Liveborn infant with congenital microcephaly, or intracranial
calcifications, or structural brain or eye abnormalities, or other congenital
central nervous system-related abnormalities not explained by another
etiology.
(As part of the complete evaluation of congenital microcephaly or other CNS
birth defects, testing for other congenital infections such as syphilis,
toxoplasmosis, rubella, cytomegalovirus infection, lymphocytic
choriomeningitis virus infection, and herpes simplex virus infections should
be considered. An assessment of potential genetic and other teratogenic causes
of the congenital anomalies should also be performed.)
Laboratory Criteria
Recent ZIKV infection
Culture of ZIKV from blood, body fluid, or tissue; OR
Detection of ZIKV antigen or viral RNA in serum, CSF, placenta, umbilical
cord, fetal tissue, or other specimen (e.g., amniotic fluid, urine, semen,
saliva), OR
Positive ZIKV IgM antibody test in serum or CSF with positive ZIKV
neutralizing antibody titers and negative neutralizing antibody titers
against dengue or other flaviviruses endemic to the region where exposure
occurred.
Recent flavivirus infection, possible ZIKV
Positive ZIKV IgM antibody test of serum or CSF with positive
neutralizing antibody titers against ZIKV and dengue virus or other
flaviviruses endemic to the region where exposure occurred Positive ZIKV IgM
antibody test AND negative dengue virus IgM antibody test with no
neutralizing antibody testing performed
Epidemiologic Linkage
Resides in or recent travel to an area with known ZIKV transmission;
OR
Sexual contact with a confirmed or probable case within the infection
transmission risk window of ZIKV infection or person with recent travel to an
area with known ZIKV transmission; OR
Receipt of blood or blood products within 30 days of symptom onset;
OR
Organ or tissue transplant recipient within 30 days of symptom onset;
OR
Association in time and place with a confirmed or probable case; OR
Likely vector exposure in an area with suitable seasonal and ecological
conditions for potential local vectorborne transmission
Case Classification
Zika Virus Disease, Congenital
Confirmed
A neonate meets the clinical criteria for congenital disease AND meets one
of the following laboratory criteria:
ZIKV detection by culture, viral antigen, or viral RNA in fetal tissue,
umbilical cord blood, or amniotic fluid; OR neonatal serum, CSF, or urine
collected within 2 days of birth; OR
Positive ZIKV IgM antibody test of umbilical cord blood, neonatal serum
or CSF collected within 2 days of birth with positive ZIKV neutralizing
antibody titers and negative neutralizing antibody titers against dengue or
other flaviviruses endemic to the region where exposure occurred.
Probable
A neonate meets clinical criteria for congenital disease; AND
The neonate’s mother has an epidemiologic linkage or meets laboratory
criteria for recent ZIKV or flavivirus infection; AND
The neonate has laboratory evidence of ZIKV or flavivirus infection by:
Positive ZIKV IgM antibody test of serum or CSF collected within 2 days
of birth; and
positive neutralizing antibody titers against ZIKV and dengue or other
flaviviruses endemic to the region where exposure occurred; OR
negative dengue virus IgM antibody test and no neutralizing antibody
testing performed.
Infection without Disease, Congenital
Confirmed
A neonate who does not meet clinical criteria for a congenital disease
case; BUT
The neonate has laboratory evidence of recent ZIKV or flavivirus infection
by:
ZIKV detection by culture, viral antigen or viral RNA in fetal tissue,
umbilical cord blood, or amniotic fluid; OR neonatal serum, CSF, or urine
collected within 2 days of birth; OR
Positive ZIKV IgM antibody test of umbilical cord blood, neonatal serum
or CSF collected within 2 days of birth with positive ZIKV neutralizing
antibody titers and negative neutralizing antibody titers against dengue or
other flaviviruses endemic to the region where exposure occurred.
Probable
A neonate who does not meet clinical criteria for a congenital disease
case; BUT
The neonate’s mother has an epidemiologic linkage or meets laboratory
criteria for recent ZIKV or flavivirus infection; AND
The neonate has laboratory evidence of ZIKV or flavivirus infection by:
Positive ZIKV IgM antibody test of serum or CSF collected within 2 days
of birth; and
negative dengue IgM antibody test and no neutralizing antibody testing
performed; or
positive neutralizing antibody titers against ZIKV and dengue or other
flaviviruses endemic to the region where exposure occurred.