Zika Virus Associated with Microcephaly

Abstract

A widespread epidemic of Zika virus (ZIKV) infection was reported in 2015 in South and Central America and the Caribbean. A major concern associated with this infection is the apparent increased incidence of microcephaly in fetuses born to mothers infected with ZIKV. In this report, we describe the case of an expectant mother who had a febrile illness with rash at the end of the first trimester of pregnancy while she was living in Brazil. Ultrasonography performed at 29 weeks of gestation revealed microcephaly with calcifications in the fetal brain and placenta. After the mother requested termination of the pregnancy, a fetal autopsy was performed. Micrencephaly (an abnormally small brain) was observed, with almost complete agyria, hydrocephalus, and multifocal dystrophic calcifications in the cortex and subcortical white matter, with associated cortical displacement and mild focal inflammation. ZIKV was found in the fetal brain tissue on reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay, with consistent findings on electron microscopy. The complete genome of ZIKV was recovered from the fetal brain.

Model-based projections of Zika virus infections in childbearing women in the Americas

“…Due to associations between Zika virus infection and a range of fetal maladies 1,2 , the epidemic trajectory of this viral infection poses a significant concern for the nearly 15 million children born in the Americas each year. Ascertaining the portion of this population that is truly at risk is an important priority.…”

“…This declaration acknowledges the high potential for Zika to establish across the Americas given that its dominant vector, the Aedes aegypti mosquito, is endophilic and occupies an exceptionally broad geographical range 7 . Concern underlying this rare WHO declaration also stems from an association between Zika virus infection in pregnant women and a range of adverse fetal outcomes 2 , most notably congenital microcephaly 1 . As of 30 June 2016, there were 1,674 confirmed cases of microcephaly associated with Zika virus infection in five countries 8 , and there is widespread concern that these numbers could increase further as the virus continues to spread across the Americas 9 .…”

Rapid diagnosis of Zika virus through saliva and urine by Loop-mediated isothermal amplification (LAMP)

“…Symptoms appear in 20% of infected individuals and include fever, cutaneous rash, headache, conjunctivitis, myalgia and arthralgia [5]. After the USA’s ZIKV outbreak in 2016, a sudden increase in microcephaly and Guillain-Barré syndrome (GBS) related with ZIKV infection prompted the World Health Organization (WHO) to declare a public health emergency of international concern [6,7]. …”

Editorial brain malformation surveillance in the Zika era

“…ZIKV has been isolated from the placentas of mothers who had clinical ZIKV infections during pregnancy, and from the brains of newborns with congenital microcephaly in the ZIKV outbreak areas in Brazil (Mlakar et al, 2016; Driggers et al, 2016; Martines et al, 2016). A causal relationship between in utero ZIKV infection and congenital microcephaly is now widely accepted (Rasmussen et al, 2016).…”