Description of 13 Infants Born During October 2015–January 2016 With Congenital Zika Virus Infection Without Microcephaly at Birth — Brazil

Linden, Vanessa van der; Pessoa, André; Dobyns, William B.; Barkovich, A. James; Júnior, Hélio van der Linden; Filho, Epitácio Leite Rolim; Ribeiro, Erlane Marques; Leal, Mariana de Carvalho; Coimbra, P.; Aragão, Máría de Fátima Viana Vasco; Verçosa, Islane; Ventura, Camila V.; Ramos, Regina Coeli Ferreira; Cruz, Danielle Di Cavalcanti Sousa; Cordeiro, Marli Tenório; Mota, Vivian Maria Ribeiro; Dott, Mary; Hillard, Christina; Moore, Cynthia A.

doi:10.15585/mmwr.mm6547e2

Cited by 381 publications

(258 citation statements)

References 10 publications

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“…Although congenital microcephaly has been a hallmark of intrauterine infection by the Zika virus [8], this condition is considered a sign of extensive encephalopathic changes [9]. The absence of microcephaly at birth does not exclude congenital infection by Zika virus [8].…”

Section: Introductionmentioning

confidence: 99%

Chronology of the First Deciduous Tooth Eruption in Brazilian Children with Microcephaly Associated with Zika Virus: A Longitudinal Study

Aguiar

Cavalcanti

Alencar

et al. 2018

Pesqui. bras. odontopediatria clín. integr.

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Objective: To analyze the chronology of first deciduous tooth eruption in children with microcephaly associated with presumed or confirmed Zika virus. Material and Methods: A longitudinal study was developed with 74 children of both sexes. Data on prematurity, gestational age (in weeks), anthropometric characteristics at birth [length (cm), weight (g) and cephalic perimeter (cm)] and dental eruption (chronological age and corrected age for prematurity in months) were collected and presented through descriptive statistics. Data was analyzed using the Statistical Package for Social Sciences. Results: The majority of children were female (54.1%) and 14.9% were born premature. The mean gestational age was 38.2 (± 1.9) weeks, while length, weight and cephalic perimeter at birth were 45.6 (± 3.1) cm, 2750 (± 526.6) and 30 (± 2.3) cm, respectively. The eruption of the first tooth occurred on average at 12.3 (± 3.0) months of chronological age and at 11.1 (± 2.3) months of corrected age. The first erupted teeth were the lower deciduous central incisors (82.4%). The mean age for dental eruption in males was 12.5 months (± 3.0) and in females 12.0 months (± 3.1) among full-term children. For premature infants, the mean corrected age of dental eruption was 11.5 months (± 3.4) for boys and 11 months (± 1.7) for girls. Conclusion: In this group of children with microcephaly, the first tooth to erupt was the lower central incisor around the first year of life. Girls had lower average eruption time when compared to boys in both chronological age and age corrected for prematurity.

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Section: Introductionmentioning

confidence: 99%

Chronology of the First Deciduous Tooth Eruption in Brazilian Children with Microcephaly Associated with Zika Virus: A Longitudinal Study

Aguiar

Cavalcanti

Alencar

et al. 2018

Pesqui. bras. odontopediatria clín. integr.

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“…In 2016, after assessing several cases and reviewing criteria of teratogenesis, ZIKV was confirmed as a new teratogen in humans and responsible for the increase in the number of microcephaly cases in Brazil [3-5]. ZIKV teratogenesis affects mainly the central nervous system (CNS), presenting marked microcephaly with significant craniofacial disproportion, cortical malformations, and intracranial calcifications among other symptoms [4, 6, 7]. Nonetheless, a proportion of babies born with a head circumference within the normal range (> 33 cm for term boys and girls) may present cerebral and neurological abnormalities [8].…”

Section: Congenital Zika Syndromementioning

confidence: 99%

“…There is a peculiar phenotype in affected babies, characterized by severe microcephaly with significant craniofacial disproportion, overlapping sutures, prominent occipital bone, destruction of the cerebral cortex, ventriculomegaly, cerebellar hypoplasia, intracranial calcifications, ophthalmic anomalies, and disorders of neuronal migration, such as lissencephaly and pachygyria. Severe neurological abnormalities and arthrogryposis are consequences of the prenatal cortical destruction [6, 7]. These anomalies are the result of a sequence of events already described as the “Fetal Brain Disruption Sequence” [21], where the sudden destruction of the brain is followed by skull collapse.…”

Section: Zikv Infection During Pregnancy and Its Effectsmentioning

confidence: 99%

“…There is a significant number of children born with a head circumference within the normal range presenting a range of abnormalities, including postnatal microcephaly, brain calcifications, ophthalmic abnormalities, seizures, and other neurological dysfunctions. At the present moment, it is too early to assess cognitive abilities in these children [6, 23, 24]. Adams et al [25], in a study in macaques, have demonstrated that even in the absence of microcephaly, the teratogenic action of ZIKV infection in the fetal brain is substantial and has long-lasting effects.…”

Section: Zikv Infection During Pregnancy and Its Effectsmentioning

confidence: 99%

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Zika Virus as a Possible Risk Factor for Autism Spectrum Disorder: Neuroimmunological Aspects

Vianna

Gomes

Boquett

et al. 2018

Neuroimmunomodulation

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The recent outbreak of the Zika virus (ZIKV) and the discovery that perinatal Zika exposure can lead to the Congenital Zika Syndrome has promoted a call for prevention measures. Due to the increased number of babies born with microcephaly, structural brain abnormalities, and neurological alterations in regions affected by ZIKV, investigations were carried out in order to better understand this process. The maternal immune system directly influences the fetal central nervous system, and complications during pregnancy have been associated with neurodevelopmental disorders. Autism spectrum disorder (ASD), a neurodevelopmental disorder commonly manifested in the first years of life, is a disease with multifactorial etiology and is manifested typically by social and communication impairments, as well as stereotyped behaviors. Brain abnormalities, including both anatomically and functionally, can be observed in this disorder, suggesting delays in neuronal maturation and altered brain connectivity. It is known that some viral congenital infections, such as rubella, and cytomegalovirus can interfere with brain development, being associated with brain calcification, microcephaly, and ASD. Here, we reviewed a range of studies evaluating the aspects concerning brain development, immunological status during pregnancy, and neuroimmunomodulation in congenital viral infections, and we discuss if the fetal brain infection caused by ZIKV could predispose to ASD. Finally, we suggest a mechanism encompassing neurological and immunological pathways that could play a role in the development of ASD in infants after ZIKV infection in pregnancy.

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“…5,6 However, there are also case reports of infants born with normal head circumference who developed postnatal-onset microcephaly following congenital Zika virus infection. 7 The full range of developmental disabilities and other adverse early childhood outcomes associated with congenital Zika virus infection in the United States can only be determined by following up the infants and children as they develop. Understanding what is happening with those infants might have far-reaching implications for other exposed infants whose congenital infection was not identified during pregnancy or at birth.…”

mentioning

confidence: 99%

Birth Defects Potentially Related to Zika Virus Infection During Pregnancy in the United States

Fitzgerald

Boyle

Honein

2018

JAMA

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Zika remains a health threat in the United States, and public health systems are essential to monitoring the full effect of congenital Zika virus infection on infants and children. Because some healthy infants born following pregnancies complicated by Zika may have developmental problems that become evident later, developmental milestones should be closely monitored throughout the child's first years of life.

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Description of 13 Infants Born During October 2015–January 2016 With Congenital Zika Virus Infection Without Microcephaly at Birth — Brazil

Cited by 381 publications

References 10 publications

Chronology of the First Deciduous Tooth Eruption in Brazilian Children with Microcephaly Associated with Zika Virus: A Longitudinal Study

Chronology of the First Deciduous Tooth Eruption in Brazilian Children with Microcephaly Associated with Zika Virus: A Longitudinal Study

Zika Virus as a Possible Risk Factor for Autism Spectrum Disorder: Neuroimmunological Aspects

Birth Defects Potentially Related to Zika Virus Infection During Pregnancy in the United States

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