Association and birth prevalence of microcephaly attributable to Zika virus infection among infants in Paraíba, Brazil, in 2015–16: a case-control study

Krow-Lucal, Elisabeth; Andrade, Marcia Regina de; Cananéa, Juliana Nunes Abath; Moore, Cynthia A.; Leite, Priscila Leal e; Biggerstaff, Brad J.; Cabral, Cibelle Mendes; Itoh, Megumi; Pércio, Jadher; Wada, Marcelo Yoshito; Powers, Ann M.; Barbosa, Aristides; Abath, Roberta Batista; Staples, J. Erin; Coelho, Giovanini Evelim; Araújo, Emerson Luiz Lima; Medeiros, Eva Lídia Arcoverde; Carvalho, Jonas Lotufo Brant de; Cerroni, Matheus de Paula; Beltrão, Henrique de Barros Moreira; Fantinato, Francieli Fontana Sutile Tardetti; Lise, Michael Laurence Zini; Ohara, Patrícia Miyuki; Resende, Elionardo; Saad, Eduardo; Maurice, Annabelle de St; Dieke, Ada; Harrist, Alexia; Kwit, Natalie; Marlow, Mariel; Soke, Gnakub N.; Pessoa, Roseanne de Arruda; Silva, Renata Candido da; Diniz, Rogéria Chelly; Ariette, Micheline César de Araújo; Lira, Clarice França; Matos, Sandra Regina; Wanderley, Taciana Mendonça Maia; Silva, Vanessa Oliveira Costa; Silva, Hélio Soares da; Carmo, Eduardo Hage; Carvalho, Myrian Kathleen Toscano de; Lentini, Nena; Miranda, Raquel Sales; Boland, Erin; Burns, Paul; Fischer, Marc; Ledermann, Jeremy P.; Coronado, Fátima; Dicent-Taillepierre, Julio; Flannery, Brendan; Oliveira, Alexandre Macedo de; Arena, J. Fernando

doi:10.1016/s2352-4642(18)30020-8

Cited by 62 publications

(94 citation statements)

References 21 publications

(25 reference statements)

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“…Mlakar et al (2016) identified ZIKV in the brain tissue of a severe microcephalic stillbirth whose mother had been infected with ZIKV in Brazil. This report was one of first to propose the possibility of an association between ZIKV and microcephaly, which was later confirmed by case-control studies with Brazilian newborns (MERG Group 2016;Cordeiro et al 2016;Brasil et al 2016;Krow-Lucal et al 2018).…”

Section: Introductionsupporting

confidence: 53%

Hypothetical Human Immune Genome Complex Gradient May Help to Explain the Congenital Zika Symdrome Catastrophe in Brazil: A New Theory

Oliveira

Bresani-Salvi

Morais

et al. 2020

Preprint

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There are few data considering human genetics as an important risk factor for birth abnormalities related to ZIKV infection during pregnancy, even though sub-Saharan African populations are apparently more resistant to CZS as compared to populations in the Americas.We hypothesized that single nucleotide variants (SNVs), especially in innate immune genes, could make some populations more susceptible to Zika congenital complications than others.Differences in the SNV frequencies among continental populations provide great potential for Machine Learning techniques. We explored a key immune genomic gradient between individuals from Africa, Asia and Latin America, working with complex signatures, using 297SNVs. We employed a two-step approach. In the first step, decision trees (DTs) were used to extract the most discriminating SNVs among populations. In the second step, machine learning algorithms were used to evaluate the quality of the SNV pool identified in step one for discriminating between individuals from sub-Saharan African and Latin-American populations.Our results suggest that 10 SNVs from 10 genes (CLEC4M, CD58, OAS2, CD80, VEPH1, CTLA4, CD274, CD209, PLAAT4, CREB3L1) were able to discriminate sub-Saharan Africans from Latin American populations using only immune genome data, with an accuracy close to 100%.Moreover, we found that these SNVs form a genome gradient across the three main continental populations. These SNVs are important elements of the innate immune system and in the response against viruses. Our data support the Human Immune Genome Complex Gradient hypothesis as a new theory that may help to explain the CZS catastrophe in Brazil.

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Section: Introductionsupporting

confidence: 53%

Hypothetical Human Immune Genome Complex Gradient May Help to Explain the Congenital Zika Symdrome Catastrophe in Brazil: A New Theory

Oliveira

Bresani-Salvi

Morais

et al. 2020

Preprint

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“…Microcephaly is challenging to monitor accurately as an outcome because it is difficult to reliably measure head circumference in a newborn, it can be affected by inaccuracies in estimated gestational age, and it does not distinguish between a small head size related to underlying pathology and one that will subsequently exhibit typical brain development ( 3 ). The sensitivity analysis suggests that the number of infants with Zika-associated birth defects could be a modest overestimate.…”

Section: Conclusion and Commentsmentioning

confidence: 99%

Vital Signs:Zika-Associated Birth Defects and Neurodevelopmental Abnormalities Possibly Associated with Congenital Zika Virus Infection — U.S. Territories and Freely Associated States, 2018

Rice¹,

Galang²,

Roth³

et al. 2018

MMWR Morb. Mortal. Wkly. Rep.

190

237

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IntroductionZika virus infection during pregnancy causes serious birth defects and might be associated with neurodevelopmental abnormalities in children. Early identification of and intervention for neurodevelopmental problems can improve cognitive, social, and behavioral functioning.MethodsPregnancies with laboratory evidence of confirmed or possible Zika virus infection and infants resulting from these pregnancies are included in the U.S. Zika Pregnancy and Infant Registry (USZPIR) and followed through active surveillance methods. This report includes data on children aged ≥1 year born in U.S. territories and freely associated states. Receipt of reported follow-up care was assessed, and data were reviewed to identify Zika-associated birth defects and neurodevelopmental abnormalities possibly associated with congenital Zika virus infection.ResultsAmong 1,450 children of mothers with laboratory evidence of confirmed or possible Zika virus infection during pregnancy and with reported follow-up care, 76% had developmental screening or evaluation, 60% had postnatal neuroimaging, 48% had automated auditory brainstem response-based hearing screen or evaluation, and 36% had an ophthalmologic evaluation. Among evaluated children, 6% had at least one Zika-associated birth defect identified, 9% had at least one neurodevelopmental abnormality possibly associated with congenital Zika virus infection identified, and 1% had both.ConclusionOne in seven evaluated children had a Zika-associated birth defect, a neurodevelopmental abnormality possibly associated with congenital Zika virus infection, or both reported to the USZPIR. Given that most children did not have evidence of all recommended evaluations, additional anomalies might not have been identified. Careful monitoring and evaluation of children born to mothers with evidence of Zika virus infection during pregnancy is essential for ensuring early detection of possible disabilities and early referral to intervention services.

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“…Evidence strongly supports a link between ZIKV infection and observed neurological complications 11, 12…”

Section: Discussionmentioning

confidence: 85%

Congenital Zika syndrome phenotype in a child born in Brazil in December 2011

Coelho

Silva²,

Pinho³

et al. 2018

Clinical Case Reports

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Association and birth prevalence of microcephaly attributable to Zika virus infection among infants in Paraíba, Brazil, in 2015–16: a case-control study

Abstract: Centers for Disease Control and Prevention.

Cited by 62 publications

References 21 publications

Hypothetical Human Immune Genome Complex Gradient May Help to Explain the Congenital Zika Symdrome Catastrophe in Brazil: A New Theory

Hypothetical Human Immune Genome Complex Gradient May Help to Explain the Congenital Zika Symdrome Catastrophe in Brazil: A New Theory

Vital Signs:Zika-Associated Birth Defects and Neurodevelopmental Abnormalities Possibly Associated with Congenital Zika Virus Infection — U.S. Territories and Freely Associated States, 2018

Congenital Zika syndrome phenotype in a child born in Brazil in December 2011

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