UKOSS update

Abstract

Increasing evidence of an association of Zika virus (ZIKV) infection in pregnancy with infant microcephaly and other neurological disorders emerged in late 2015, leading to a declaration of a Public Health Emergency of International Concern by the World Health Organization on 1 February 2016. At the early stage of the epidemic, little was known about the clinical presentation or the level of risk that ZIKV infection posed to pregnant women travelling to affected areas. Several systems in addition to UKOSS exist within the UK to facilitate a rapid response to public health emergencies and surveillance of rare congenital infections. This study combined results from UKOSS surveillance with those from the British Paediatric Surveillance Unit and the Public Health England Rare and Imported Pathogens Laboratory to establish the number of pregnant women potentially exposed, identify affected children, estimate the risk to the travelling UK population and help further knowledge of the natural history of congenital Zika syndrome. From 1 March 2016 to 28 February 2017, 827 women were reported to have travelled from the UK to countries with active Zika transmission during pregnancy or in the 4 weeks prior to conception. Acombined total of 11womenexperiencingadversepregnancy outcomes after possible ZIKV exposure were reported by the three surveillance systems; five women had miscarriages, two had stillborn babies and four had children with clinical presentations potentially associated with ZIKV infection. Sixteen women were diagnosed with ZIKV infection during pregnancy in the UK. Among the offspring of these women, there was unequivocal laboratory evidence of infection in only one child. Employing established surveillance systems at an early stage of the outbreak facilitated information on the risk to the travelling UK population and showed that in the UK, the risk of congenital ZIKV infection for travellers returning from Zika-affected countries is very small. The prompt and effective response of these separate surveillance systems provided reassurance that suitable approaches are in place to respond to similar threats in a coordinated effort in the future.