2021 U.S. Virgin Islands Zika health brigade: Providing recommended pediatric health screenings for children born to mothers with laboratory evidence of possible Zika virus infection during pregnancy

Leah H de Wilde; Cosme Jeremy Harrison; Binta E Ceesay; Charmaine S Mayers; Janney Ferrol-Hawley; Jacqueline Canton; Shana Godfred-Cato; Megan R Reynolds; Lessely Brown-Shuler; Sukhdeep Randhawa; Dan Schoelles; Braeanna Hillman; Maria Paz Carlos; Tracey Ambrose; Derek Bitner; Sandra Holgado; Cristie Jones; Daniel J Lattin; Sarah B Mulkey; Angeline Nguyen; Mary Payne; S Grace Prakalapakorn; Ann Shue; Esther M Ellis

doi:10.1002/bdr2.2143

2021 U.S. Virgin Islands Zika health brigade: Providing recommended pediatric health screenings for children born to mothers with laboratory evidence of possible Zika virus infection during pregnancy

Birth Defects Res. 2023 Mar 15;115(5):572-577. doi: 10.1002/bdr2.2143. Epub 2022 Dec 27.

Authors

Leah H de Wilde¹, Cosme Jeremy Harrison², Binta E Ceesay¹, Charmaine S Mayers¹, Janney Ferrol-Hawley¹, Jacqueline Canton¹, Shana Godfred-Cato³, Megan R Reynolds³, Lessely Brown-Shuler², Sukhdeep Randhawa⁴, Dan Schoelles⁴, Braeanna Hillman¹, Maria Paz Carlos⁵, Tracey Ambrose⁶, Derek Bitner⁷, Sandra Holgado⁸, Cristie Jones⁹, Daniel J Lattin¹⁰, Sarah B Mulkey^{11

12

13}, Angeline Nguyen^{14

15}, Mary Payne¹⁶, S Grace Prakalapakorn^{17

18

19}, Ann Shue^{20

21}, Esther M Ellis¹

Affiliations

¹ U.S. Virgin Islands Department of Health, Christiansted and Charlotte Amalie, Virgin Islands, USA.
² Chickasaw Nation Industries, Norman, Oklahoma, USA.
³ Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
⁴ Deloitte Consulting LLP, New York, New York, USA.
⁵ Maternal Child Health Bureau (MCHB), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (HHS), Washington, D.C., USA.
⁶ Hearing and Speech Center, Children's National Hospital, Washington, D.C., USA.
⁷ Wolfe Eye Clinic, West Des Moines, Iowa, USA.
⁸ Duke Eye Center, Durham, North Carolina, USA.
⁹ Austin Regional Clinic, Austin, Texas, USA.
¹⁰ Nemours Children's Health, Jacksonville, Florida, USA.
¹¹ Prenatal Pediatrics Institute, Children's National Hospital, Washington, D.C., USA.
¹² Department of Neurology, The George Washington University School of Medicine and Health Sciences, Washington, D.C., USA.
¹³ Department of Pediatrics, The George Washington School of Medicine and Health Sciences, Washington, D.C., USA.
¹⁴ Pediatric Ophthalmology and Adult Strabismus, Children's Hospital Los Angeles, Los Angeles, California, USA.
¹⁵ Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
¹⁶ Marshall University School of Medicine, Huntington, West Virginia, USA.
¹⁷ Department of Ophthalmology, Duke University, Durham, North Carolina, USA.
¹⁸ Department of Pediatrics, Duke University, Durham, North Carolina, USA.
¹⁹ Duke Global Health Institute, Duke University, Durham, North Carolina, USA.
²⁰ Byers Eye Institute, Department of Ophthalmology, Stanford University, Palo Alto, California, USA.
²¹ Stanford Children's Health, Palo Alto, California, USA.

Abstract

Background: The United States Virgin Islands (USVI) Department of Health (DOH) conducted a second Zika health brigade (ZHB) in 2021 to provide recommended Zika-related pediatric health screenings, including vision, hearing, neurologic, and developmental screenings, for children in the USVI. This was replicated after the success of the first ZHB in 2018, which provided recommended Zika-related pediatric health screenings to 88 infants and children exposed to Zika virus (ZIKV) during pregnancy.

Methods: Ten specialty pediatric care providers were recruited and traveled to the USVI to conduct the screenings. USVI DOH scheduled appointments for children included in CDC's U.S. Zika Pregnancy and Infant Registry (USZPIR). During the ZHB, participants were examined by pediatric ophthalmologists, pediatric audiologists, and pediatric neurologists. We report the percentage of participants who were referred for additional follow-up care or given follow-up recommendations in the 2021 ZHB and compare these referrals and recommendations to those given in the 2018 ZHB.

Results: Thirty-three children born to mothers with laboratory evidence of ZIKV infection during pregnancy completed screenings at the 2021 ZHB, of which 15 (45%) children were referred for additional follow-up care. Ophthalmological screenings resulted in the highest number of new referrals for a specialty provider among ZHB participants, with 6 (18%) children receiving referrals for that specialty. Speech therapy was the most common therapy referral, with 10 (30%) children referred, of which 9 (90%) were among those who attended the 2018 ZHB.

Conclusions: Thirty-three children in a jurisdiction with reduced access to healthcare specialists received recommended Zika-related pediatric health screenings at the ZHB. New and continuing medical and developmental concerns were identified and appropriate referrals for follow-up care and services were provided. The ZHB model was successful in creating connections to health services not previously received by the participants.

Keywords: Zika virus infection; congential Zika virus; health brigade; health screening; pediatric; pediatric screening; specialty care.

Publication types

Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Child
Female
Humans
Infant
Parturition
Pregnancy
Pregnancy Complications, Infectious*
United States Virgin Islands
Zika Virus Infection*
Zika Virus*

Abstract

Publication types

MeSH terms

Grants and funding