by":"publisher","first-page":"1409","DOI":"10.15585\/mmwr.mm6549e1","article-title":"Preliminary report of microcephaly potentially associated with Zika virus infection during pregnancy\u2014Colombia, January\u2013November 2016.","volume":"65","author":"Cuevas","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"key-10.3201\/eid2702.202047-202101041140-R8","doi-asserted-by":"publisher","first-page":"242","DOI":"10.15585\/mmwr.mm6509e2","article-title":"Increase in reported prevalence of microcephaly in infants born to women living in areas with confirmed Zika virus transmission during the first trimester of pregnancy\u2014Brazil, 2015.","volume":"65","author":"Kleber de Oliveira","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"key-10.3201\/eid2702.202047-202101041140-R9","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1001\/jamapediatrics.2016.3982","article-title":"Characterizing the pattern of anomalies in congenital Zika syndrome for pediatric clincians.","volume":"171","author":"Moore","year":"2017","journal-title":"JAMA Pediatr"},{"key":"key-10.3201\/eid2702.202047-202101041140-R10","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1002\/ajmg.1320170213","article-title":"In utero brain destruction resulting in collapse of the fetal skull, microcephaly, scalp rugae, and neurologic impairment: the fetal brain disruption sequence.","volume":"17","author":"Russell","year":"1984","journal-title":"Am J Med Genet"},{"key":"key-10.3201\/eid2702.202047-202101041140-R11","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1002\/ajmg.a.38170","article-title":"The phenotypic spectrum of congenital Zika syndrome.","volume":"173","author":"Del Campo","year":"2017","journal-title":"Am J Med Genet A"},{"key":"key-10.3201\/eid2702.202047-202101041140-R12","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1016\/S0140-6736(16)30902-3","article-title":"Congenital Zika virus syndrome in Brazil: a case series of the first 1501 livebirths with complete investigation.","volume":"388","author":"Fran\u00e7a","year":"2016","journal-title":"Lancet"},{"key":"key-10.3201\/eid2702.202047-202101041140-R13","doi-asserted-by":"publisher","first-page":"858","DOI":"10.15585\/mmwr.mm6731e1","article-title":"Vital signs: Zika-associated birth defects and neurodevelopmental abnormalities possibly associated with congenital Zika virus infection\u2014U.S. territories and freely associated states, 2018.","volume":"67","author":"Rice","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"key-10.3201\/eid2702.202047-202101041140-R14","doi-asserted-by":"publisher","first-page":"j5018","DOI":"10.1136\/bmj.j5018","article-title":"Prevalence and clinical profile of microcephaly in South America pre-Zika, 2005-14: prevalence and case-control study.","volume":"359","author":"Orioli","year":"2017","journal-title":"BMJ"},{"key":"key-10.3201\/eid2702.202047-202101041140-R15","unstructured":"Costa Rica Bicentennial Government. First imported case of Zika in Costa Rica [in Spanish] [cited 2019 Aug 14]. https:\/\/presidencia.go.cr\/comunicados\/2016\/01\/primer-caso-importado-de-zika-en-costa-rica\/"},{"key":"key-10.3201\/eid2702.202047-202101041140-R16","unstructured":"\u00c1valos A. Pregnant woman becomes first native case of Zika in Costa Rica [in Spanish] [cited 2019 Aug 14]. https:\/\/www.nacion.com\/el-pais\/salud\/embarazada-se-convierte-en-primer-caso-autoctono-de-zika-en-costa-rica\/PSI4Z6V75ZGARLKBA62NAH6INA\/story\/"},{"key":"key-10.3201\/eid2702.202047-202101041140-R17","doi-asserted-by":"publisher","first-page":"574","DOI":"10.7326\/L16-0075","article-title":"Zika virus infection in a Massachusetts resident after travel to Costa Rica: a case report.","volume":"164","author":"Chen","year":"2016","journal-title":"Ann Intern Med"},{"key":"key-10.3201\/eid2702.202047-202101041140-R18","unstructured":"Ministerio de Salud de Costa Rica, Instituto Costarricense de Investigaci\u00f3n y Ense\u00f1anza en Nutrici\u00f3n y Salud, Caja Costarricense del Seguro Social. Surveillance protocol for microcephaly and congenital syndrome associated with Zika virus in Costa Rica [in Spanish] [cited 2019 Sep 14]. https:\/\/www.ministeriodesalud.go.cr\/index.php\/vigilancia-de-la-salud\/normas-protocolos-y-guias\/malformaciones-congenitas\/3786-protocolo-vigilancia-zika-congenito-microcefalia-marzo-2018\/file"},{"key":"key-10.3201\/eid2702.202047-202101041140-R19","unstructured":"World Health Organization. Birth defects surveillance: a manual for programme managers [cited 2019 Sep 14]. https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/110223\/9789241548724_eng.pdf"},{"key":"key-10.3201\/eid2702.202047-202101041140-R20","unstructured":"World Health Organization Multicentre Growth Reference Study Group. WHO child growth standards: methods and development [cited 2019 Aug 14]. https:\/\/www.who.int\/childgrowth\/standards\/second_set\/technical_report_2\/en"},{"key":"key-10.3201\/eid2702.202047-202101041140-R21","unstructured":"Centers for Disease Control and Prevention. CDC instructions for Zika MAC-ELISA protocol. 2018 Feb 2 [cited 2019 Aug 21]. https:\/\/www.cdc.gov\/zika\/pdfs\/zika-mac-elisa-instructions-for-use.pdf"},{"key":"key-10.3201\/eid2702.202047-202101041140-R22","unstructured":"Benavides-Lara A, Barboza-Arguello MP. Abbreviated report of microcephaly cases reported to Costa Rican Birth Defects Register Center, Costa Rica 2011\u20132017 [in Spanish] [cited 2019 Aug 14]. https:\/\/www.inciensa.sa.cr\/vigilancia_epidemiologica\/informes_vigilancia\/2018\/Malformaciones%20Congenitas\/Reporte%20abreviado%20de%20Microcefalia%20en%20Costa%20Rica%202011-2017.pdf"},{"key":"key-10.3201\/eid2702.202047-202101041140-R23","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1016\/S0140-6736(17)31368-5","article-title":"Infection-related microcephaly after the 2015 and 2016 Zika virus outbreaks in Brazil: a surveillance-based analysis.","volume":"390","author":"de Oliveira","year":"2017","journal-title":"Lancet"},{"key":"key-10.3201\/eid2702.202047-202101041140-R24","doi-asserted-by":"publisher","first-page":"67","DOI":"10.15585\/mmwr.mm6903a3","article-title":"Population-based surveillance for birth defects potentially related to Zika virus infection\u201422 states and territories, January 2016\u2013June 2017.","volume":"69","author":"Smoots","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"key-10.3201\/eid2702.202047-202101041140-R25","doi-asserted-by":"publisher","first-page":"30181","DOI":"10.2807\/1560-7917.ES.2016.21.13.30181","article-title":"Congenital cerebral malformations and dysfunction in fetuses and newborns following the 2013 to 2014 Zika virus epidemic in French Polynesia.","volume":"21","author":"Besnard","year":"2016","journal-title":"Euro Surveill"},{"key":"key-10.3201\/eid2702.202047-202101041140-R26","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1001\/jama.2016.19006","article-title":"Birth defects among fetuses and infants of US women with evidence of possible Zika virus infection during pregnancy.","volume":"317","author":"Honein","year":"2017","journal-title":"JAMA"},{"key":"key-10.3201\/eid2702.202047-202101041140-R27","doi-asserted-by":"publisher","first-page":"615","DOI":"10.15585\/mmwr.mm6623e1","article-title":"Pregnancy outcomes after maternal Zika virus infection during pregnancy\u2014U.S. Territories, January 1, 2016\u2013April 25, 2017.","volume":"66","author":"Shapiro-Mendoza","year":"2017","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"key-10.3201\/eid2702.202047-202101041140-R28","doi-asserted-by":"publisher","first-page":"2125","DOI":"10.1016\/S0140-6736(16)00651-6","article-title":"Association between Zika virus and microcephaly in French Polynesia, 2013-15: a retrospective study.","volume":"387","author":"Cauchemez","year":"2016","journal-title":"Lancet"},{"key":"key-10.3201\/eid2702.202047-202101041140-R29","unstructured":"Pacheco O, Beltr\u00e1n M, Nelson CA, Valencia D, Tolosa N, Farr SL,  Zika virus disease in Colombia\u2014preliminary report [cited 2019 Jun 14]. https:\/\/www.nejm.org\/doi\/10.1056\/NEJMoa1604037"},{"key":"key-10.3201\/eid2702.202047-202101041140-R30","doi-asserted-by":"publisher","first-page":"242","DOI":"10.15585\/mmwr.mm6509e2","article-title":"Increase in reported prevalence of microcephaly in infants born to women living in areas with confirmed Zika virus transmission during the first trimester of pregnancy\u2014Brazil, 2015.","volume":"65","author":"Kleber de Oliveira","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"key-10.3201\/eid2702.202047-202101041140-R31","doi-asserted-by":"publisher","first-page":"701","DOI":"10.5123\/S1679-49742016000400004","article-title":"Microcephaly in Brazil: prevalence and characterization of cases from the Live Birth Information System (Sinasc), 2000\u20132015","volume":"25","author":"Marinho","year":"2016","journal-title":"Epidemiol Serv Saude"},{"key":"key-10.3201\/eid2702.202047-202101041140-R32","doi-asserted-by":"publisher","first-page":"e20173811","DOI":"10.1542\/peds.2017-3811","article-title":"Pre-Zika microcephaly in Brazil: closer to the elusive baseline and new questions raised.","volume":"141","author":"Dufort","year":"2018","journal-title":"Pediatrics"},{"key":"key-10.3201\/eid2702.202047-202101041140-R33","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.15585\/mmwr.mm6547e2","article-title":"Description of 13 infants born during October 2015\u2013January 2016 with congenital Zika virus infection without microcephaly at birth\u2014Brazil.","volume":"65","author":"van der Linden","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"key-10.3201\/eid2702.202047-202101041140-R34","doi-asserted-by":"publisher","first-page":"638","DOI":"10.17269\/s41997-019-00215-2","article-title":"Maternal infection with Zika virus and prevalence of congenital disorders in infants: systematic review and meta-analysis.","volume":"110","author":"Nithiyanantham","year":"2019","journal-title":"Can J Public Health"},{"key":"key-10.3201\/eid2702.202047-202101041140-R35","doi-asserted-by":"publisher","first-page":"1876","DOI":"10.1016\/j.ophtha.2017.06.009","article-title":"Anterior-segment ocular findings and microphthalmia in congenital Zika syndrome.","volume":"124","author":"de Paula Freitas","year":"2017","journal-title":"Ophthalmology"},{"key":"key-10.3201\/eid2702.202047-202101041140-R36","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1001\/jamapediatrics.2017.1474","article-title":"Screening criteria for ophthalmic manifestations of congenital Zika virus infection.","volume":"171","author":"Zin","year":"2017","journal-title":"JAMA Pediatr"},{"key":"key-10.3201\/eid2702.202047-202101041140-R37","doi-asserted-by":"publisher","first-page":"917","DOI":"10.15585\/mmwr.mm6534e3","article-title":"Hearing loss in Infants with microcephaly and evidence of congenital Zika virus infection\u2014Brazil, November 2015\u2013May 2016.","volume":"65","author":"Leal","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"key-10.3201\/eid2702.202047-202101041140-R38","doi-asserted-by":"publisher","first-page":"i1901","DOI":"10.1136\/bmj.i1901","article-title":"Clinical features and neuroimaging (CT and MRI) findings in presumed Zika virus related congenital infection and microcephaly: retrospective case series study.","volume":"353","author":"de Fatima Vasco Aragao","year":"2016","journal-title":"BMJ"},{"key":"key-10.3201\/eid2702.202047-202101041140-R39","doi-asserted-by":"publisher","first-page":"S154","DOI":"10.1542\/peds.2017-2038D","article-title":"Development of infants with congenital Zika syndrome: what do we know and what can we expect?","volume":"141","author":"Wheeler","year":"2018","journal-title":"Pediatrics"},{"key":"key-10.3201\/eid2702.202047-202101041140-R40","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1007\/s40471-014-0028-y","article-title":"Challenges in studying modifiable risk factors for birth defects.","volume":"2","author":"Tinker","year":"2015","journal-title":"Curr Epidemiol Rep"},{"key":"key-10.3201\/eid2702.202047-202101041140-R41","doi-asserted-by":"publisher","first-page":"2677","DOI":"10.3389\/fmicb.2017.02677","article-title":"Advances in diagnosis, surveillance, and monitoring of Zika virus: an update.","volume":"8","author":"Singh","year":"2018","journal-title":"Front Microbiol"},{"key":"key-10.3201\/eid2702.202047-202101041140-R42","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.15585\/mmwr.mm6641a1","article-title":"Update: interim guidance for the diagnosis, evaluation, and management of infants with possible congenital Zika virus infection\u2014United States, October 2017.","volume":"66","author":"Adebanjo","year":"2017","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"key-10.3201\/eid2702.202047-202101041140-R43","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1016\/j.ajog.2017.01.020","article-title":"Testing for Zika virus infection in pregnancy: key concepts to deal with an emerging epidemic.","volume":"216","author":"Eppes","year":"2017","journal-title":"Am J Obstet Gynecol"},{"key":"key-10.3201\/eid2702.202047-202101041140-R44","unstructured":"Pan American Health Organization. Guidelines for surveillance of Zika virus disease and its complications. 2018 edition [cited 2019 Aug 5]. https:\/\/iris.paho.org\/xmlui\/bitstream\/handle\/123456789\/49518\/9789275120194_eng.pdf"},{"key":"key-10.3201\/eid2702.202047-202101041140-R45","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1002\/bdr2.1007","article-title":"Population-based pregnancy and birth defects surveillance in the era of Zika virus.","volume":"109","author":"Gilboa","year":"2017","journal-title":"Birth Defects Res"},{"key":"key-10.3201\/eid2702.202047-202101041140-R46","unstructured":"Ministerio de Salud (Costa Rica). National guidelines for the comprehensive approach of pregnant women and newborn, related to Zika infection [in Spanish] [cited 2019 Aug 5]. https:\/\/www.ministeriodesalud.go.cr\/index.php\/vigilancia-de-la-salud\/normas-protocolos-y-guias\/enfermedades-de-transmision-vectorial\/3054-lineamientos-nacionales-para-el-abordaje-integral-de-la-mujer-embarazada-y-el-recien-nacido-relacionado-con-la-infeccion-del-zika\/file"}],"container-title":["Emerging Infectious Diseases"],"original-title":[],"link":[{"URL":"https:\/\/wwwnc.cdc.gov\/eid\/article\/27\/2\/20-2047_article","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,30]],"date-time":"2024-11-30T17:50:00Z","timestamp":1732989000000},"score":1,"resource":{"primary":{"URL":"https:\/\/wwwnc.cdc.gov\/eid\/article\/27\/2\/20-2047_article.htm"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2]]},"references-count":46,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"URL":"https:\/\/doi.org\/10.3201\/eid2702.202047","relation":{},"ISSN":["1080-6040","1080-6059"],"issn-type":[{"value":"1080-6040","type":"print"},{"value":"1080-6059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2]]}}}