Possible Association Between Zika Virus Infection and Microcephaly — Brazil, 2015

Schüler‐Faccini, Lavínia; Ribeiro, Erlane Marques; Feitosa, Ian M. L.; Horovitz, Dafne Dain Gandelman; Cavalcanti, Denise Pontes; Pessoa, André; Doriqui, Maria Juliana R.; Neri, Joao Ivanildo; Neto, João Monteiro de Pina; Wanderley, Héctor Yuri Conti; Cernach, Mirlene Cecília Soares Pinho; El-Husny, Antonette S.; Pone, Marcos V.S.; Serao, Cassio L. C.; Sanseverino, Maria Teresa Vieira

doi:10.15585/mmwr.mm6503e2

Cited by 922 publications

(614 citation statements)

References 4 publications

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“…Neurological deformities include brainstem dysfunction, cerebral lesions, absence of swallowing and polymalformative syndromes [73]. Markedly, certain other characteristic features, for example chorioretinitis and hepatosplenomegaly, have not been reported [74]. Ultrasonographic examination shows intracranial calcifications specifically over the white matter of the frontal lobes, lentostriatal vessels, caudate, cerebellum, around the lateral and fourth ventricles, cerebral atrophy, dysgenesis of corpus callosum, enlarged cisterna magna, vermis and thalami, asymmetrical cerebral hemispheres, midline shift, severe unilateral ventriculomegaly and thinning of the parenchyma on the dilated side, brainstem and pons [68,74].…”

Section: Intrauterine (Congenital) Infectionmentioning

confidence: 99%

“…As proposed by the preliminary data, the risk of congenital deformities and microcephaly is highest if ZIKV infection occurs in the first trimester [73]. In Brazil, out of the total 35 women having infants born with microcephaly, 57 and 14 % had a rash during the first and second trimesters, respectively [74]. There is also a possibility that ZIKV infection occurring in later stages of pregnancy appears in a different way with less severe deformities, for example, sensorineural deafness, ophthalmological lesions, mental retardation or miscarriage [74].…”

Section: Intrauterine (Congenital) Infectionmentioning

confidence: 99%

“…In Brazil, out of the total 35 women having infants born with microcephaly, 57 and 14 % had a rash during the first and second trimesters, respectively [74]. There is also a possibility that ZIKV infection occurring in later stages of pregnancy appears in a different way with less severe deformities, for example, sensorineural deafness, ophthalmological lesions, mental retardation or miscarriage [74]. Newborns with possible perinatal ZIKV transmission seem to have mild disease and favorable consequence [52].…”

Section: Intrauterine (Congenital) Infectionmentioning

confidence: 99%

“…The affected cases have head circumferences ≥2 standard deviations below the mean for sex and gestational age at birth [74]. During the period from March 2015 to February 2016, a greater than 20-fold increase in microcephaly cases was observed in Brazilian newborns compared to previous years [22].…”

Section: Intrauterine (Congenital) Infectionmentioning

confidence: 99%

See 3 more Smart Citations

Zika virus disease: a current review of the literature

et al. 2016

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Section: Intrauterine (Congenital) Infectionmentioning

confidence: 99%

Section: Intrauterine (Congenital) Infectionmentioning

confidence: 99%

Section: Intrauterine (Congenital) Infectionmentioning

confidence: 99%

Section: Intrauterine (Congenital) Infectionmentioning

confidence: 99%

See 2 more Smart Citations

Zika virus disease: a current review of the literature

et al. 2016

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“…It is truly remarkable how the virus has spread within a short time to these seemingly isolated islands. However, nothing brought ZIKV to the attention of the world more than the horrific images of newborn babies with microcephaly in north eastern Brazil (Adibi et al, 2016, Rubin et al, 2016Schuler-Faccini et al, 2016). These images were the impetus for concerted efforts to study viral tropism and to put into motion efforts to combat its spread.…”

Section: Introductionmentioning

confidence: 99%

Accidental discovery and isolation of Zika virus in Uganda and the relentless epidemiologist behind the investigations

Zhou

Eaton²,

Wang

et al. 2016

Virol. Sin.

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Birth Defects Among Fetuses and Infants of US Women With Evidence of Possible Zika Virus Infection During Pregnancy

Honein

Dawson

Petersen

et al. 2017

JAMA

716

435

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; for the US Zika Pregnancy Registry Collaboration IMPORTANCE Understanding the risk of birth defects associated with Zika virus infection during pregnancy may help guide communication, prevention, and planning efforts. In the absence of Zika virus, microcephaly occurs in approximately 7 per 10 000 live births. OBJECTIVE To estimate the preliminary proportion of fetuses or infants with birth defects after maternal Zika virus infection by trimester of infection and maternal symptoms. DESIGN, SETTING, AND PARTICIPANTS Completed pregnancies with maternal, fetal, or infant laboratory evidence of possible recent Zika virus infection and outcomes reported in the continental United States and Hawaii from January 15 to September 22, 2016, in the US Zika Pregnancy Registry, a collaboration between the CDC and state and local health departments. EXPOSURES Laboratory evidence of possible recent Zika virus infection in a maternal, placental, fetal, or infant sample. MAIN OUTCOMES AND MEASURES Birth defects potentially Zika associated: brain abnormalities with or without microcephaly, neural tube defects and other early brain malformations, eye abnormalities, and other central nervous system consequences. RESULTS Among 442 completed pregnancies in women (median age, 28 years; range, 15-50 years) with laboratory evidence of possible recent Zika virus infection, birth defects potentially related to Zika virus were identified in 26 (6%; 95% CI, 4%-8%) fetuses or infants. There were 21 infants with birth defects among 395 live births and 5 fetuses with birth defects among 47 pregnancy losses. Birth defects were reported for 16 of 271 (6%; 95% CI, 4%-9%) pregnant asymptomatic women and 10 of 167 (6%; 95% CI, 3%-11%) symptomatic pregnant women. Of the 26 affected fetuses or infants, 4 had microcephaly and no reported neuroimaging, 14 had microcephaly and brain abnormalities, and 4 had brain abnormalities without microcephaly; reported brain abnormalities included intracranial calcifications, corpus callosum abnormalities, abnormal cortical formation, cerebral atrophy, ventriculomegaly, hydrocephaly, and cerebellar abnormalities. Infants with microcephaly (18/442) represent 4% of completed pregnancies. Birth defects were reported in 9 of 85 (11%; 95% CI, 6%-19%) completed pregnancies with maternal symptoms or exposure exclusively in the first trimester (or first trimester and periconceptional period), with no reports of birth defects among fetuses or infants with prenatal exposure to Zika virus infection only in the second or third trimesters. CONCLUSIONS AND RELEVANCE Among pregnant women in the United States with completed pregnancies and laboratory evidence of possible recent Zika infection, 6% of fetuses or infants had evidence of Zika-associated birth defects, primarily brain abnormalities and microcephaly, whereas among women with first-trimester Zika infection, 11% of fetuses or infants had evidence of Zika-associated birth defects. These findings support the importance of screening pregnant women for Zika virus exposure.

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Possible Association Between Zika Virus Infection and Microcephaly — Brazil, 2015

Cited by 922 publications

References 4 publications

Zika virus disease: a current review of the literature

Zika virus disease: a current review of the literature

Accidental discovery and isolation of Zika virus in Uganda and the relentless epidemiologist behind the investigations

Birth Defects Among Fetuses and Infants of US Women With Evidence of Possible Zika Virus Infection During Pregnancy

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