Puerto Rico University Pediatric Hospital Zika Protocol | 50588
Journal of Infectious Diseases & Therapy
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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.
Leticia Gely has completed her MD from University of Puerto Rico, School of Medicine. She has completed Pediatric Residency at the University of Puerto Rico in the year 2013 and is a Board Certified Pediatrician. She is currently a 2nd year Fellow in the Neonatal-Perinatal Medicine Program at the University of Puerto Rico. She is a Member of National Academic Associations.