• Augustina Delaney, Cara Mai, Ashley Smoots, Janet Cragan, Sascha Ellington, Peter Langlois, Rebecca Breidenbach, Jane Fornoff, Julie Dunn, Mahsa Yazdy, Nancy Scotto-Rosato, Joseph Sweatlock, Deborah Fox, Jessica Palacios, Nina Forestieri, Vinita Leedom, Mary Smiley, Amy Nance, Heather Lake-Burger, Paul Romitti, Carrie Fall, Miguel Valencia Prado, Jerusha Barton, J Michael Bryan, William Arias, Samara Viner Brown, Jonathan Kimura, Sylvia Mann, Brennan Martin, Lucia Orantes, Amber Taylor, John Nahabedian, Amanda Akosa, Ziwei Song, Stacey Martin, Roshan Ramlal, Carrie Shapiro-Mendoza, Jennifer Isenburg, Cynthia A Moore, Suzanne Gilboa, and Margaret A Honein.
• MMWR Morb. Mortal. Wkly. Rep. 2018 Jan 26; 67 (3): 91-96.

AbstractZika virus infection during pregnancy can cause serious birth defects, including microcephaly and brain abnormalities (1). Population-based birth defects surveillance systems are critical to monitor all infants and fetuses with birth defects potentially related to Zika virus infection, regardless of known exposure or laboratory evidence of Zika virus infection during pregnancy. CDC analyzed data from 15 U.S. jurisdictions conducting population-based surveillance for birth defects potentially related to Zika virus infection.* Jurisdictions were stratified into the following three groups: those with 1) documented local transmission of Zika virus during 2016; 2) one or more cases of confirmed, symptomatic, travel-associated Zika virus disease reported to CDC per 100,000 residents; and 3) less than one case of confirmed, symptomatic, travel-associated Zika virus disease reported to CDC per 100,000 residents. A total of 2,962 infants and fetuses (3.0 per 1,000 live births; 95% confidence interval [CI] = 2.9-3.2) (2) met the case definition.† In areas with local transmission there was a non-statistically significant increase in total birth defects potentially related to Zika virus infection from 2.8 cases per 1,000 live births in the first half of 2016 to 3.0 cases in the second half (p = 0.10). However, when neural tube defects and other early brain malformations (NTDs)§ were excluded, the prevalence of birth defects strongly linked to congenital Zika virus infection increased significantly, from 2.0 cases per 1,000 live births in the first half of 2016 to 2.4 cases in the second half, an increase of 29 more cases than expected (p = 0.009). These findings underscore the importance of surveillance for birth defects potentially related to Zika virus infection and the need for continued monitoring in areas at risk for Zika.

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