Surveillance of congenital Zika syndrome in England and Wales: methods and results of laboratory, obstetric and paediatric surveillance

• Published in: Epidemiology and infection Vol. 147; p. e262
• Main Authors: Oeser, C, Aarons, E, Heath, P T, Johnson, K, Khalil, A, Knight, M, Lynn, R M, Morgan, D, Pebody, R
• Format: Journal Article
• Language: English
• Published: England Cambridge University Press 04.09.2019
• Subjects: Age; Assessments; Babies; Children; Children & youth; Childrens health; Complications; Congenital diseases; Emergencies; England - epidemiology; Epidemiological Monitoring; Health risks; Humans; Infections; Laboratories; Microcephaly; Obstetrics; Offspring; Original Paper; Outbreaks; Pediatrics; Pregnancy; Pregnancy complications; Public health; Rare diseases; Risk Assessment; Southern Hemisphere; Surveillance systems; Travel; Travel-Related Illness; Travellers; Vector-borne diseases; Viral infections; Viruses; Wales - epidemiology; Womens health; Zika virus; Zika Virus Infection - epidemiology; England; Wales; United Kingdom > UK; Infectious disease control; Arboviruses; Surveillance system; Surveillance; Congenital (intrauterine) infection
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268819001535

The spread of the Zika virus (ZIKV) in the Americas led to large outbreaks across the region and most of the Southern hemisphere. Of greatest concern were complications following acute infection during pregnancy. At the beginning of the outbreak, the risk to unborn babies and their clinical presentation was unclear. This report describes the methods and results of the UK surveillance response to assess the risk of ZIKV to children born to returning travellers. Established surveillance systems operating within the UK - the paediatric and obstetric surveillance units for rare diseases, and national laboratory monitoring - enabled rapid assessment of this emerging public health threat. A combined total of 11 women experiencing adverse pregnancy outcomes after possible ZIKV exposure were reported by the three surveillance systems; five miscarriages, two intrauterine deaths and four children with clinical presentations potentially associated with ZIKV infection. Sixteen women were diagnosed with ZIKV during pregnancy in the UK. Amongst the offspring of these women, there was unequivocal laboratory evidence of infection in only one child. In the UK, the number and risk of congenital ZIKV infection for travellers returning from ZIKV-affected countries is very small.