(CNSNews.com) – Rear Adm. Anne Schuchat, M.D., principal deputy director of the Centers for Disease Control and Prevention (CDC) testified in a Senate hearing Wednesday on preparing for and preventing the Zika virus that “it’s too soon for us to have a very confident set of information to counsel women with about just what to expect and how to plan” for possible birth defects such as microcephaly.
Sen. Tom Carper (D-Del.) asked Schuchat, “Where is the intersection between Zika, microcephaly, a woman’s right to have an abortion, when we have the ability to determine that the fetus is going to be, child is going to maybe someday may be severely damaged?”
Carper had mentioned earlier that he’d heard the lifetime cost per child of raising a child with microcephaly was $10 million - something CDC Director Tom Frieden had also said in March.
“You know we’re really at the beginning of understanding Zika in pregnancy,” Schuchat stressed in her response. “We don’t know, if a woman has laboratory-confirmed Zika in pregnancy, exactly what that means for her and her baby. You know with something like a Down Syndrome test or some of the genetic testing that’s done, there’s a lot of science behind the counseling that goes on with the family about what that means for the pregnancy, but with Zika we really don’t know.”
“We don’t know that a child is going to be born with microcephaly until the child is born - the delivery?” Carper asked.
“The clinicians will do serial ultrasounds to see whether it looks like the brain is developing okay or whether there are calcifications or some other warning signs, and we don’t have a big enough experience to know how predictive the findings are,” Schuchat replied.
“We’ve had examples where the ultrasounds were looking okay but the baby wasn’t okay and others where there seemed to be problems and then the baby turned out to be okay,” she explained. “I think it’s too soon for us to have a very confident set of information to counsel women with about just what to expect and how to plan.”
Col. Christopher Zahn, M.D., vice president of practice activities for the American College of Obstetricians and Gynecologists, also weighed in on Carper’s question.
Zahn largely agreed with Schuchat, saying, “The only thing we really have once a woman tests positive to determine what her outcome might-- the fetal outcome might be is following with ultrasound, and certainly, there are severe outcomes that may develop, and those are - I shouldn’t say obvious but - relatively obvious and should be apparent for counseling.
“Other times, it’s a little bit more subtle and it may not really show the effects until after birth and furthermore as was mentioned earlier we don’t know if the virus will continue to attack the brain neurons, the nerve cells even beyond birth and what the impact of that might be,” he said.
Zahn added that “what really becomes challenging, because we don’t have a confirmatory test to know if the fetus is going to be clearly affected and to what degree, the ultrasounds add time.”
“For example, a woman travels and gets infected in her first trimester, 10 or 11 weeks gestation. She tests positive within a few weeks after, and then we start the ultrasounds. She may not show a severe effect in the brain until maybe in her late, 20, 30 weeks or even further along, so now she’s faced with being in the third trimester seven months approximately along with this - what do I do,” he explained.
“You can imagine the psychological stress that that creates and the anxiety, so it’s really unfortunate that again even with the testing that we do have knowing whether or not the fetus will be affected and to what degree is very challenging,” Zahn concluded.