How American Doctors Are Preparing Families for Children With Zika

About 100 pregnant women in Florida have tested positive for Zika. Doctors expect most of them will be carried to term.

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Oct 24 2016, 9:00am

Maria Ramírez de Mendoza and her baby, both diagnosed with Zika, are flocked by reporters. Image: Jackson Memorial Hospital/University of Miami

Doctors in Florida are preparing for the possibility of a few hundred babies born with Zika-related birth defects. While few children have been born in the US with Zika, most pregnant women who became infected in South Florida are due this spring.

To combat this issue, Jackson Memorial Hospital and the University of Miami established a Zika response unit made up of doctors from pediatrics, infectious disease and other specialities to follow these children as they grow up.

"Does the child eventually develop developmental issues? Does the child eventually develop learning issues?" said Dr. Patricia Rodriguez, a pediatric infectious disease doctor with the Zika response team. "We don't know what's going to happen when they're 5 or 6 years old."

"We don't know what's going to happen when they're 5 or 6 years old."

So far, the Centers for Disease Control and Prevention have recorded 878 cases of pregnant women testing positive for Zika in the US, including about 100 in Florida. The agency is also aware of 1,806 cases in US territories, including Puerto Rico. The island territory had been hit particularly hard by Zika this summer.

"We're not looking at thousands of cases and thousands of pregnant ladies," said Dr. Kenneth Ratzan, infectious disease chair of Mount Sinai Medical Center in Miami Beach. "Even though it's not a very widespread problem, it's a very serious problem. It affects their families."

The Zika virus, spread through mosquitoes and by sexual contact, gained a foothold in Miami in July after it began spreading from individuals who had traveled internationally to areas where Zika was prevalent. While the virus doesn't affect adults much—only about 20 percent of cases even have symptoms such as a mild fever—it can have cause a range of birth defects if a pregnant woman is infected.

Experts aren't completely sure why, but actually, the odds are low that a child born with Zika-related disabilities will also have microcephaly, a condition characterized by babies born with small heads.

Instead, they might struggle to read or could take longer to walk. They might have problems with their vision and hearing. Some of these problems might not make sense when isolated, but a team of doctors can piece together options.

"We've come up with protocols...because we want to be prepared before there's a big influx of patients," Rodriguez said. So far, one baby born at Jackson Memorial has been confirmed as diagnosed with Zika.

"Most of these children are probably going to be fine, but we don't know that yet."

Jackson Memorial already has a team established to help mothers with HIV and AIDS and their children. Because of teams like that, researchers have been able to prevent the spread of HIV from mothers to their babies in utero, as well as decide what treatment plans to prescribe, Rodriguez said.

Since the team is so new, the hospital has not allocated specific funds for the response unit yet, Jackson Memorial spokeswoman Kai Hill said.

Doctors are mostly having to help patients cope with the fear that comes from the fact that little is known about how Zika affects a developing child.

"For Zika, there is no tool yet, there's no medication or treatment," said University of Miami and Jackson Memorial Hospital OBGYN Dr. Christine Curry. "Most of these children are probably going to be fine, but we don't know that yet."

A child born with birth defects due to Zika truly has the odds stacked against them. A 2015 study looking at a prior Zika virus outbreak in French Polynesia, stated pregnant women infected with the Zika virus had a one percent chance of giving birth to a child with microcephaly.

But other studies have suggested odds as high as 13 percent, and full studies haven't been done about the risk of other birth defects, Ratzan said.

Most of the children with Zika in South Florida will be carried to term. South Florida's Planned Parenthood office and Jackson Memorial confirmed they are not expecting an uptick in Zika-related abortions in the coming months.

Part of that is due to the delayed testing cycle. It takes at least a month, if not more, from the point of the first test to the point of confirming a woman is carrying the Zika virus, Ratzan said. That delay, often more than five weeks, can put women past the point of considering an early-term abortion.

That delay also puts stress on parents-to-be who simply want to know whether they need to emotionally prepare themselves for the responsibility of caring for a child with potential developmental delays, Ratzan said.

"There's a lag of about 30 days to get this [tissue] test completed so you can imagine the anxiety a pregnant woman would have … while she's waiting," he said. "It's problematic."

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