Normal Hearing Function in Children Prenatally Exposed to Zika Virus

Abstract

Introduction The association between prenatal Zika virus infection and hearing alterations in offspring has been the object of some studies, although few have assessed children without microcephaly. However, a current trend to include prenatal Zika virus exposure in the group of risk indicators for hearing loss is noted. Objective To present a series of 27 children prenatally exposed to the Zika virus submitted to multiple hearing assessments over time. Methods A cohort of children born to symptomatic mothers with laboratorial Zika virus infection confirmation during pregnancy was submitted to an otoacoustic emission test, auditory brainstem response test (automated, neurodiagnostic and frequency-specific), audiometry, and imitanciometry over a period of 36 months since birth. The hearing assessment was performed independently of the presence of microcephaly or other apparent signs of congenital Zika syndrome. Results The hearing tests presented predominantly normal results. Some children had signs of middle ear pathology. The only microcephalic child had normal electrophysiological tests, as well as preserved audiometric thresholds, but presented altered motor responses to sound. Conclusion Prenatal exposure to Zika virus does not always determine hearing impairment. This risk seems to be more associated to the severity of the central nervous system damage. Hearing screening and follow-ups of the affected children are important, as well as further research in this area.

Three-Year Clinical Follow-Up of Children Intrauterine Exposed to Zika Virus

“…Hearing impairment can occur in ZIKV-exposed children, but it is not a frequent manifestation. In a study made in Pernambuco in 2015, from 104 microcephalic children positive for ZIKV infection, hearing impairment was detected only in the two (12%) with the most severe microcephaly case [ 30 ]. Sensorineural hearing loss was described in another study, with 5 out 70 ZIKV-exposed children detected [ 31 ].…”

Congenital Deafness and Recent Advances Towards Restoring Hearing Loss

“…This mosquito-borne pathogen is able to pass through the placental barrier to infect the fetus and create developmental problems ( Almeida et al, 2020 ; Cugola et al, 2016 ). The incidence of birth defects is difficult to assess with lack of access to the RT-PCR equipment necessary to rule out the infection in affected areas ( Barbosa et al, 2020 ; Fandino-Cardenas, Idrovo, Velandia, Molina-Franky, & Alvarado-Socarras, 2019 ; Leal, Muniz, Caldas Neto, van der Linden, & Ramos, 2020 ). This problem could explain the wide range of hearing deficits assessed in different studies, which range from 0% to 68% of infected fetuses ( Barbosa et al, 2020 ; Fandino-Cardenas et al, 2019 ; Satterfield-Nash et al, 2017 ).…”

“…The incidence of birth defects is difficult to assess with lack of access to the RT-PCR equipment necessary to rule out the infection in affected areas ( Barbosa et al, 2020 ; Fandino-Cardenas, Idrovo, Velandia, Molina-Franky, & Alvarado-Socarras, 2019 ; Leal, Muniz, Caldas Neto, van der Linden, & Ramos, 2020 ). This problem could explain the wide range of hearing deficits assessed in different studies, which range from 0% to 68% of infected fetuses ( Barbosa et al, 2020 ; Fandino-Cardenas et al, 2019 ; Satterfield-Nash et al, 2017 ). Another explanation could be the presence of different strains of ZIKV with different levels of aggressiveness ( Russo, Jungmann, & Beltrao-Braga, 2017 ).…”

Does a patient with acquired arbovirus infection have a hearing impairment? A scoping review of hearing changes in an adult with Dengue, Chikungunya, and Zika

“…Early evidence 9 has shown that prenatal exposure to ZIKV infection is associated with sensory-neural hearing loss. In general, its effect on the infant population has been well studied, 10 and in 2019, the Joint Committee on Infant Hearing inserted prenatal exposure to ZIKV as a risk factor for hearing loss. 11 This report provided strong evidence of the relationship of ZIKV with early hearing impairment and suggested follow-up beyond the pediatric age group.…”