niman Posted March 7, 2016 Report Posted March 7, 2016 (edited) The pregnant woman was in her 30s and, like a growing number of patients at Richard Newman's practice in downtown Washington, worried about a threat the obstetrician himself had learned about only recently: Zika.In December, during her first trimester, she'd taken a vacation to Central America. Weeks later, U.S. officials began warning pregnant women about traveling to regions where the virus was spreading rapidly. She'd gotten a mosquito bite, followed by a rash, fever and joint pain -- all potential symptoms of infection.Newman recommended she see a specialist at Sibley Memorial Hospital and encouraged her to have her blood tested by the Centers for Disease Control and Prevention. He'd already done the same for more than a dozen anxious patients in 2016, and each time the results were negativeThis time, the test came back positive. The outcome was different for the expectant mother at Newman's practice.Everything looked fine on the sonogram he'd ordered when she was 16 weeks along. But the image a month later showed distinct abnormalities with "very little brain development," Newman said. A fetal MRI confirmed severe brain atrophy, and analysis of the woman's amniotic fluid detected the presence of Zika.Newman told his patient that the results suggested her child, if carried to term, might not survive long and almost certainly would have "no chance for a normal quality of life."Last month, after the final tests results came in, the woman called and told him she planned to terminate the pregnancy."I just listened and sympathized," he said. "I can only imagine how hard this was for her. ... It was one of the saddest moments of my medical career."http://www.chicagotribune.com/news/nationworld/ct-zika-virus-pregnant-women-20160307-story.html Edited March 7, 2016 by niman
niman Posted March 7, 2016 Author Report Posted March 7, 2016 Zika has pregnant women in the U.S. worried, and doctors have few answersLena H. Sun and Brady DennisThe Washington Post The pregnant woman was in her 30s and, like a growing number of patients at Richard Newman's practice in downtown Washington, worried about a threat the obstetrician himself had learned about only recently: Zika.In December, during her first trimester, she'd taken a vacation to Central America. Weeks later, U.S. officials began warning pregnant women about traveling to regions where the virus was spreading rapidly. She'd gotten a mosquito bite, followed by a rash, fever and joint pain -- all potential symptoms of infection.Newman recommended she see a specialist at Sibley Memorial Hospital and encouraged her to have her blood tested by the Centers for Disease Control and Prevention. He'd already done the same for more than a dozen anxious patients in 2016, and each time the results were negative.This time, the test came back positive."We'll obviously have to watch you very closely," Newman told the woman, knowing he'd never encountered a case with such risks in his long career.Across the country, obstetricians and specialists in high-risk pregnancies are fielding similar concerns and more because of Zika. Patients are alarmed given recent trips to the countries with growing outbreaks in the Caribbean and Latin America. They want reassurance that they're not infected, that their babies will be safe from the potentially devastating birth defects associated with the virus. Some are even putting fertility treatments on hold.There's only so much their doctors can tell them since so much about Zika remains unknown. The virus is spread primarily through mosquitoes -- but sexual transmission is also possible and more common than once thought. Detecting an infection can be tricky because as many as 80 percent of people never show symptoms -- but one of the most serious may be a rare paralysis.Yet pregnant women face the most devastating consequences because of the danger Zika seems to pose to a developing fetus. Many physicians say that they're struggling, often for the first time in their careers, to advise patients on what to do.Two studies released Friday could further rachet up the worries. Although scientists have yet to determine precisely how the virus is linked to microcephaly, in which babies are born with abnormally small heads and often have severe brain damage, a team of U.S. researchers has discovered how the virus selectively infects cells forming the brain's outer layer. Once it does, the cells are more likely to die and less likely to make new brain cells.And in Brazil, researchers tracking dozens of infected pregnant women found "grave" fetal complications and birth defects in nearly a third of cases.At a recent workshop held by the National Academy of Sciences, a leading obstetrician described the kinds of questions she and other doctors have been getting: If a pregnant woman becomes infected, how likely are birth defects for her baby? How do the risks differ by trimester? How often should ultrasounds be performed to look for abnormalities?"A lot of these questions are unanswerable right now," Newman said. "In most of the things I do, I have 35 years of experience. I've seen it all. I know what to expect, and I can give really good advice. The scariest part for us is that nobody has had any experience with this."In Florida, where the warm, humid climate is ideal for the mosquitoes that transmit the virus, anxiety among pregnant women has been palpable. The state already has declared a public health emergency in 11 counties because of Zika."Because we are so far south, we seem to have more patients traveling to or from these countries than other places in the U.S.," said Loraine Endres, who works at a Fort Myers practice that counsels high-risk pregnant women. "Truthfully, this is one of the most difficult things we have had to deal with just because there's so much uncertainty."One of her patients, Nina Burt, was 13 weeks pregnant when she visited family in Brazil over Thanksgiving. She got a mosquito bite while there but never saw a rash or any of the other minor telltale symptoms. After the CDC broadened its testing recommendations to include pregnant women without any signs of infection, Burt quickly responded. She's won't know those test results for several more weeks.So far, ultrasounds show that the baby is developing normally. The 38-year-old mother of two remains cautious but optimistic as her late-May due date approaches."The unknown is kind of stressful, [but] it's in God's hands," Burt said.Laura Riley, director of labor and delivery at Massachusetts General Hospital, is relying on the CDC's guidance and her own knowledge of congenital viruses. But she still finds herself unable to counsel women as she'd like to do. About 50 patients in her practice may have been exposed during holiday travel in the Americas. Five have shown symptoms of the virus."You can imagine, I'm sitting in a small room with a couple that wants answers," Riley said. Even if a Zika test comes back negative, she's not sure at what point it is "truly negative" so she can say with confidence that a patient is in the clear."Pregnant women go to their doctors and hope their doctors can do a test and make it all better," Riley said. "This is one of those situations where you just don't have enough information to do that."The CDC is establishing a registry of pregnant women who may be at risk for Zika infections. Of nine pregnant Americans with confirmed infections, at least two recently chose to have abortions, two suffered miscarriages, and one gave birth to an infant with serious birth defects. Two others delivered healthy infants, and two are still pregnant.At MedStar Washington Hospital Center in the District, Jennifer Ballard has been following about a dozen patients potentially exposed to Zika during recent trips. Two did contract the virus and either gave birth or terminated the pregnancy, she said, declining to provide specifics. The rest are still awaiting test results."It's really hard to be in a place to reassure your patients when you don't have information to feel reassured yourself," Ballard acknowledged. "We don't know if, just because we can't see microcephaly, that it doesn't mean there's not something else that could be a problem."Ami Levy, 35, had vacationed in Argentina in late December. She and her husband spent time in Buenos Aires but also visited Igazu Falls, a popular tourist spot that straddles the Brazilian border. There, she got a bug bite on her arm, followed by a rash, and her eyes became red. The symptoms soon subsided, and she didn't think much more about them."No one was talking about Zika. It wasn't on my radar," she said. Only later, after she returned home to Washington and discovered she was pregnant, did she began to fret.On Jan. 15, Levy flew to Puerto Rico for a long-planned trip with her sister and aunt. Her husband called a few hours later. The CDC had just issued an alert urging pregnant woman to consider postponing travel to 14 countries and territories -- including Puerto Rico. The couple agreed she should catch the next possible flight home. She did, but not before finding multiple mosquito bites on her leg.Concerned about the two possible exposures, Levy soon saw her doctor and sent a blood sample to the CDC. Two tense weeks passed. Finally, word arrived that she had tested negative."I felt very lucky," said Levy, a psychotherapist. "We could breathe a little bit and get excited about the baby, about our family."The outcome was different for the expectant mother at Newman's practice.Everything looked fine on the sonogram he'd ordered when she was 16 weeks along. But the image a month later showed distinct abnormalities with "very little brain development," Newman said. A fetal MRI confirmed severe brain atrophy, and analysis of the woman's amniotic fluid detected the presence of Zika.Newman told his patient that the results suggested her child, if carried to term, might not survive long and almost certainly would have "no chance for a normal quality of life."Last month, after the final tests results came in, the woman called and told him she planned to terminate the pregnancy."I just listened and sympathized," he said. "I can only imagine how hard this was for her. ... It was one of the saddest moments of my medical career."
niman Posted March 7, 2016 Author Report Posted March 7, 2016 Map updatedhttps://www.google.com/maps/d/edit?hl=en&hl=en&authuser=0&authuser=0&mid=zv94AJqgUct4.kT4qLMXp3SLU
niman Posted March 7, 2016 Author Report Posted March 7, 2016 The pregnant woman was in her 30s and, like a growing number of patients at Richard Newman's practice in downtown Washington, worried about a threat the obstetrician himself had learned about only recently: Zika.In December, during her first trimester, she'd taken a vacation to Central America. Weeks later, U.S. officials began warning pregnant women about traveling to regions where the virus was spreading rapidly. She'd gotten a mosquito bite, followed by a rash, fever and joint pain -- all potential symptoms of infection.Newman recommended she see a specialist at Sibley Memorial Hospital and encouraged her to have her blood tested by the Centers for Disease Control and Prevention. He'd already done the same for more than a dozen anxious patients in 2016, and each time the results were negativeThis time, the test came back positive. The outcome was different for the expectant mother at Newman's practice.Everything looked fine on the sonogram he'd ordered when she was 16 weeks along. But the image a month later showed distinct abnormalities with "very little brain development," Newman said. A fetal MRI confirmed severe brain atrophy, and analysis of the woman's amniotic fluid detected the presence of Zika.Newman told his patient that the results suggested her child, if carried to term, might not survive long and almost certainly would have "no chance for a normal quality of life."Last month, after the final tests results came in, the woman called and told him she planned to terminate the pregnancy."I just listened and sympathized," he said. "I can only imagine how hard this was for her. ... It was one of the saddest moments of my medical career."http://www.chicagotribune.com/news/nationworld/ct-zika-virus-pregnant-women-20160307-story.html Patient B. In January 2016, a pregnant woman in her 30s underwent laboratory testing for Zika virus infection. She reported a history of travel to a Zika-affected area at approximately 11–12 weeks’ gestation. One day after returning from travel, she developed fever, eye pain, and myalgia. The next day, she developed a rash. Serologic testing confirmed recent Zika virus infection. At approximately 20 weeks’ gestation, she underwent a fetal ultrasound that suggested absence of the corpus callosum, ventriculomegaly, and brain atrophy; subsequent fetal magnetic resonance imaging demonstrated severe brain atrophy. Amniocentesis was performed, and Zika virus RNA was detected by RT-PCR testing. After discussion with her health care providers, the patient elected to terminate her pregnancy.http://www.cdc.gov/mmwr/volumes/65/wr/mm6508e1.htm?s_cid=mm6508e1_w
niman Posted April 1, 2016 Author Report Posted April 1, 2016 Ultrasounds missed her Zika infection–until one showed serious harm to her fetus Resize Text Print Article Comments 35 Book mark article Read later list Saved to Reading List By Lena H. Sun March 30 What a new case reveals about pregnant women and the Zika virus Play Video1:15 The case of a Washington, D.C., woman who terminated her pregnancy after contracting Zika provides new information on detecting fetal brain abnormalities. (Gillian Brockell,Claritza Jimenez/The Washington Post)Zika successfully hid through nearly half of a District woman’s pregnancy, its damage to her fetus not showing despite a series of early ultrasounds. But suddenly at 19 weeks, another scan revealed significant abnormalities, and a more sophisticated test one week later identified even greater damage in her baby’s brain. In early February, the woman terminated the pregnancy.The report, published Wednesday in the New England Journal of Medicine, provides troubling new information about the capacity of the virus to infect a fetus and cause serious harm. The case also indicates that Zika may remain in the blood for a long time: The 33-year-old woman still tested positive for Zika 10 weeks after she likely was infected during a trip to Guatemala – far beyond what scientists have thought is the case."This helps put more pieces together in the puzzle because we know so little about how this virus acts and when and how long it stays in your blood after you have symptoms," said Laura Riley, vice chair of obstetrics and gynecology at Massachusetts General Hospital in Boston, who was not part of the study. Even though the study only involves one patient, "it's very important because she was followed so closely and there is so much detailed information. " Get Zika news by emailWe will update you when news breaks about the virus.Sign up [Doctors struggle to counsel pregnant women with Zika]While the case offers important details to researchers and obstetricians-gynecologists counseling pregnant women who may have been exposed to the virus, "we're going to need to study this with a large number of patients to provide guidance for women," said Catherine Spong, acting director for the National Institute of Child Health and Human Development.The woman and her husband traveled on vacation to Mexico, Guatemala and Belize in late November when she was 11 weeks pregnant. The couple told researchers they had been bitten by mosquitoes during their trip, particularly in Guatemala. After returning home, the woman developed eye and muscle pain, fever and a rash. A series of ultrasounds that began one week after her symptoms subsided -- at 13, 16 and 17 weeks of pregnancy -- showed none of the characteristic problems linked to Zika. The most prominent in utero are an abnormally small head and brain calcifications, bright, white spots that indicate something is amiss. Both are key to a diagnosis of a rare condition called microcephaly. Yet on the ultrasound at 19 weeks, significant brain abnormalities appeared: The baby's brain was small and contained an unusual amount of fluid. The cerebral cortex, its outer layer, was very thin. By the 20th week, a fetal MRI showed severe atrophy, especially in the front and top brain areas that are involved in decision-making, learning, vision, hearing, touch and taste. The fetus did not meet the threshold to be diagnosed with microcephaly. CONTENT FROM AUDIBeyond chads: Voting technology catches upThe U.S. has come a long way from hand-counted paper ballots and lever machines.In the initial ultrasounds, "they only looked at the size of the head and looked for brain calcifications to make sure she didn't have microcephaly and reassured her that everything looks okay," said Rita Driggers, one of the study's lead authors and medical director of Sibley Memorial Hospital’s maternal-fetal medicine division. Driggers, an assistant professor of gynecology and obstetrics at Johns Hopkins University School of Medicine, was involved in the patient's care.The takeaway for clinicians, she and others said, is to make sure during ultrasounds to look for other brain changes beyond microcephaly and intracranial calcifications.[Here are CDC's guidelines for couples worried about Zika while trying to get pregnant]Adre du Plessis, director of Children's National Health System's Fetal Medicine Institute and another study author, said Wednesday that the lack of those markers in the earlier ultrasounds may have led to "false reassurances" for the mother. What's more, he said, such delayed diagnosis of brain infection in the fetus may put women who'd opt to terminate a pregnancy "outside the legal limits" of an abortion. Forty-three states prohibit abortions after a specified point in pregnancy -- most often the point of fetal viability -- except when necessary to protect the woman’s life or health.Researchers said they are not recommending that all pregnant women infected with Zika uniformly seek out fetal MRIs, which are expensive and not readily available in many of the countries in Central and South America that have been hardest hit by the Zika epidemic. In the United States, the technology is available at most major medical centers.It's possible that researchers might be able to develop other markers to predict whether babies will become infected and develop abnormalities, du Plessis said.The study also provides new information about how long the virus persists in the blood of an infected person. The common thinking has been that the virus is only present for seven days to about two weeks at the outer limits. But this patient had virus in her blood from the time she became infected, when she was about 11 weeks pregnant, up until the time of her abortion, at 21 weeks."That's a very novel finding and important for future study," said Roberta DeBiasi, Children's chief of infectious disease division and another study author.Have you had an experience with Zika? We'd like to hear from you.It's possible that the woman's persistent infection was the result of the virus replicating in the fetus or placenta, the researchers said.Researchers also found "significant" cell death of neurons in the part of the brain that plays a role in sight, hearing and language, researchers said.https://www.washingtonpost.com/news/to-your-health/wp/2016/03/30/why-ultrasounds-may-give-mothers-with-zika-a-false-sense-of-security/
What a new case reveals about pregnant women and the Zika virus Play Video1:15 The case of a Washington, D.C., woman who terminated her pregnancy after contracting Zika provides new information on detecting fetal brain abnormalities. (Gillian Brockell,Claritza Jimenez/The Washington Post)Zika successfully hid through nearly half of a District woman’s pregnancy, its damage to her fetus not showing despite a series of early ultrasounds. But suddenly at 19 weeks, another scan revealed significant abnormalities, and a more sophisticated test one week later identified even greater damage in her baby’s brain. In early February, the woman terminated the pregnancy.The report, published Wednesday in the New England Journal of Medicine, provides troubling new information about the capacity of the virus to infect a fetus and cause serious harm. The case also indicates that Zika may remain in the blood for a long time: The 33-year-old woman still tested positive for Zika 10 weeks after she likely was infected during a trip to Guatemala – far beyond what scientists have thought is the case."This helps put more pieces together in the puzzle because we know so little about how this virus acts and when and how long it stays in your blood after you have symptoms," said Laura Riley, vice chair of obstetrics and gynecology at Massachusetts General Hospital in Boston, who was not part of the study. Even though the study only involves one patient, "it's very important because she was followed so closely and there is so much detailed information. " Get Zika news by emailWe will update you when news breaks about the virus.Sign up [Doctors struggle to counsel pregnant women with Zika]While the case offers important details to researchers and obstetricians-gynecologists counseling pregnant women who may have been exposed to the virus, "we're going to need to study this with a large number of patients to provide guidance for women," said Catherine Spong, acting director for the National Institute of Child Health and Human Development.The woman and her husband traveled on vacation to Mexico, Guatemala and Belize in late November when she was 11 weeks pregnant. The couple told researchers they had been bitten by mosquitoes during their trip, particularly in Guatemala. After returning home, the woman developed eye and muscle pain, fever and a rash. A series of ultrasounds that began one week after her symptoms subsided -- at 13, 16 and 17 weeks of pregnancy -- showed none of the characteristic problems linked to Zika. The most prominent in utero are an abnormally small head and brain calcifications, bright, white spots that indicate something is amiss. Both are key to a diagnosis of a rare condition called microcephaly. Yet on the ultrasound at 19 weeks, significant brain abnormalities appeared: The baby's brain was small and contained an unusual amount of fluid. The cerebral cortex, its outer layer, was very thin. By the 20th week, a fetal MRI showed severe atrophy, especially in the front and top brain areas that are involved in decision-making, learning, vision, hearing, touch and taste. The fetus did not meet the threshold to be diagnosed with microcephaly. CONTENT FROM AUDIBeyond chads: Voting technology catches upThe U.S. has come a long way from hand-counted paper ballots and lever machines.In the initial ultrasounds, "they only looked at the size of the head and looked for brain calcifications to make sure she didn't have microcephaly and reassured her that everything looks okay," said Rita Driggers, one of the study's lead authors and medical director of Sibley Memorial Hospital’s maternal-fetal medicine division. Driggers, an assistant professor of gynecology and obstetrics at Johns Hopkins University School of Medicine, was involved in the patient's care.The takeaway for clinicians, she and others said, is to make sure during ultrasounds to look for other brain changes beyond microcephaly and intracranial calcifications.[Here are CDC's guidelines for couples worried about Zika while trying to get pregnant]Adre du Plessis, director of Children's National Health System's Fetal Medicine Institute and another study author, said Wednesday that the lack of those markers in the earlier ultrasounds may have led to "false reassurances" for the mother. What's more, he said, such delayed diagnosis of brain infection in the fetus may put women who'd opt to terminate a pregnancy "outside the legal limits" of an abortion. Forty-three states prohibit abortions after a specified point in pregnancy -- most often the point of fetal viability -- except when necessary to protect the woman’s life or health.Researchers said they are not recommending that all pregnant women infected with Zika uniformly seek out fetal MRIs, which are expensive and not readily available in many of the countries in Central and South America that have been hardest hit by the Zika epidemic. In the United States, the technology is available at most major medical centers.It's possible that researchers might be able to develop other markers to predict whether babies will become infected and develop abnormalities, du Plessis said.The study also provides new information about how long the virus persists in the blood of an infected person. The common thinking has been that the virus is only present for seven days to about two weeks at the outer limits. But this patient had virus in her blood from the time she became infected, when she was about 11 weeks pregnant, up until the time of her abortion, at 21 weeks."That's a very novel finding and important for future study," said Roberta DeBiasi, Children's chief of infectious disease division and another study author.Have you had an experience with Zika? We'd like to hear from you.It's possible that the woman's persistent infection was the result of the virus replicating in the fetus or placenta, the researchers said.Researchers also found "significant" cell death of neurons in the part of the brain that plays a role in sight, hearing and language, researchers said.https://www.washingtonpost.com/news/to-your-health/wp/2016/03/30/why-ultrasounds-may-give-mothers-with-zika-a-false-sense-of-security/
niman Posted April 14, 2016 Author Report Posted April 14, 2016 Patient B. In January 2016, a pregnant woman in her 30s underwent laboratory testing for Zika virus infection. She reported a history of travel to a Zika-affected area at approximately 11–12 weeks’ gestation. One day after returning from travel, she developed fever, eye pain, and myalgia. The next day, she developed a rash. Serologic testing confirmed recent Zika virus infection. At approximately 20 weeks’ gestation, she underwent a fetal ultrasound that suggested absence of the corpus callosum, ventriculomegaly, and brain atrophy; subsequent fetal magnetic resonance imaging demonstrated severe brain atrophy. Amniocentesis was performed, and Zika virus RNA was detected by RT-PCR testing. After discussion with her health care providers, the patient elected to terminate her pregnancy.http://www.cdc.gov/mmwr/volumes/65/wr/mm6508e1.htm?s_cid=mm6508e1_w
niman Posted April 14, 2016 Author Report Posted April 14, 2016 Zika Virus Infection with Prolonged Maternal Viremia and Fetal Brain AbnormalitiesRita W. Driggers, M.D., Cheng-Ying Ho, M.D., Ph.D., Essi M. Korhonen, M.Sc., Suvi Kuivanen, M.Sc., Anne J. Jääskeläinen, Ph.D., Teemu Smura, Ph.D., Avi Rosenberg, M.D., Ph.D., D. Ashley Hill, M.D., Roberta L. DeBiasi, M.D., Gilbert Vezina, M.D., Julia Timofeev, M.D., Fausto J. Rodriguez, M.D., Lev Levanov, Ph.D., Jennifer Razak, M.G.C., C.G.C, Preetha Iyengar, M.D., Andrew Hennenfent, D.V.M., M.P.H., Richard Kennedy, M.D., Robert Lanciotti, Ph.D., Adre du Plessis, M.B., Ch.B., M.P.H., and Olli Vapalahti, M.D., Ph.D.March 30, 2016DOI: 10.1056/NEJMoa1601824 SOURCE INFORMATIONFrom the Department of Gynecology and Obstetrics, Division of Maternal Fetal Medicine (R.W.D., J.T.), and the Department of Pathology (F.J.R.), Johns Hopkins University School of Medicine, Baltimore; the Division of Maternal Fetal Medicine, Sibley Memorial Hospital (R.W.D., J.T., J.R.), the Division of Pathology and Center for Genetic Medicine Research (C.-Y.H., A.R., D.A.H.), Division of Pediatric Infectious Diseases (R.L.D.), Department of Diagnostic Radiology and Imaging (G.V.), and the Fetal Medicine Institute, Division of Fetal and Transitional Medicine (A.P.), Children’s National Health System, the Departments of Integrative Systems Biology (C.-Y.H., D.A.H.), Pediatrics and Microbiology, Immunology and Tropical Medicine (R.L.D.B.), and Radiology and Pediatrics (G.V.), George Washington University School of Medicine and Health Sciences, the Center for Policy, Planning and Evaluation (P.I.) and Centers for Disease Control and Prevention (CDC)–Council of State and Territorial Epidemiologists (CSTE) Applied Epidemiology Fellowship (A.H.), District of Columbia Department of Health, and One Medical Group (R.K.) — all in Washington, DC; the Departments of Virology (E.M.K., S.K., T.S., L.L., O.V.) and Veterinary Biosciences (E.M.K., O.V.), University of Helsinki, and the Department of Virology and Immunology, University of Helsinki and Helsinki University Hospital (A.J.J., O.V.), Helsinki; and the Arboviral Diseases Branch, Division of Vector-Borne Diseases, National Center for Emerging Zoonotic Infectious Diseases, CDC, Atlanta (R.L.).Address reprint requests to Dr. Driggers at [email protected], to Dr. du Plessis at [email protected], or to Dr. Vapalahti at [email protected].http://www.nejm.org/doi/full/10.1056/NEJMoa1601824#t=article
niman Posted April 14, 2016 Author Report Posted April 14, 2016 The current outbreak of Zika virus (ZIKV) infection has been associated with an apparent increased risk of congenital microcephaly. We describe a case of a pregnant woman and her fetus infected with ZIKV during the 11th gestational week. The fetal head circumference decreased from the 47th percentile to the 24th percentile between 16 and 20 weeks of gestation. ZIKV RNA was identified in maternal serum at 16 and 21 weeks of gestation. At 19 and 20 weeks of gestation, substantial brain abnormalities were detected on ultrasonography and magnetic resonance imaging (MRI) without the presence of microcephaly or intracranial calcifications. On postmortem analysis of the fetal brain, diffuse cerebral cortical thinning, high ZIKV RNA loads, and viral particles were detected, and ZIKV was subsequently isolated.
niman Posted April 21, 2016 Author Report Posted April 21, 2016 Microcephaly and other fetal malformations potentially associated with Zika virus infection or suggestive of congenital infection have been reported in six countries (Brazil, Cabo Verde, Colombia, French Polynesia, Martinique and Panama). Two cases, each linked to a stay in Brazil, were detected in Slovenia and the United States of America. A further case, linked to a brief stay in Mexico, Guatemala and Belize, was detected in a pregnant woman in the United States of America.http://www.who.int/emergencies/zika-virus/situation-report/21-april-2016/en/
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