niman Posted February 8, 2016 Report Share Posted February 8, 2016 (edited) The microcephaly associated with Zika is also linked to severe brain injury in newborns. http://www.nbcnews.com/storyline/zika-virus-outbreak/zika-suspected-brain-defects-puzzle-doctors-n513651 Edited February 8, 2016 by niman Link to comment Share on other sites More sharing options...
niman Posted February 8, 2016 Author Report Share Posted February 8, 2016 HEALTH ZIKA VIRUS OUTBREAK FEB 8 2016, 1:06 PM ETZika-Suspected Brain Defects Puzzle Doctorsby REUTERS Elison carries his brother Jose Wesley. Brazil's government wants to train more than 7,500 physical therapists, doctors and psychologists in techniques to help develop motor and language skills in infants and toddlers with microcephaly. Felipe Dana / APSHARE Experts on microcephaly, the birth defect that has sparked alarm in the current Zika virus outbreak, say they are struck by the severity of a small number of cases they have reviewed from Brazil.Consultations among doctors in Brazil and the United States have increased in the last two weeks, and some of the leading authorities on the condition are finding patterns of unusual devastation in scans of the newborns' malformed brains.While it's not known how representative the scans are, the early observations of these doctors point to a tough road ahead for the babies, their families and their communities and heighten the concern surrounding Zika, which is suspected of causing microcephaly."We are in the process of very rapid information gathering on what has been seen," said Dr. William Dobyns, a geneticist at Seattle Children's Hospital. "The condition that I've been able to review, very preliminarily, is more severe than simple microcephaly."Related: White House Seeks $1.8 Billion for Zika ResponseDobyns has spent 30 years researching and treating microcephaly, a condition defined by abnormally small heads in newborns that can lead to developmental disabilities, from mild to severe. The U.S. Centers for Disease Control and Prevention (CDC) has sought out his expertise in understanding the unfolding epidemic.With a small group of geneticists and other microcephaly specialists, he recently reviewed scans of a handful of babies sent by a colleague in Brazil. All the experts were struck by the scale of malformations, he said.FacebookTwitterGoogle PlusEmbed Microcephaly and Zika Present a Public Health Emergency, WHO Declares 0:25"These children have a very severe form of microcephaly," Dobyns said. "The brain is not just small, it's small with malformations of the cerebral cortex and calcifications. It has the appearance of a very severe, destructive injury to the brain."Particularly alarming, Dobyns said, is the presence in the Brazilian cases of excess spinal fluid between the brain and skull of the babies."If the brain is growing and then suddenly shrinks, then you'll see fluid between the brain and skull," he said. "It has a pattern that suggests that the brain has actually decreased in size."Dr. Leonardo Vedolin, a neuroradiologist and researcher at the Moinhos de Vento hospital in Porto Alegre, Brazil, shared with Dobyns scans of two more microcephalic babies this week. The doctors belong to a brain defects study group that convenes via videoconference each month. The group is now focused on Zika.Neither Vedolin nor Brazil's Health Ministry were able to provide a breakdown on the severity of confirmed microcephaly cases. In general, Vedolin said, 5 percent of microcephaly cases are severe. But the proportion appears greater among the cases in Brazil, he said.Public health officials in Brazil are investigating more than 4,000 cases of suspected microcephaly, and have confirmed more than 400. Prior to the Zika outbreak, Brazil saw on average 163 cases annually of microcephaly over the past five years, according to WHO. In 17 of the new cases, traces of Zika were found in the mother or the baby.A study of 35 Brazilian babies born with microcephaly during the Zika outbreak reported by the CDC Jan. 29 added strength to the suspected connection.The mothers of all 35 infants had lived in or visited Zika virus-affected areas during pregnancy, the report said. Twenty-five infants had severe microcephaly, and 17 had at least one neurologic abnormality.Related: How Does Zika Spread?Dr. Frank Esper, an infectious disease expert from Rainbow Babies & Children's Hospital in Cleveland, said he expects a steady wave of studies on Zika and microcephaly that will provide a much clearer picture over the first half of 2016.By the broadest definition, about 2.3 percent of all babies are microcephalic, Dobyns said. Some cases are so mild they involve no complications at all.About one tenth of one percent of the cases are so severe that lifelong care is required, he said. There are many known causes, including a wide range of genetic disorders such as Down syndrome, as well as oxygen deprivation to the fetus, cytomegalovirus and severe fetal alcohol syndrome.Lifespan in severe cases can be months or as long as 10 years, depending on proximity to good medical care, Dobyns said.Dr. Dawn Nolt, a member of the American Association of Pediatrics' Committee on Infectious Diseases, and other doctors, said more severely affected children often require treatment for epileptic seizures, as well as physical, respiratory and speech therapy. They may need help with everyday activities, such as eating or walking.FacebookTwitterGoogle PlusEmbed NBC News' Rehema Ellis in Brazil With Mother of Baby Apparently Affected by Zika 1:02"It's crucial to go to a care center with good neurology and genetics teams that can evaluate the child comprehensively," said Dr. Ghayda Mirzaa, a pediatric neurologist and colleague of Dobyns at Seattle Children's.Doctors in Recife, Brazil are sending mothers with afflicted babies for therapy to help stimulate eyesight, hearing and motor skills to minimize retardation in mental and physical development."We need to get the message out that this is real, and coming, without getting everybody to panic," Dobyns said. "There will be a steep curve of new information coming in." Link to comment Share on other sites More sharing options...
niman Posted February 9, 2016 Author Report Share Posted February 9, 2016 Zika expert: ‘Microcephaly may just be the tip of the iceberg.’By Lena H. Sun February 9 at 7:00 AM A 6-week-old baby born with microcephaly is treated at a clinic in Recife, Pernambuco state, Brazil. (Mario Tama/Getty Images)Albert Ko, an epidemiologist and infectious disease expert at the Yale University School of Public Health, has been studying Zika virus and its link to birth defects in newborns in Brazil. The mosquito-borne virus is suspected in a huge increase in cases of microcephaly, a rare condition in which babies have unusually small heads and damaged brains.Ko spent December in Salvador, Brazil’s third largest city, working with researchers from the Oswaldo Cruz Foundation, a branch of that country's health ministry, and from the University of Texas Medical Branch in Galveston. The team was investigating microcephaly cases at three maternity hospitals.The Washington Post spoke with Ko on two occasions; his answers have been edited for clarity and length.What has your research found so far at these three hospitals?We are still in the middle of our investigation. We strongly believe that the cases of microcephaly we are identifying during this outbreak are due to Zika virus.However, there are important caveats. First, it’s very likely that because of the high surveillance, we’re identifying cases that would not normally be reported or identified. Secondly, we still need to confirm that Zika virus is causing the large majority of the cases. Brazilian researchers have shown that Zika virus can cause congenital infections, and they have detected the virus in tissues of stillbirths as well as fetuses with congenital malformations.But for the large majority of cases that have been reported as microcephaly, we still don’t have firm evidence. This is one of the primary objectives of our research.Jose Wesley, who suffers from microcephaly, sleeps on a large pillow on his mother's bed in Bonito, Pernambuco state, Brazil. (AP Photo/Felipe Dana)How many babies have been born with suspected cases of microcephaly at these hospitals?We have identified both stillbirths and live births. We have identified 100 live births. But not all of those [cases] may be caused by Zika. We are trying to rule out other common causes, such as prematurity and congenital infections, including toxoplasmosis (an infection caused by a parasite commonly found in cat feces or cat litter).Can you describe the different kinds of birth defects you’re seeing?We’re seeing a spectrum. Many have fairly severe central nervous system lesions. There are also a lot of calcium deposits. … Those can cause seizures and cause impairment in terms of function for the brain.We’re also seeing that in some babies, the brains, which usually have wrinkles, are actually smooth. That’s a sign that development of the brain has been impaired. Several of them are also impaired with respect to vision and hearing.What else are you finding?It seems like microcephaly may just be the tip of the iceberg. The preliminary evidence is that [some] babies who don’t have microcephaly may also have neurological lesions or birth defects that are not as obvious as microcephaly. We’re really concerned because of Zika, but we need to rule out other causes of congenital infection to really make sure.How are the parents and families handling the stress and anxiety?Obviously there’s a large amount of fear, especially among pregnant women. … For many people, the level of anxiety is extremely great. People want a birth. It’s one of the greatest pleasures or expressions of love in a person’s life. …For many of the families, it really hasn’t hit yet what the future is going to be. Not all the brains are severely compromised. Some of the babies, now one month or two months old, they’re feeding, they’re growing.There is a wide mix of emotions. Some families are in denial. Some are just devastated. All of the physicians are just feeling the enormous weight of seeing this unfold, the uncertainty of what has caused this and what the future holds for these babies. There’s a strange heaviness across all the physicians.Once individuals are infected, do they have immunity for life?We know so little. We presume that like other flaviviruses, except for dengue, if you’ve been exposed, you will have long-term immunity to being reinfected.https://www.washingtonpost.com/news/to-your-health/wp/2016/02/09/zika-expert-microcephaly-may-just-be-the-tip-of-the-iceberg/ Link to comment Share on other sites More sharing options...
A 6-week-old baby born with microcephaly is treated at a clinic in Recife, Pernambuco state, Brazil. (Mario Tama/Getty Images)Albert Ko, an epidemiologist and infectious disease expert at the Yale University School of Public Health, has been studying Zika virus and its link to birth defects in newborns in Brazil. The mosquito-borne virus is suspected in a huge increase in cases of microcephaly, a rare condition in which babies have unusually small heads and damaged brains.Ko spent December in Salvador, Brazil’s third largest city, working with researchers from the Oswaldo Cruz Foundation, a branch of that country's health ministry, and from the University of Texas Medical Branch in Galveston. The team was investigating microcephaly cases at three maternity hospitals.The Washington Post spoke with Ko on two occasions; his answers have been edited for clarity and length.What has your research found so far at these three hospitals?We are still in the middle of our investigation. We strongly believe that the cases of microcephaly we are identifying during this outbreak are due to Zika virus.However, there are important caveats. First, it’s very likely that because of the high surveillance, we’re identifying cases that would not normally be reported or identified. Secondly, we still need to confirm that Zika virus is causing the large majority of the cases. Brazilian researchers have shown that Zika virus can cause congenital infections, and they have detected the virus in tissues of stillbirths as well as fetuses with congenital malformations.But for the large majority of cases that have been reported as microcephaly, we still don’t have firm evidence. This is one of the primary objectives of our research.Jose Wesley, who suffers from microcephaly, sleeps on a large pillow on his mother's bed in Bonito, Pernambuco state, Brazil. (AP Photo/Felipe Dana)How many babies have been born with suspected cases of microcephaly at these hospitals?We have identified both stillbirths and live births. We have identified 100 live births. But not all of those [cases] may be caused by Zika. We are trying to rule out other common causes, such as prematurity and congenital infections, including toxoplasmosis (an infection caused by a parasite commonly found in cat feces or cat litter).Can you describe the different kinds of birth defects you’re seeing?We’re seeing a spectrum. Many have fairly severe central nervous system lesions. There are also a lot of calcium deposits. … Those can cause seizures and cause impairment in terms of function for the brain.We’re also seeing that in some babies, the brains, which usually have wrinkles, are actually smooth. That’s a sign that development of the brain has been impaired. Several of them are also impaired with respect to vision and hearing.What else are you finding?It seems like microcephaly may just be the tip of the iceberg. The preliminary evidence is that [some] babies who don’t have microcephaly may also have neurological lesions or birth defects that are not as obvious as microcephaly. We’re really concerned because of Zika, but we need to rule out other causes of congenital infection to really make sure.How are the parents and families handling the stress and anxiety?Obviously there’s a large amount of fear, especially among pregnant women. … For many people, the level of anxiety is extremely great. People want a birth. It’s one of the greatest pleasures or expressions of love in a person’s life. …For many of the families, it really hasn’t hit yet what the future is going to be. Not all the brains are severely compromised. Some of the babies, now one month or two months old, they’re feeding, they’re growing.There is a wide mix of emotions. Some families are in denial. Some are just devastated. All of the physicians are just feeling the enormous weight of seeing this unfold, the uncertainty of what has caused this and what the future holds for these babies. There’s a strange heaviness across all the physicians.Once individuals are infected, do they have immunity for life?We know so little. We presume that like other flaviviruses, except for dengue, if you’ve been exposed, you will have long-term immunity to being reinfected.https://www.washingtonpost.com/news/to-your-health/wp/2016/02/09/zika-expert-microcephaly-may-just-be-the-tip-of-the-iceberg/
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