Last year, however, concerns about the virus skyrocketed following the link between Zika virus
infection with microcephaly in Brazil.
Not exact matches
This appears to be the first US case of a baby born
with microcephaly, a condition in which the brain is abnormally small, after having a Zika
infection.
After taking samples and conducting brain scans, the researchers found that 41 percent of mothers of babies
with microcephaly tested positive for Zika
infection in blood or cerebrospinal fluid samples, compared
with none of those whose babies did not have
microcephaly.
Earlier on Friday, U.S. health officials published a study estimating that as many as 270 babies in Puerto Rico may be born
with the severe birth defect known as
microcephaly caused by Zika
infections in their mothers during pregnancy.
As most studies have only carefully examined infants
with presumed or confirmed congenital ZIKV
infection who have
microcephaly, more studies are needed to understand ocular findings in those infants
with congenital ZIKV
infection without
microcephaly.
Other
infections also can cause
microcephaly; in fact, out of 121 infants tested for other pathogens, 26 had evidence of
infection with either toxoplasmosis, herpes simplex, cytomegalovirus, and syphilis.
One in 150 babies in the U.S. is born
with a congenital CMV
infection, and of those, one in five suffers from complications, according to the CDC, which can include including hearing loss, vision loss, cerebral palsy, cognitive impairments and
microcephaly.
An association between Zika
infections during pregnancy and the birth of babies
with microcephaly (a birth defect in which an infant's brain does not develop properly resulting in a smaller than normal head) was first suggested by Brazilian physicians in August 2015, and in November
microcephaly cases potentially associated
with Zika started to be recorded; three months later WHO made its announcement.
The
infection has been linked to
microcephaly, a condition in which infants are born
with unusually small heads and brain damage.
«As we learn more about the consequences of Zika
infection, including the recent revelation that babies of Zika - infected mothers who had normal head sizes at birth have been diagnosed
with microcephaly months later, it is vital that we know this enemy and remain vigilant in protecting ourselves,» Diaz concludes.
To build their tool, Alison Galvani, from Yale University in New Haven, USA, and colleagues focused on the two known serious consequences of Zika
infection:
microcephaly, a condition in which children are born
with a small brain causing mental impairment, and Guillain - Barré syndrome or GBS, a potentially fatal disease that can cause neural damage and paralysis.
Even as the Zika virus becomes more prevalent — the Centers for Disease Control reports that the number of U.S. infants born
with microcephaly and other birth defects is 20 times over the normal rate — researchers are still trying to fully pin down the identifying consequences of the viral
infection.
The physical characteristic most associated
with Zika
infection is
microcephaly, a birth defect in which the baby's brain does not develop properly resulting in a smaller than normal head.
In humans, Zika virus
infection during pregnancy has been linked to a suite of birth defects including a condition known as
microcephaly, which leaves babies
with shrunken heads and brains (SN: 4/2/16, p. 26).
Data from the Brazilian metropolis have confirmed this suspicion and, together
with other studies, enable the researchers to estimate the absolute risk of
microcephaly upon
infection of the mother during pregnancy: approximately one out of 100 mothers infected during early pregnancy will bear a child
with microcephaly.
«The increased number of newborns
with microcephaly observed during the Zika outbreak in Brazil is linked to Zika
infection of the mother during early pregnancy,» explains Drexler.
The U.S. Centers for Disease Control and Prevention recently concluded that Zika virus
infection in pregnant women can stunt neonatal brain development, leading to babies born
with abnormally small heads, a condition known as
microcephaly.
Petersen's remarks were among the strongest suggestions yet from a top CDC scientist that Zika
infection during pregnancy can — at least in some cases — cause
microcephaly, a condition in which infants are born
with abnormally small heads and possibly brain damage.
«What we show is the first piece of evidence» consistent
with the hypothesis that Zika
infections cause
microcephaly, said Hengli Tang, a virologist at Florida State University and another lead author.
«In addition to
microcephaly,
infection with Zika virus in adults can lead to destruction of myelin, a mixture of proteins and fatty substances that insulate nerves to speed electrical communication between neurons, a condition called Guillain - Barre syndrome.»
The report demonstrates phenotypic variability in regard to the presence of observed
microcephaly as well as the degree of brain damage and affected brain structures
with congenital ZIKV
infection.
Based on that, we recommend using the term congenital Zika syndrome instead of
microcephaly associated
with Zika virus
infection, which involves a spectrum of changes, including other neurological and fetal development manifestations.
In addition, the mechanism by which the ZIKV
infection can cause fetal brain damage is not known, and some reports suggest that the virus is able to evade the normal immunoprotective responses of the placenta.15 Zika virus is not the only pathogen associated
with neonate
microcephaly.
In the recent case series, most infants
with probable congenital ZIKV
infection were noted to have craniofacial disproportion (95.8 %) and, to a lesser degree, biparietal depression (83.3 %), prominent occiput (75 %), and excess nuchal skin (47.9 %).38 Features supportive of the FBDS phenotype scattered through published reports include redundant scalp, 27,36,39,41 occipital prominence and / or overlapping sutures,14,20,22 - 24, 26,27,38 and typical craniofacial appearance
with disproportion.13, 27,33,34,40 The FBDS phenotype is also prevalent in ZIKV - related media.47 Among infants
with severe
microcephaly, the pattern appears to be consistent, although the degree of cranial vault deformation varies.
The 3 largest case series of infants
with microcephaly also reporting congenital contractures found that, among 35, 48, and 52 infants
with microcephaly and presumed congenital ZIKV
infection, isolated clubfoot occurred in 14 %, 10.4 %, and 3.8 % and arthrogryposis in 11 %, 10.4 %, and 5.7 %, respectively.36 - 38 Among a series of 104 infants under clinical investigation, 7 (6.7 %)
with presumed (5 infants) and laboratory - confirmed (2 infants) congenital ZIKV
infection had arthrogryposis; 6 of these infants had a head circumference of at least 2 SD below the mean.41 All had bilateral congenital hip dislocation, which previously has been reported to occur in 30 % to 40 % of children
with arthrogryposis of various etiologies and 3 of 7 had dislocation or partial dislocation of 1 or both knees.41, 57
Structural eye anomalies (in particular, microphthalmia and coloboma), cataracts, intraocular calcifications, and posterior ocular findings have been reported in infants
with presumed and laboratory - confirmed prenatal ZIKV
infection; however, posterior findings have been the most prevalent.21,25,28,33,35,36,41 - 43 Case series report chorioretinal atrophy, focal pigmentary mottling of the retina, and optic nerve atrophy / anomalies.28, 34,37,41 - 43,55 Series of 20 or more infants
with presumed ZIKV - associated
microcephaly report ocular findings in 24 % to 55 %.28, 33,42 In one study, testing for ZIKV IgM was performed in 24 of 40 infants (60 %)
with microcephaly and the results were positive in the cerebrospinal fluid in 100 % of those tested.42 The proportion of infants
with ocular lesions did not differ in those
with and without testing.42 In that series, first trimester maternal
infection and smaller head circumference significantly correlated
with the presence of abnormal ocular findings.42
Recife is experiencing an outbreak of ZIKV
infection as well as an increase in the number of newborns
with microcephaly.
Contracted through the bite of an infected mosquito or through sexual or other modes of transmission, Zika virus (ZIKV)
infection can be prenatally passed from mother to fetus.1 The virus was first identified in the region of the Americas in early 2015, when local transmission was reported in Brazil.2 Six months later, a notable increase in the number of infants
with congenital
microcephaly was observed in northeast Brazil.3, 4 Clinical, epidemiologic, and laboratory evidence led investigators to conclude that intrauterine ZIKV
infection was a cause of
microcephaly and serious brain anomalies.5 - 7 However, as
with other newly recognized teratogens, these features likely represent a portion of a broader spectrum.
Objective To evaluate the ocular findings in infants
with microcephaly associated
with presumed intrauterine ZIKV
infection in Salvador, Bahia, Brazil.
Although many of the components of this syndrome, such as cognitive, sensory, and motor disabilities, are shared by other congenital
infections, 5 features differentiate CZS from other congenital
infections: (1) severe
microcephaly with partially collapsed skull; (2) thin cerebral cortices
with subcortical calcifications; (3) macular scarring and focal pigmentary retinal mottling; (4) congenital contractures; and (5) marked early hypertonia
with symptoms of extrapyramidal involvement (Table).
To evaluate the ocular findings in infants
with microcephaly associated
with presumed intrauterine ZIKV
infection in Salvador, Bahia, Brazil.
The FBDS phenotype has been reported in an infant
with laboratory - confirmed ZIKV
infection, 13 in a neuroimaging report documenting cranial bone collapse in infants born to mothers
with suspected ZIKV
infection during pregnancy, 14 and a recent case series of infants
with probable ZIKV - associated
microcephaly.38 In 3 of the largest case series reporting 35, 48, and 104 infants primarily
with suspected congenital ZIKV
infection, 33,37,38 approximately two - thirds of infants had severe
microcephaly.
The included birth defects were based primarily on case reports of outcomes occurring in association
with Zika virus
infection during pregnancy; there is more evidence for some of these birth defects than for others, and a causal link has not been established for all.5,10,12,21 - 27 Because much of the focus to date has been on
microcephaly and brain abnormalities, data were summarized in 2 mutually exclusive categories: (1) brain abnormalities
with or without
microcephaly regardless of the presence of additional birth defects and (2) neural tube defects and other early brain malformations, eye abnormalities, and other consequences of central nervous system dysfunction among those without evident brain abnormalities or
microcephaly.
The central nervous system damage seen
with prenatal ZIKV
infection is likely due to direct cellular injury, as ZIKV RNA15, 17,32 and live virus15 have been identified in the brain tissue of infants
with microcephaly.
Other congenital
infections are known to cause hearing problems, but this is one of the first times its been documented among children
with Zika - related
microcephaly.
The researchers add that it's possible some children born
with Zika
infections but without
microcephaly could also be at risk for hearing problems, though this has not yet been determined.
To see the alternative story about Zika
infections, Mike Adams, the Health Ranger, did some studies on Brazilian populations
with a high incidence of
microcephaly and did find that the incidences of
microcephaly corresponded more
with environmental toxins.