By Richard Westlund / Special to UM News —

With the arrival of the Zika virus in South Florida last summer, the University of Miami Miller School of Medicine immediately launched a new multidisciplinary clinical initiative to provide the best possible care for pregnant women and their babies.

Although relatively little was known about this dangerous tropical virus, UM’s Zika Response Team quickly became known as the “go-to” source for the latest information, appropriate counseling and comprehensive clinical care. Women from throughout South Florida, the U.S. and aboard who tested positive for Zika took advantage of the unique clinical resources of the Miller School and UHealth – The University of Miami Health System.

Led by Ivan Gonzalez, M.D., assistant professor of pediatrics, he is director of the University of Miami’s Zika Response Team. UM’s Zika Response Team continues to take a proactive approach to clinical care and research. A year after the 2016 outbreak, the team’s clinical care and research is focused on follow-up care and screening of infants born to moms who tested positive for Zika.

“UM is in a unique position of having the patient population to conduct research,” said Gonzalez. “The goal is to try to detect signs of abnormalities that might be missed early on. The research will help us contribute to the growing knowledge base of Zika, which will help us develop therapies and fully know the virus’ impact.”

Here are the highlights of a recent interview with Dr. Gonzalez.

Q. What is the mission of the team?

Our goal is to provide the most expert care possible to families that may need assistance, while educating the community about the threat of Zika.

Q. Who is on the team?

We have experienced professionals in high-risk obstetrical care, pediatric infectious diseases, audiology, ophthalmology, endocrinology, neurology and developmental care, and we coordinate with support programs such as Early Steps.

Q. What do you do when a mother tests positive for Zika?

Members of the team, in collaboration with our obstetrics specialists, meet monthly, to discuss each case. We follow both the pregnant women and the infants in utero until birth, and extensively screen the infants after delivery.

Q. What do you do after a baby exposed to Zika is born?

We conduct a comprehensive evaluation, looking at the size of the head, the eyes and ears for evidence of immediate problems. We have eight pediatric subspecialties involved in their care, which may include early intervention with physical therapy, speech or vision. There are definitely eye problems, but we have not found hearing problem yet but continue to screen. We are also screening for other neurodevelopmental problems, as well as the infant’s kidneys for possible renal problems.

Q. Do you continue to follow the mother and infant after birth?

Yes. From the time of birth to one year, we are following the infants every three months, then about every six months until age 3.

Q. What about Zika-positive babies with no obvious problems?

We have a state research grant to follow these infants for three years to be sure that nothing develops later on.  Currently, we are following more than 30 pediatric patients, who are 10 months old or younger.

Q. How do you encourage new mothers to return regularly for follow-up care?

Our team has found an effective way to address that challenge. First of all, we talk with the moms during pregnancy so they get to know us personally.  After the child is born,  we continue to talk with the mothers regularly, asking about their families, and emphasizing the importance of regular follow-up care and examinations. Because they are part of a state-funded research study, the moms receive financial assistance for their participation.

Q. What are the goals of your Zika research?

UM is in a unique position in the U.S. of having a local patient population exposed to the Zika virus. As a result, our team is deeply involved in many different aspects of research  that will contribute to the growing knowledge base of Zika, understand the virus’ impact and help us develop new therapies.

Q. Where are you focusing your pediatric Zika research program?

We are paying particular attention to newborns born to Zika-positive mothers who appear normal at birth. We want to monitor their development and detect possible signs of abnormalities that might be missed early on.

Q. What other research assessments and evaluations are you doing?

We are checking brain wave activity in infants with congenital Zika syndrome, as well as those without evident abnormalities. We are also doing extensive laboratory work to detect blood markers, cardioechograms for possible heart abnormalities, ultrasounds of the eye and hearing tests, along with other general assessments.

Q. What if a mosquito carrying the Zika virus bites a young child?

Because the virus attacks the neurons, it might harm the developing brain of a young child. But we have no evidence of that right now, one way or the other. We also want to be sure a mosquito does not transmit Zika is to older siblings and adults in the family.

Q. How do I get more information about the Zika Response Team?

• Pediatrics: Call 305-243-5437 and ask for Dr. Gonzalez.
• To speak to the Zika Response Team directly call Dr. Gonzalez at 305-243-2700.

UM’s Zika Response Team
Director:
• Ivan Gonzalez, M.D., Assistant Professor of Pediatrics

Other Team Members:
• Charles Bauer, M.D., Professor of Pediatrics, Assoc. Director of Neonatology, and Director, Miami-Dade North Early Steps
• Gary Berkovitz, M.D., Professor of Pediatrics and Director, Pediatric Endocrinology
• Audina Berrocal, M.D., Professor of Clinical Ophthalmology
• Jeffrey Brosco, M.D., Ph.D., Professor of Pediatrics and Associate Director, Mailman Center for Child Development
• Robert C. Fifer, Ph.D., Associate Professor of Pediatrics and Director, Pediatric Audiology & Speech Pathology
• Roberto Lopez-Alberola, M.D., Assistant Professor of Neurology & Pediatrics, and Director, Pediatric Neurology
• Gaurav Saigal, M.D., Professor of Diagnostic Radiology and Director, Pediatric Radiology & Neuroradiology
• Ramzi Younis, M.D.,Professor and Chief of Pediatric Otolaryngology
• Emmalee S. Bandstra, M.D., Professor of Pediatrics, Obstetrics and Gynecology

For additional information, see: http://uhealthsystem.com/zika-virus