ISDS Annual Conference Proceedings 2017. This is an Open Access article distributed under the terms of the Creative Commons Attribution-
Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution,  
and reproduction in any medium, provided the original work is properly cited.

ISDS 2016 Conference Abstracts

Pregnant women with suspected Zika virus infection: 
A claims data analysis
Silvia Valkova*
Government Solutions, IMS Health, Plymouth Meeting, PA, USA

Objective
Demonstrate the value of consolidated claims data from community 

healthcare providers in Zika Virus Disease surveillance at local level.

Introduction
Zika virus disease and Zika virus congenital infection are 

nationally notifiable conditions that became prominent recently as a 
growing number of travel-associated infections have been identified 
in the United States. The Centers for Disease Control and Prevention 
(CDC) have dedicated significant time and effort on determining and 
addressing the risks and impact of Zika on pregnant women and their 
babies who are most vulnerable to the disease. CDC relies on two 
sources of information, reported voluntarily by healthcare providers, 
to monitor Zika virus disease: ArboNET and the newly established 
U.S. Zika Pregnancy Registry. A study by IMS Health compared U.S. 
trends of the Zika virus disease in general and pregnant women with 
Zika virus disease in particular observed in an IMS healthcare claims 
database and the CDC ArboNET and the newly established U.S. Zika 
Pregnancy Registry.

Methods
IMS used for this analysis claims for reimbursement from office-

based healthcare providers, which are widely accepted standard 
business practice records throughout the healthcare industry. IMS 
claims data is collected daily from office-based providers throughout 
the U.S. and processed, stored and analyzed in a centralized database. 
The information is available at the patient and visit level, with the 
ability to characterize deidentified patients by age, gender and 
ZIP3 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 the 
continental United States covered in claims between October 1, 2016 
and May 24, 2016 with ICD 10 diagnosis code A92.8, Other Specified 
Mosquito-Borne Viral Fevers. This sample was compared to the 
sample of laboratory-confirmed Zika virus disease cases reported 
to ArboNET by state or territory from the CDC Arboviral Disease 
Branch from January 1, 2015 through May 18, 2016. In addition, 
IMS compared the subset of patients with both a Zika virus disease 
diagnosis and any ICD 10 pregnancy diagnosis to the CDC sample 
of patients captured by the U.S. Zika Pregnancy Registry with any 
laboratory evidence of possible Zika virus infection in the United 
States and territories.

Results
Throughout the continental United States, the IMS claims-based 

sample captured 875 patients with a Zika virus disease diagnosis 
compared to 548 travel-associated cases reported by CDC. At the 
state level, especially in New York, New Jersey, Illinois and Texas, 
the IMS data captured a much larger number of cases that the CDC 
reported cases. Most of these possible Zika cases are concentrated 
in the large metropolitan areas around New York City, Chicago 
and Houston. Many of them are diagnosed and treated by the same 
healthcare providers.

The IMS sample captured 577 pregnant women with a possible 
Zika virus infection compared to the 168 pregnant women with a 

possible Zika virus infection reported in the U.S. Zika Pregnancy 
Registry as of May 24, 2016. Many of the pregnant women in the IMS 
sample had multiple visits, often in consecutive months, associated 
with the Zika virus disease diagnosis. Pregnant women are more 
likely to be tested and diagnosed with a Zika virus infection due to 
the risk of fetal malformations from the disease. As many as 250 of 
the 577 pregnant women with a possible Zika virus infection also had 
a diagnosis of suspected fetal damage due to a viral disease. Of all 
women with a possible Zika virus infection in the IMS sample, 120 
were in New Jersey, 111 in New York, 93 in Illinois and 74 in Texas, 
and most were concentrated in the large metropolitan areas around 
New York City, Chicago and Houston.

Conclusions
These findings suggest that all-payer claims data can be used 

succesfully to monitor Zika transmission trends at local and state 
level, especially with a focus on pregnant women. Healthcare claims 
data is fast, granular, relevant at local level and can be used to 
supplement CDC ArboNET data for local and state level surveillance 
and response to the evolving Zika virus infection outbreak. This 
study is an example of a novel approach to surveillance for Zika virus 
disease and potentially many other infectious diseases.

Keywords
Zika; pregnancy; local signal

*Silvia Valkova
E-mail: svalkova@us.imshealth.com

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 9(1):e49, 2017