Antonio Augusto Moura da SilvaComments to Author , Jucelia Sousa Santos Ganz, Patricia da Silva Sousa, Maria Juliana Carvalho Doriqui, Marizelia Rodrigues Costa Ribeiro, Maria dos Remédios Freitas Carvalho Branco, Rejane Christine de Sousa Queiroz, Maria de Jesus Torres Pacheco, Flavia Regina Vieira da Costa, Francelena de Sousa Silva, Vanda Maria Ferreira Simões, Marcos Antonio Barbosa Pacheco, Fernando Lamy-Filho, Zeni Carvalho Lamy, and Maria Teresa Seabra Soares de Britto e Alves. Early growth and neurologic outcomes of infants with probable congenital Zika virus syndrome. Emerging infectious diseases. Volume 22, Number 11—November 2016.
We report the early growth and neurologic findings of 48 infants in Brazil diagnosed with probable congenital Zika virus syndrome and followed to age 1–8 months. Most of these infants had microcephaly (86.7%) and craniofacial disproportion (95.8%). The clinical pattern included poor head growth with increasingly negative z-scores, pyramidal/extrapyramidal symptoms, and epilepsy.
"These babies do not catch up as they grow," says Dr. Antonio Augusto Moura da Silva of the Federal University of Maranhao, Sao Luis, Brazil.
He's describing the findings from a study of 48 babies whose mothers were believed to have been infected with the Zika virus. Forty-two of the children were diagnosed with microcephaly. The study, on the early neurological growth pattern of the infants, will be published in the journal Emerging Infectious Diseases in November but was released early online.
The infants were studied for about four months and up to 8 months of age. Born below average on measures of weight, length and head circumference, they fell even further below average as time passed.
"As they grow, they get worse, and we would expect that they will continue to fall further behind," says da Silva, who was part of the research team. "We were expecting some degree of falling behind average, but we were astonished by the degree to which they were lagging behind."
Even when babies exposed to the Zika virus in the uterus are born with normal-size heads, they might suffer other forms of brain damage. In fact, da Silva says, six of the Zika-infected babies in the study did not have microcephaly. And yet, when examined with electroencephalographs to measure brain activity, they showed evidence of brain damage that caused problems including seizures and involuntary muscle movements.
Most of the mothers of the 48 babies were thought to be infected with Zika during the first trimester of their pregnancy. And because the babies were enrolled at a regional center that assists children with neurological disorders, their symptoms may be among the most severe. Some questions are still unanswered, da Silva says: If an infant is infected after birth, is the virus still able to damage the baby's brain? And what will be the long-term consequences for infants born with less severe cases of microcephaly? "So far, we've studied only the tip of the iceberg," da Silva says.
Courtesy of Doximity