84. Developing a Centralized Process for Screening and Monitoring Patients for Zika Virus Infection in Preparation for Local Vector-Borne Transmission in the United States
Session: Oral Abstract Session: Vectors and Viruses
Thursday, October 27, 2016: 8:30 AM
Room: 283-285

Background: Zika virus is a flavivirus that is spread primarily through the bite of an infected Aedes mosquito. It has been associated with severe neurologic effects including microcephaly in neonates. Vector-borne transmission has been identified throughout Latin America, and the United States Centers for Disease Control and Prevention (CDC) has issued travel advisories for all pregnant women to avoid nonessential travel to affected regions. Furthermore, several ecological models have predicted that local transmission may occur in the continental United States. Consequently, a need has emerged to develop a coordinated program devoted to the screening of returning travelers for Zika virus infection, as well as building the capacity for increased patient care in the setting of potential local transmission.

Methods: A centralized process was developed for surveillance, serum testing, reporting, and performing serial anatomical ultrasonography. Between January 15 and May 15 of 2016, 189 pregnant women who had recently traveled to a Zika-affected area were screened, resulting in 533 patient encounters (Figure 1).

Results: Of the 189 patients enrolled in the Zika screening program,147 (78%) underwent serum screening.  All patients tested had a negative Zika PCR result. Thirty one patients (21%) had a positive screening antibody result, of which 17 had negative confirmatory plaque-reduction neutralization tests (PRNT).  The remainder declined PRNT or had pending results.

Conclusion: Given the lack of positive test results to this point in our patient population, we have observed that the duration and location of travel within specific countries should be taken into account when counseling patients on risk. Maintenance of this outpatient screening program has required significant resource redistribution within the health system, particularly given the long interval between serum testing and obtaining a result. A contingency plan for scaling up the process should be developed to address the scenario of transmission in the New York City area, in which case the approximately 6200 pregnant women who deliver in our facility per year would require screening and monitoring.

Figure 1: Zika screening program patient encounters

Daniel Eiras, MD, MPH1, Michael Phillips, MD1, Jennifer Merritt, RN2 and Ashley Roman, MD2, (1)Infection Prevention and Control, NYU Langone Medical Center, New York, NY, (2)Division of Maternal Fetal Medicine, NYU Langone Medical Center, New York, NY

Disclosures:

D. Eiras, None

M. Phillips, None

J. Merritt, None

A. Roman, None

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