scholarly journals Medicaid claims data to supplement Zika-related birth defects case identification

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Carrie W. Mills ◽  
Tenzin Tseyang ◽  
Katharine McVeigh ◽  
George Askew
Keyword(s):  
New York ◽  
Virus Infection ◽  
Birth Defects ◽  
Zika Virus ◽  
Claims Data ◽  
Diagnostic Codes ◽  
Chart Abstraction ◽  
Icd 10 ◽  
Congenital Zika Syndrome ◽  
Birth Records

ObjectiveTo assess the use of Medicaid claims data to conduct surveillance for cases of Zika-related birth defects identified after birth among infants born in New York City (NYC).IntroductionAs a part of the Zika Birth Defects Surveillance, a national effort coordinated by the Centers for Disease Control and Prevention (CDC), NYC is conducting enhanced surveillance of all births with defects included in the congenital Zika syndrome (CZS) phenotype among infants born in NYC beginning in 2016. The intent of the project is to provide background on the prevalence of these conditions, regardless of cause. The surveillance project builds on the New York State (NYS) Congenital Malformations Registry, a passive, mandatory reporting system that relies on reporting from hospitals and providers. For the Surveillance project, potential cases of Zika-related birth defects (ZBD) are identified by hospital and administrative data of birth records with one or more of the International Classification of Diseases, 10th Revision (ICD-10) diagnostic codes associated with CZS.1 The list of included diagnostic codes was specified by the NYS registry following guidance established by CDC. Full medical record chart abstraction of the birth hospital visit of potential cases is then conducted applying further inclusion guidelines to identify ZBD cases.Recent reports of late presentation of birth defects consistent with CZS suggest that some cases are being missed due to identification and diagnosis of the condition after birth.2 As one component of a broader strategy to obtain a more accurate surveillance count, we seek to identify potential ZBD cases first diagnosed in the 6-month postpartum period using Medicaid claims data.MethodsWe will obtain Medicaid records for all infants born in NYC in 2016 from Jan 1, 2016 through June 30, 2017 using Salient, a data mining system of Medicaid data (Salient Interactive Miner, Version 5.70.079). The 85 ICD-10 diagnostic codes currently being used to identify potential ZBD cases will be applied to birth records and all outpatient and inpatient visits to a medical provider for the 6-month period after birth. All visits containing one or more of the codes from either primary or secondary diagnosis will be identified. A unique list of infants receiving one or more included diagnoses within the 6-month postpartum period will be obtained and cross-referenced with the current case list using a matching algorithm based on child’s name, date of birth, and other identifying variables.ResultsPreliminary resultsSurveillance measures to-date have identified 380 cases of infants born in NYC in 2016 with birth defects that could be due to Zika virus; it is anticipated that a majority have Medicaid. (In 2015, 59% of all births in NYC were to mothers with Medicaid.)Analysis will determine (a) the extent of overlap of cases identified from surveillance activities and Medicaid claims data, and (b) the extent of ZBD potential cases missing from surveillance but found with Medicaid data of in- and out-patient visits. Descriptive statistics will include age and class of earliest diagnosis of infants. Those identified by Medicaid analysis will be considered potential ZBD cases pending full abstraction of record.Full results pending.ConclusionsIf results indicate missed potential ZBD cases, medical chart abstraction of such cases will be warranted. Further, as CZS is a relatively new syndrome, findings may provide support in the determination of accurate follow-up time for future surveillance projects.3Full conclusion pending.References1. Moore CA, Staples JE, Dobyns WB, et al. Characterizing the Pattern of Anomalies in Congenital Zika Syndrome for Pediatric Clinicians. JAMA Pediatrics. 2017;171(3):288-295. doi:10.1001/jamapediatrics.2016.3982.2. Cragan JD, Mai CT, Petersen EE, et al. Baseline Prevalence of Birth Defects Associated with Congenital Zika Virus Infection — Massachusetts, North Carolina, and Atlanta, Georgia, 2013–2014. MMWR Morb Mortal Wkly Rep. 2017;66:219–222. DOI: http://dx.doi.org/10.15585/mmwr.mm6608a4.3. Shapiro-Mendoza CK, Rice ME, Galang RR, et al. Pregnancy Outcomes After Maternal Zika Virus Infection During Pregnancy — U.S. Territories, January 1, 2016–April 25, 2017. MMWR Morb Mortal Wkly Rep. 2017;66:615-621. DOI: http://dx.doi.org/10.15585/mmwr.mm6623e1. 

scholarly journals Pregnant women with suspected Zika virus infection: A claims data analysis

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Silvia Valkova
Keyword(s):  
United States ◽  
New York ◽  
Virus Infection ◽  
Pregnant Women ◽  
Zika Virus ◽  
Claims Data ◽  
Virus Disease ◽  
Healthcare Providers ◽  
Zika Virus Infection ◽  
Icd 10

ObjectiveDemonstrate the value of consolidated claims data from communityhealthcare providers in Zika Virus Disease surveillance at local level.IntroductionZika virus disease and Zika virus congenital infection arenationally notifiable conditions that became prominent recently as agrowing number of travel-associated infections have been identifiedin the United States. The Centers for Disease Control and Prevention(CDC) have dedicated significant time and effort on determining andaddressing the risks and impact of Zika on pregnant women and theirbabies who are most vulnerable to the disease. CDC relies on twosources of information, reported voluntarily by healthcare providers,to monitor Zika virus disease: ArboNET and the newly establishedU.S. Zika Pregnancy Registry. A study by IMS Health compared U.S.trends of the Zika virus disease in general and pregnant women withZika virus disease in particular observed in an IMS healthcare claimsdatabase and the CDC ArboNET and the newly established U.S. ZikaPregnancy Registry.MethodsIMS used for this analysis claims for reimbursement from office-based healthcare providers, which are widely accepted standardbusiness practice records throughout the healthcare industry. IMSclaims data is collected daily from office-based providers throughoutthe U.S. and processed, stored and analyzed in a centralized database.The information is available at the patient and visit level, with theability to characterize deidentified patients by age, gender andZIP3 location and to trace a patient’s history of visits, diagnoses,procedures, drugs prescribed and tests performed or ordered.The general IMS study sample captured all patients throughout thecontinental United States covered in claims between October 1, 2016and May 24, 2016 with ICD 10 diagnosis code A92.8, Other SpecifiedMosquito-Borne Viral Fevers. This sample was compared to thesample of laboratory-confirmed Zika virus disease cases reportedto ArboNET by state or territory from the CDC Arboviral DiseaseBranch from January 1, 2015 through May 18, 2016. In addition,IMS compared the subset of patients with both a Zika virus diseasediagnosis and any ICD 10 pregnancy diagnosis to the CDC sampleof patients captured by the U.S. Zika Pregnancy Registry with anylaboratory evidence of possible Zika virus infection in the UnitedStates and territories.ResultsThroughout the continental United States, the IMS claims-basedsample captured 875 patients with a Zika virus disease diagnosiscompared to 548 travel-associated cases reported by CDC. At thestate level, especially in New York, New Jersey, Illinois and Texas,the IMS data captured a much larger number of cases that the CDCreported cases. Most of these possible Zika cases are concentratedin the large metropolitan areas around New York City, Chicagoand Houston. Many of them are diagnosed and treated by the samehealthcare providers.The IMS sample captured 577 pregnant women with a possibleZika virus infection compared to the 168 pregnant women with apossible Zika virus infection reported in the U.S. Zika PregnancyRegistry as of May 24, 2016. Many of the pregnant women in the IMSsample had multiple visits, often in consecutive months, associatedwith the Zika virus disease diagnosis. Pregnant women are morelikely to be tested and diagnosed with a Zika virus infection due tothe risk of fetal malformations from the disease. As many as 250 ofthe 577 pregnant women with a possible Zika virus infection also hada diagnosis of suspected fetal damage due to a viral disease. Of allwomen with a possible Zika virus infection in the IMS sample, 120were in New Jersey, 111 in New York, 93 in Illinois and 74 in Texas,and most were concentrated in the large metropolitan areas aroundNew York City, Chicago and Houston.ConclusionsThese findings suggest that all-payer claims data can be usedsuccesfully to monitor Zika transmission trends at local and statelevel, especially with a focus on pregnant women. Healthcare claimsdata is fast, granular, relevant at local level and can be used tosupplement CDC ArboNET data for local and state level surveillanceand response to the evolving Zika virus infection outbreak. Thisstudy is an example of a novel approach to surveillance for Zika virusdisease and potentially many other infectious diseases.

scholarly journals Asymptomatic Prenatal Zika Virus Infection and Congenital Zika Syndrome

2018 ◽  
Vol 5 (4) ◽  
Author(s):  
Enny S Paixao ◽  
Wei-Yee Leong ◽  
Laura C Rodrigues ◽  
Annelies Wilder-Smith
Keyword(s):  
Virus Infection ◽  
Birth Defects ◽  
Prospective Studies ◽  
Zika Virus ◽  
Retrospective Studies ◽  
Recall Bias ◽  
Virus Infections ◽  
Fetal Outcomes ◽  
Zika Virus Infection ◽  
Congenital Zika Syndrome

Abstract To investigate to what extent asymptomatic vs symptomatic prenatal Zika virus infections contribute to birth defects, we identified 3 prospective and 8 retrospective studies. The ratio varied greatly in the retrospective studies, most likely due to recruitment and recall bias. The prospective studies revealed a ratio of 1:1 for asymptomatic vs symptomatic maternal Zika infections resulting in adverse fetal outcomes.

scholarly journals Zika viruses of both African and Asian lineages cause fetal harm in a vertical transmission model

2018 ◽  
Author(s):  
Anna S. Jaeger ◽  
Reyes A. Murreita ◽  
Lea R. Goren ◽  
Chelsea M. Crooks ◽  
Ryan V. Moriarty ◽  
...  
Keyword(s):  
Mouse Model ◽  
Vertical Transmission ◽  
Birth Defects ◽  
Asian American ◽  
Zika Virus ◽  
French Polynesia ◽  
Transmission Model ◽  
Foreseeable Future ◽  
Zikv Infection ◽  
Congenital Zika Syndrome

AbstractCongenital Zika virus (ZIKV) infection was first linked to birth defects during the American outbreak 1–3. It has been proposed that mutations unique to the Asian/American-genotype explain, at least in part, the ability of Asian/American ZIKV to cause congenital Zika syndrome (CZS) 4,5. Recent studies identified mutations in ZIKV infecting humans that arose coincident with the outbreak in French Polynesia and were stably maintained during subsequent spread to the Americas 5. Here we show that African ZIKV can infect and harm fetuses and that the S139N mutation that has been associated with the American outbreak is not essential for fetal harm. Our findings, in a vertical transmission mouse model, suggest that ZIKV will remain a threat to pregnant women for the foreseeable future, including in Africa, southeast Asia, and the Americas. Additional research is needed to better understand the risks associated with ZIKV infection during pregnancy, both in areas where the virus is newly endemic and where it has been circulating for decades.

Zika Virus Infection Associated With Congenital Birth Defects in a HIV-infected Pregnant Woman

2017 ◽  
Vol 36 (5) ◽  
pp. 500-501 ◽  
Author(s):  
Esaú Custódio João ◽  
Maria Isabel Fragoso da Silveira Gouvea ◽  
Maria de Lourdes Benamor Teixeira ◽  
Wallace Mendes-Silva ◽  
Juliana Silva Esteves ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Virus Infection ◽  
Birth Defects ◽  
Zika Virus ◽  
Congenital Birth Defects ◽  
Zika Virus Infection ◽  
Infected Pregnant Woman

scholarly journals Risk estimates for microcephaly related to Zika virus infection - from French Polynesia to Bahia, Brazil

2016 ◽  
Author(s):  
Michael A Johansson ◽  
Luis Mier-y-Teran-Romero ◽  
Jennita Reefhuis ◽  
Suzanne M Gilboa ◽  
Susan L Hills
Keyword(s):  
Virus Infection ◽  
Confidence Interval ◽  
Infection Rate ◽  
Birth Defects ◽  
Zika Virus ◽  
First Trimester ◽  
French Polynesia ◽  
Zikv Infection ◽  
Risk Estimates ◽  
First Trimester Of Pregnancy

Zika virus (ZIKV) infection during pregnancy has been linked to birth defects,1 yet the magnitude of risk remains uncertain. A study of the Zika outbreak in French Polynesia estimated that the risk of microcephaly due to ZIKV infection in the first trimester of pregnancy was 0.95% (95% confidence interval: 0.34-1.91%), based on eight microcephaly cases identified retrospectively in a population of approximately 270,000 people with an estimated 66% ZIKV infection rate.2

scholarly journals Population-Based Surveillance of Birth Defects Potentially Related to Zika Virus Infection — 15 States and U.S. Territories, 2016

2018 ◽  
Vol 67 (3) ◽  
pp. 91-96 ◽  
Author(s):  
Augustina Delaney ◽  
Cara Mai ◽  
Ashley Smoots ◽  
Janet Cragan ◽  
Sascha Ellington ◽  
...  
Keyword(s):  
Virus Infection ◽  
Birth Defects ◽  
Zika Virus ◽  
Population Based ◽  
Zika Virus Infection

scholarly journals Zika virus infection from a newborn point of view. TORCH or TORZiCH?

2018 ◽  
Vol 11 (4) ◽  
pp. 241-246 ◽  
Author(s):  
Adriana Tahotná ◽  
Jana Brucknerová ◽  
Ingrid Brucknerová
Keyword(s):  
Virus Infection ◽  
Zika Virus ◽  
Clinical Symptoms ◽  
Global Climate ◽  
Point Of View ◽  
Zikv Infection ◽  
Global Climate Changes ◽  
Zika Virus Infection ◽  
Congenital Zika Syndrome ◽  
The Media

Abstract Zika virus (ZIKV) belongs to the group of viruses called arboviruses. Congenital Zika syndrome is a new disease with infectious teratogenic aetiology. The clinical symptoms are divided into morphological and functional. Most severe complication is the foetal brain disruption sequence that includes severe microcephaly, anomalies of the eyes and congenital contractions of joints. The aim of this paper was to review available facts about Zika virus infection from a newborn point of view in a form of the summary of all important information. Zika virus infection is a problem of past, present and future. Epidemics may occur because of global climate changes, also in countries where natural conditions for life of mosquitos are not present. This clearly indicates the need to continue developing of vaccines and specific antiviral drugs. Until this happens, we must adhere individual preventive measures. Zika virus has proven to us how it can affect the health of adults and neonates but also thinking of healthy people. Newborns with microcephaly on the front pages of the media caused in 2015 panic and fear around the world – for this reason education of people is necessary. Due to serious congenital disorders associated with ZIKV infection and global impact of virus we suggest modifying old acronym TORCH for new TORZiCH to accent the position of Zika virus.

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