Five women who may have been infected with Zika, but were told by D.C. they were healthy, have given birth

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At least one woman with the Zika virus and four others who may have been infected but were mistakenly told last year they were healthy — because of botched tests at a D.C. government lab — have since given birth, according to health-care providers.

There have been no reports of babies born in the District during that time with microcephaly, the extreme neurological disorder associated with Zika that causes a baby’s head to be small.

But Zika can result in other birth defects that may not show up until a year after birth or longer, including hearing loss, irritability, difficulty swallowing, and cognitive, sensory and motor-skill problems. Children born to Zika-infected mothers need to be regularly monitored, health experts say.

The births ensure that it could be years before the full impact of mistakes made at the District’s public-health lab can be tallied.

The D.C. lab erroneously told at least nine pregnant women that they tested negative for Zika between July and December of last year. That’s when a new lab director discovered lab workers had overdiluted a solution used in testing and erred in entering a math formula in a spreadsheet used to calculate results.

The mistakes, first made public Feb. 9, prompted officials to ask the Centers for Disease Control and Prevention and other public-health laboratories to redo more than 400 tests that had been performed at the D.C. lab, including those for nearly 300 pregnant women.

Jennifer Smith, director of the D.C. Department of Forensic Sciences, which oversees the public-health lab, said on Feb. 23 that retesting was about halfway completed and had yielded one case in which Zika had been confirmed and eight others in which results were inconclusive. In those cases, patients had markers that suggested either Zika or a similar virus, such as dengue. Smith told the D.C. Council at the time that she expected retesting to be completed within weeks.

But the department has since declined to provide results of that retesting.

Council member Charles Allen (D-Ward 6), chairman of the public safety committee, said he was briefed Friday morning by Smith, who told him that the number of updated retests that confirmed a Zika infection or were inconclusive was higher than nine. He declined to elaborate, saying it was an unofficial tally and that he was told final numbers would be made public by the health lab in the coming days.

The Washington Post surveyed major health-care providers to see if any had been informed of patients with new test results that differed from their original results.

 Unity Health Care, the city’s largest network of health centers, said it had been informed that six of its patients — all pregnant women — had their results changed upon retesting.

One woman had a confirmed case of a Zika infection, while results from the other five were inconclusive, said Diana Lapp, Unity’s deputy chief medical officer and vice president for medical administration.

The woman with Zika and four of the five others have since given birth, Lapp said.

The District’s public-health lab was one of 45 entities across the country approved to perform one of three tests for Zika.

The District appeared to be the only jurisdiction in the country to have mishandled the test, according to the CDC.

The Centers for Medicare and Medicaid Services (CMS) visited the lab at the end of February to review its operations and investigate how the mistakes were made. It is not clear what kind of disciplinary action regulators may take, if any, as a result of the fumbled virus testing.

Lapp said doctors have been working since they were informed of their patients’ new results, some of which were delivered last week, to locate and meet with the women.

Unity serves a largely low-income community that includes many immigrants.

“Health-care literacy is very low among some of our patients,” Lapp said, “to explain the results, and what they mean, and could mean, and the follow-up testing that’s required is not something that we have wanted to do by phone.”

Unity may also be contending with a problem of undocumented immigrants who are reluctant to be identified and placed in a national registry for tracking future health-care complications related to Zika.

Lapp said doctors are trying the best they can to explain the lab error to patients and prepare them for future testing and uncertainty about the health of their children.

“The amount of follow-up that they are being requested to do is not simple,” she said. “It’s not ‘Okay, you’re born, you’re fine.’ It’s a long road now.”

Lapp and other health-care providers said they were informed last week on a conference call with the D.C. Department of Health that they would be responsible for locating and informing their affected patients, and reporting any issues related to the retesting.

Allen said the responsibility to inform patients should lie with the city’s health officials, not private providers.

“It feels like there should be a higher sense of priority and urgency by [the agencies] to give these women clear information, not just for their own sake but for their children’s,” he said. “It makes me angry.”

Allen said he was told Friday that some of those who were possibly infected now live in Maryland. Lapp said another has since moved to Utah.

Interviews and public documents show that the testing debacle unfolded over a period of months last year during which the D.C. lab was in a state of turmoil — understaffed, lacking permanent leadership, spread thin on competing projects and relying on new employees to test for the emerging public-health threat in Zika.

 

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