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Zika and the Florida Birth Defects Registry (FBDR)

Contact the Florida Birth Defects Registry (FBDR)

  •  850-245-4444

    Mailing Address

    Division of Community Health Promotion - Public Health Research 

    4052 Bald Cypress Way  

    Tallahassee, FL 32399 

Surveillance Activities for Microcephaly and other Zika Related Birth Defects 

Surveillance Activities for Microcephaly and other Zika Related Birth Defects

In 1997, the Florida Legislature provided funding to the Department of Health (DOH) to operate and manage a statewide population-based birth defects registry. Per Section 381.0031(4) Florida Statutes and further specified in Florida Administrative Code 64D-3.041, birth defects are reportable to the Florida Birth Defects Registry (FBDR). In Florida, there are approximately 220,000 live births annually and one out of every 28 babies is born with a major birth defect. The FBDR’s surveillance activities are imperative for tracking birth defect occurrence, coordinating with our partners to develop effective prevention programs, and ensuring families are referred to services.

The Zika virus is a mosquito-borne flavivirus transmitted primarily through the bite of an infected Aedes species mosquito but is also spread through sexual contact, blood transfusions, and from mother to child in utero. In March 2016, the Centers for Disease Control and Prevention issued a Morbidity and Mortality Weekly Report acknowledging the relationship between Zika virus infection in the 1st trimester of pregnancy and increased birth prevalence of severe microcephaly. Microcephaly is a congenital malformation resulting in a smaller than normal head size for the infant’s age and sex. The FBDR collected data passively on microcephaly from 1998 to 2013; but as accuracy and validation studies were published on the diagnosis of microcephaly, it was dropped nationally as a surveillance outcome because the diagnosis approach was deemed inaccurate. During this period of surveillance, the prevalence of microcephaly was 6.8 per 10,000 live births or approximately 1 in 1,500 live births.

On February 3, 2016, the Governor of Florida declared a public health emergency, Executive Order No: 16-29, which prompted the activation of Florida DOH’s Incident Command System to control Zika virus through mosquito control efforts and respond to possible outbreaks of Zika virus disease. Following the Executive Order, the FBDR increased their capacity for a rapid, population-based, Zika related birth defects surveillance system through a two-pronged approach using an active case-finding methodology with standard case definitions. The FBDR began in-depth medical record abstractions of infants born with possible microcephaly and other associated central nervous system conditions to investigate and better understand possible causes, evaluate the accuracy of International Classification of Diseases, ninth edition, Clinical Modification (ICD-9-CM) and ICD-10-CM codes used in the FBDR’s passive surveillance system, and provide a baseline for comparison. The second strategy is a prospective surveillance study of pregnant women with laboratory evidence of Zika virus infection to further understand the impact of Zika virus on Florida communities, develop population-level prevention strategies, as well as assess and improve referral services for affected families. For both surveillance strategies, medical record data is abstracted from maternal and infant medical records including pre-natal care, birth information, and infant follow-ups through age one. The FBDR, in collaboration with the Bureau of Epidemiology, reports data to the U.S. Zika Pregnancy Registry and the U.S. Zika Birth Defects Surveillance Task Force.

For current case counts and more information on Zika virus in Florida please visit

Approximate number of hospital admissions reviewed for lab evidence of Zika virus infection with a birth outcome in Florida between January 1, 2016- March 31, 2018

2016: (202) 2017: (241) 2018: (22)


Approximate number of hospital admissions reviewed with an ICD code at discharge for microcephaly and other central nervous system malformations between January 1, 2016- March 31, 2018

2016: (5,705) 2017: (2,884) 2018: (32)


*Updated 5/1/2018   

*FBDR case counts are based on birth outcome date