Dear Editor, Thank you to Wiwanitkit and Wiwanitkit for a thoughtful response to our article, "Addressing the Global Zika Epidemic Locally: An Interprofessional Model of Universal Screening at One Center." We agree that any call to action requires a multidisciplinary approach. Our success in implementing Zika virus screening centered on an existing network of nurses, nurse-practitioners, certified nurse midwives, women's health managers, and obstetricians.

The comment about the potential for false-positive with large-scale screening is timely. Early in the epidemic, the high prevalence of Zika virus infection naturally drove a higher positive predictive value. As the epidemic has thankfully waned, the recommendations of the Centers for Disease Control and Prevention have changed to limit testing to pregnant women with exposure risk who have demonstrated symptoms of Zika virus infection.1 Shared decision-making, incorporating the likelihood of a positive result being a false-positive, should guide decisions surrounding testing for asymptomatic women with Zika virus exposure risk.

Sincerely,

-Rosha Forman, CNM, MSN

Instructor

Boston University School of Medicine

Boston, Massachusetts

-Christina Yarrington, MD

Assistant Professor

Boston University School of Medicine

Boston, Massachusetts

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