The Centers Disease Control and Prevention issued revised clinical guidance regarding the care of babies born to mothers who were likely infected with the Zika virus during their pregnancy in light of the rising number of locally-transmitted cases.
South Beach was identified as a second site of Zika transmission by mosquitoes on the U.S. mainland, and containing it there will be difficult because high-rise buildings and strong winds make it impractical to spray the neighborhood from the air, officials said Friday.
Five cases of Zika have been connected to mosquitoes in Miami Beach, bringing the state's caseload to 36 infections not related to travel outside the U.S., Florida's governor and health department said Friday.
The discovery prompted the CDC to expand its travel warning for pregnant women to include an area in Miami Beach known for nightclubs, pedestrian thoroughfares and beaches.
The new clinical recommendations update guidance the agency issued back in February for providing care to infants at risk for congenital Zika infection, which has been associated with severe birth defects.
The CDC recommends healthcare providers conduct laboratory testing for congenital Zika virus infection for infants whose mothers have tested positive for Zika, as well as for babies who show signs of congenital Zika infection. Testing is also recommended in cases where epidemiological evidence supports the possibility of transmission from the mother to the child regardless of whether the mother tested positive or negative for infection.
Healthcare providers were urged to perform a comprehensive physical examination on babies born to Zika-infected mothers, which includes measuring the head as well as cranial ultrasounds even in cases when a prenatal ultrasound showed no signs of abnormalities.
The guidance recommends infants who either show signs of having abnormalities or test positive for congenital Zika infection but show no signs receive follow-up care through a multidisciplinary team with a medical home.
But access to such medical resources will likely be out of reach for some affected families who lack adequate health coverage and do not have the means to pay for such additional services out of pocket. Zika infections are most likely to arise in states with large numbers of residents who lack insurance coverage and access to care.
Though the proportion of poor people who live in southern states has declined since the 1960s–when they made up nearly half the population—the South still has a larger share of people living in poverty, 41%, than any other region.
“Families might face language and cultural barriers, financial barriers, and inadequate access," the CDC says in the new guidance. "Rural populations might have difficulty accessing specialists. ... Barriers to care for all affected infants and their families should be addressed through linkage to national, state, and local health programs.”
There had been more than 2,200 cases of Zika infections in the U.S. as of Aug. 17, according the CDC, including 14 cases that were contracted from local mosquitoes in South Florida. As of Aug. 11, more than 500 U.S. cases involved pregnant women, resulting in 16 infants born with birth defects and five lost pregnancies.