Bridging Knowledge Gaps to Understand How Zika Virus (ZIKV) Exposure and Infection Affect Child Development

September 22-23, 2016

Sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) and the Office of Research on Women's Health (ORWH)

Meeting Goals:

Develop a research strategy to improve assessment, evaluation, and monitoring of the neonate/infant/child affected by ZIKV in utero based on available clinical guidelines
Identify research strategies to improve evaluation for new/emerging complications of in utero ZIKV exposure and infection and to understand the prospective impact of these complications on the developing child

e.g. subtle or absent neurologic abnormalities in asymptomatic neonates who later develop seizures, cognitive impairment and abnormal behavioral development; non-CNS abnormalities such as those affecting endocrine, cardiac, GI and GU systems

Use available information from other vertically transmitted pathogens to provide recommendations for assessment, evaluation, and management
Outline the research needs for treatment and rehabilitation approaches that optimize cognitive and physical function for Zika-affected children
Evaluate and expand on treatment options currently offered, such as intensive physical therapy and immersion therapies, role of parents and caregivers in treatments, including the evidence base for these therapies and current research gaps

September 22, 2016

8:30–9:00 am	Registration
Session I	Statement of the Problem	Moderator: Nahida Chakhtoura, M.D. Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Bethesda, MD
9:00-9:15	Statement of the problem, including ZIKV epidemiology and transmission dynamics, incidence and prevalence of congenital ZIKV infection and rationale for focus on children	Catherine Y. Spong, M.D. Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Bethesda, MD
9:15-9:30	State of the science on diagnostics, therapeutics and vaccines	Anthony Fauci, M.D. National Institute of Allergy and Infectious Diseases (NIAID) Bethesda, MD
9:30-10:15	Clinical manifestations and complications of congenital ZIKV infection in Brazilian infants and the evaluation, monitoring, and treatment currently used	Vanessa Van der Linden, M.D. Association for Assistance of Disabled Children Recife, Brazil
10:15-10:45	Break	Discussion Alison Cernich National Center for Medical Rehabilitation Research (NCMRR), NICHD, NIH, HHS
10:45-11:30	Case examples of infants exposed to ZIKV	Carmen Zorrilla, M.D. University of Puerto Rico San Juan, PR
Session II	Impact on the Child	Moderator: Bill Kapogiannis, M.D. Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Bethesda, MD
	Overarching questions: How can the management of and interventions for other congenital syndromes be useful to that in ZIKV infection? What knowledge gaps remain? What are the assessments needed and how often? What is the role of parents and caregivers in interventions and what can be done to improve their involvement? What is the evidence (and gaps) for specific therapies?
11:30 am-12:15 pm	Other congenital infections with neurodevelopmental consequences	William Britt, M.D. University of Alabama at Birmingham Birmingham, AL
12:15-1:15	Lunch
1:15-2:00	Microcephaly and other brain abnormalities	Sonja Rasmussen, M.D. Centers for Disease Control and Prevention (CDC) Atlanta, GA
2:00-2:30	Panel discussion of overarching questions Panel participants: Vanessa Van der Linden, M.D. Carmen Zorrilla, M.D. William Britt, M.D. Sonja Rasmussen, M.D. Phil Heine, M.D.	Moderator: Jeanne Sheffield, M.D. Johns Hopkins Medicine Baltimore, MD
2:30-3:00	Break
3:00-3:45	Neurologic abnormalities (seizures, etc.)	Steven Miller, M.D. Hospital for Sick Children Toronto, Canada
3:45-4:30	Screening and monitoring for neurobehavioral and neurodevelopmental abnormalities	Chandy John, M.D. Indiana University Indianapolis, IN
4:30-5:00	Panel discussion of overarching questions Panel participants: Steven Miller, M.D. Chandy John, M.D. Melissa Parisi, M.D., Ph.D. Betty Vohr, M.D. Charles Nelson, III, Ph.D.	Moderator: Adam Hartman, M.D. National Institute of Neurological Disorders and Stroke (NINDS) Bethesda, MD

September 23, 2016

Session II cont'd	Impact on the Child	Moderator: Bill Kapogiannis, M.D. Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Bethesda, MD
8:00-8:45 am	Screening and monitoring for sensory outcomes (hearing, etc.)	Betty Vohr, M.D. Brown University Providence, RI
8:45-9:30	Ophthalmologic abnormalities (chorioretinal scar, optic disk hypoplasia, optic nerve problems, etc.)	Camila Ventura, M.D. Bascom Palmer Eye Institute Miami, FL
9:30-10:15	Screening and monitoring for other abnormalities (cardiac, GI, GU, endocrine)	Sandra Mattos, M.D. Royal Portuguese Hospital Recife, Brazil
10:15-10:45	Break
10:45-11:30	Screening, monitoring, therapies for motor outcomes/limb abnormalities (hypertonia, arthrogryposis, etc)	Vanessa Van der Linden, M.D.
11:30 am-12:00 pm	Panel discussion of overarching questions Panel participants: Betty Vohr, M.D. Camila Ventura, M.D. Sandra Mattos, M.D. Vanessa Van der Linden, M.D.	Moderator: Lillian Shum, Ph.D. National Institute of Dental and Craniofacial Research (NIDCR) Bethesda, MD
12:00-1:00	Lunch
Session III	Opportunities	Moderator: Alison Cernich, Ph.D., Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Bethesda, MD
1:00-1:30	Role of parents and caregivers in interventions What is the role of parents and caregivers in interventions and what can be done to improve their involvement? How is the parent-child dyad affected by Zika infection? What role is there for preventive mental health interventions for new mothers and/ or pregnant women diagnosed with Zika infection? What lessons can be learned from other chronic childhood diseases (e.g. CMV, HIV, etc.) to optimize a medical home for ZIKV affected children?
1:00-1:10	Overview	Len Abbeduto, Ph.D. University of California Davis, CA
1:10-1:30	Panel discussion of questions on parent and caregiver interventions Panel participants: Sandra Mattos, M.D. Carmen Zorrilla, M.D. Vanessa Van der Linden, M.D. Jeanne Sheffield, M.D.	Moderator: Len Abbeduto, Ph.D.
1:30-2:15	Panel discussion of research gaps Panel participants: Jeanne Sheffield, M.D. Adam Hartman, M.D. Lillian Shum, Ph.D. Len Abbeduto, Ph.D.	Moderator: Melissa Parisi, M.D., Ph.D. National Institute of Child Health and Human Development (NICHD) Bethesda, MD
2:15-2:45	Professional society discussion: What research is needed to better inform practice recommendations? Panel participants: Phil Heine, M.D. Mary Norton, M.D. Fan Tait, M.D.	Moderator: Rohan Hazra, M.D. National Institute of Child Health and Human Development (NICHD) Bethesda, MD
2:45-3:00	Closing remarks	Catherine Y. Spong, M.D.

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