Congenital Zika Syndrome: A Case Study

The care of infants with abnormalities consistent with congenital Zika syndrome requires a multidisciplinary approach and an established medical home to facilitate the coordination of care, which is critical to ensuring that these infants receive necessary testing and consultations , and that abnormal findings are detected and appropriately addressed . If abnormalities are noted on prenatal evaluation, counseling specific to congenital Zika syndrome should occur during pregnancy, preferably with the involvement of obstetric and pediatric providers. Before the infant’s discharge from the birth hospital, follow-up appointments with specialists and services recommended during initial evaluation should be made. Consideration should be given to
If not already initiated, neurology referral should occur for evaluation of any abnormalities, including sleep problems and excess irritability. If the ophthalmology exam performed within the first month of life was normal, another exam (including retinal assessment) is recommended at age 3 months. ABR testing is the preferred test to detect hearing loss resulting from neurologic damage. If the initial newborn hearing screen was performed using only otoacoustic emission testing, the infant should be referred for ABR screening before 1 month of age. If the newborn hearing screen was normal, an ABR should be performed at age 4–6 months. If vision or hearing results are abnormal, referrals to appropriate specialists should occur as soon as
Thyroid screening, including measurement of thyroid stimulation hormone (TSH) and thyroxine (either free T4 or both total T4 and estimated free T4) should be performed at age 2 weeks and again at age 3 months. If either of these results is abnormal, further evaluation of pituitary function should be performed by an endocrinologist.
Developmental monitoring should occur at each routine visit, and standardized, validated screening tools should be used to assess the presence of developmental delay . Referral to a developmental specialist and early intervention services should occur as soon as possible. It is important that primary care providers continue to monitor the child’s development and progress with standardized, validated developmental screening tools to ensure that the child’s developmental needs are