ika virus (ZIKV) is now established among the growing list of infectious agents known to cause congenital malformations in the developing fetus during pregnancy, and as ZIKV continues to spread to areas with competent vectors, the World Health Organization continues to recommend high vigilance. 1 Since ZIKV infection surfaced in Brazil during early 2015, 2 more than 70 countries have reported evidence of ZIKV transmission, and 20 countries have cumulatively reported more than 2000 newborns with microcephaly and other brain abnormalities either possibly associated with ZIKV infection or described as congenital Zika syndrome. The vast majority of these reported cases have come from Brazil (Figure).The associations between ZIKV and microcephaly and other serious developmental defects, [3][4][5][6] including devastating problems reminiscent of fetal brain disruption sequence first described decades ago 7 and miscarriages and stillbirth, 8,9 make addressing this growing epidemic a critical priority. While these outcomes are some of the most prominent complications described to date, there is a growing list of complications associated with in utero ZIKV exposure and infection. The congenital ZIKV epidemic has profoundly affected the lives of children and families across the Americas 10,11 and has been associated with many central nervous system, 12-17 ocular, 18-20 and auditory 21,22 abnormalities. As the number of children born with complications continues to grow, the long-term developmental trajectory for these children and the effect on their families remains largely unknown. 23 Lessons learned from a number of other congenital infections may provide valuable clues about the complexities and the optimal approaches for evaluating, treating, and caring for the children. 23 More importantly, any gaps in knowledge that remain must be addressed and informed by evidence from research activities.
IMPORTANCEThe Zika virus (ZIKV) epidemic has profoundly affected the lives of children and families across the Americas. As the number of children born with ZIKV-related complications continues to grow, the long-term developmental trajectory for these children and the effect on their families remains largely unknown. In September 2016, the Eunice Kennedy Shriver National Institute of Child Health and Human Development and partner National Institutes of Health institutes convened a workshop to develop a research agenda to improve the evaluation, monitoring, and management of neonates, infants, or children affected by ZIKV and its complications. The agenda also aims to optimally address the prospective effect of ZIKV exposure on the developing child.OBSERVATIONS The full clinical spectrum of congenital ZIKV syndrome has yet to be elucidated. In addition to the well-described anatomic and neurologic manifestations, clinicians are now describing infants with exaggerated primitive reflexes, epilepsy, acquired hydrocephalus and microcephaly, neurodevelopmental delay, gastrointestinal motility problems, and respiratory complications,...