Infectious Diseases

Biography

Biography: Leticia Gely

Abstract

Zika virus (ZV) is a mosquito-borne Flavivirus primarily transmitted by Aedes aegypti mosquitoes found in tropical regions. ZV infection may occur by vertical transmission to the fetus or by intrapartum transmission from a viremic mother to the newborn, and may have severe implications to the newborn health including microcephaly. The World Health Organization and the Centers for Disease Control and Prevention (CDC) activated their respective emergency operations centers to better coordinate response to the ZV outbreak. The Neonatology Section, University of Puerto Rico provides services in a Level 3 Neonatal Intensive Care Unit. A protocol was design based on the CDC and the Puerto Rico Health Department guidelines. The specific aim is to identify, evaluate and treat appropriately all fetus/newborns with possible intrauterine ZV exposure. The protocol included a quality improvement strategy with process mapping for all deliveries with documented prenatal ZV exposure. All interventions will follow the standard evaluations and procedures based on the infant’s needs as recommended by the American Academy of Pediatrics and the CDC recommendations. Review of the process map with local managers and frontline health professionals revealed multiple areas which require improvement, such as including new questions of events occurring during prenatal period and accessibility to prenatal laboratory and fetal ultrasounds for appropriate identification of cases and avoid adding steps that do not add value to the process, will dramatically increase the cost of interventions in a time of decreased funding and may interfere with the standard newborn care and the promotion of breastfeeding practices.