{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T15:06:35Z","timestamp":1761491195005},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,2]]},"abstract":"<jats:title>Abstract.<\/jats:title><jats:p>The objective of the study was to describe the complexity of diagnosis and evaluation of Zika-exposed pregnant women\/fetuses and infants in a U.S. Congenital Zika Program. Pregnant women\/fetuses and\/or infants referred for clinical evaluation to the Congenital Zika Program at Children\u2019s National (Washington, DC) from January 2016 to June 2018 were included. We recorded the timing of maternal Zika-virus (ZIKV) exposure and ZIKV laboratory testing results. Based on laboratory testing, cases were either confirmed, possible, or unlikely ZIKV infection. Prenatal and postnatal imaging by ultrasound and\/or magnetic resonance imaging (MRI) were categorized as normal, nonspecific, or as findings of congenital Zika syndrome (CZS). Of 81 women\u2013fetus\/infant pairs evaluated, 72 (89%) had confirmed ZIKV exposure; 18% of women were symptomatic; only a minority presented for evaluation within the time frame for laboratory detection. Zika virus could only be confirmed in 29 (40%) cases, was possible in 26 (36%) cases, and was excluded in 17 (24%) cases. Five cases (7%) had prenatal ultrasound and MRI findings of CZS, but in only three was ZIKV confirmed by laboratory testing. Because of timing of exposure to presentation, ZIKV infection could not be excluded in many cases. Neuroimaging found CZS in 7% of cases, and in many patients, there were nonspecific imaging findings that warrant long-term follow-up. Overall, adherence to postnatal recommended follow-up evaluations was modest, representing a barrier to care. These challenges may be instructive to future pediatric multidisciplinary clinics for congenital infectious\/noninfectious threats to pregnant women and their infants.<\/jats:p>","DOI":"10.4269\/ajtmh.20-1256","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T12:57:01Z","timestamp":1618837021000},"page":"2210-2219","source":"Crossref","is-referenced-by-count":5,"title":["Complexities of Zika Diagnosis and Evaluation in a U.S. Congenital Zika Program"],"prefix":"10.4269","volume":"104","author":[{"given":"Sarah B.","family":"Mulkey","sequence":"first","affiliation":[{"name":"1Division of Fetal and Transitional Medicine, Children's National Hospital, Washington, District of Colombia;"},{"name":"2Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"3Department of Neurology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Ansusinha","sequence":"additional","affiliation":[{"name":"4Division of Pediatric Infectious Diseases, Children's National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caitlin","family":"Cristante","sequence":"additional","affiliation":[{"name":"1Division of Fetal and Transitional Medicine, Children's National Hospital, Washington, District of Colombia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie M.","family":"Russo","sequence":"additional","affiliation":[{"name":"1Division of Fetal and Transitional Medicine, Children's National Hospital, Washington, District of Colombia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cara","family":"Biddle","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"5Division of General and Community Pediatrics, Children's National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youssef A.","family":"Kousa","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"6Division of Neurology, Children's National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay","family":"Pesacreta","sequence":"additional","affiliation":[{"name":"1Division of Fetal and Transitional Medicine, Children's National Hospital, Washington, District of Colombia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Jantausch","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"4Division of Pediatric Infectious Diseases, Children's National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Hanisch","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"4Division of Pediatric Infectious Diseases, Children's National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nada","family":"Harik","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"4Division of Pediatric Infectious Diseases, Children's National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rana F.","family":"Hamdy","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"4Division of Pediatric Infectious Diseases, Children's National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Hahn","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"4Division of Pediatric Infectious Diseases, Children's National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taeun","family":"Chang","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"3Department of Neurology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"6Division of Neurology, Children's National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad","family":"Jaafar","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"7Division of Ophthalmology, Children's National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracey","family":"Ambrose","sequence":"additional","affiliation":[{"name":"8Division of Audiology, Children's National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilbert","family":"Vezina","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"9Division of Radiology, Children's National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorothy I.","family":"Bulas","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"9Division of Radiology, Children's National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Wessel","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"10Division of Chief Medical Officer, Children\u2019s National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adre J.","family":"du Plessis","sequence":"additional","affiliation":[{"name":"1Division of Fetal and Transitional Medicine, Children's National Hospital, Washington, District of Colombia;"},{"name":"2Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"3Department of Neurology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"6Division of Neurology, Children's National Hospital, Washington, District of Columbia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta L.","family":"DeBiasi","sequence":"additional","affiliation":[{"name":"2Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia;"},{"name":"4Division of Pediatric Infectious Diseases, Children's National Hospital, Washington, District of Columbia;"},{"name":"11Department of Microbiology, Immunology and Tropical Medicine, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and 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