Epidemic preparedness: Prenatal Zika virus screening during the next epidemic

• Main Authors: Nuria Sanchez Clemente, Demócrito de Barros Miranda-Filho, Ricardo Arraes de Alencar Ximenes, Elizabeth B Brickley, Anna Ramond, Thalia Velho Barreto de Araújo, Luxi Qiao, Celina M Turchi Martelli, Amber I Raja
• Format: Article
• Language: English
• Published: BMJ Publishing Group 2021-06-01
• Series: BMJ Global Health
• Online Access: https://gh.bmj.com/content/6/6/e005332.full

Zika virus (ZIKV) is a vectorborne infectious agent of global public health significance due to its potential to cause severe teratogenic outcomes. The question of whether health systems should consider adopting screening programmes for ZIKV infections during pregnancy warrants consideration. In this analysis, we apply the Wilson-Jungner framework to appraise the potential utility of a prenatal ZIKV screening programme, outline potential screening strategies within the case-finding pathway, and consider other epidemiological factors that may influence the planning of such a screening programme. Our evaluation of a potential prenatal ZIKV screening programme highlights factors affirming its usefulness, including the importance of Congenital Zika Syndrome as a public health problem and the existence of analogous congenital prenatal screening programmes for STORCH agents (syphilis, toxoplasmosis, others (eg, human immunodeficiency virus, varicella-zoster virus, parvovirus B19), rubella, cytomegalovirus, and herpes simplex virus). However, our assessment also reveals key barriers to implementation, such as the need for more accurate diagnostic tests, effective antiviral treatments, increased social service capacity, and surveillance. Given that the reemergence of ZIKV is likely, we provide a guiding framework for policymakers and public health leaders that can be further elaborated and adapted to different contexts in order to reduce the burden of adverse ZIKV-related birth outcomes during future outbreaks.