Demócrito de Barros Miranda-Filho, Celina Maria Turchi Martelli, Ricardo Arraes de Alencar Ximenes, Thalia Velho Barreto Araújo, Maria Angela Wanderley Rocha, Regina Coeli Ferreira Ramos, Rafael Dhalia, Rafael Freitas de Oliveira França, Ernesto Torres de Azevedo Marques Júnior, and Laura Cunha Rodrigues.  Initial Description of the Presumed Congenital Zika Syndrome. American Journal of Public Health: April 2016, Vol. 106, No. 4, pp. 598-600.

doi: 10.2105/AJPH.2016.303115

 

Accepted on: Feb 3, 2016

 

Initial Description of the Presumed Congenital Zika Syndrome

 

http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2016.303115

Demócrito de Barros Miranda-Filho, PhD, Celina Maria Turchi Martelli, PhD, Ricardo Arraes de Alencar Ximenes, PhD, Thalia Velho Barreto Araújo, PhD, Maria Angela Wanderley Rocha, MsC, Regina Coeli Ferreira Ramos, MsC, Rafael Dhalia, PhD, Rafael Freitas de Oliveira França, PhD, Ernesto Torres de Azevedo Marques Júnior, PhD, and Laura Cunha Rodrigues, PhD

Demócrito de Barros Miranda-Filho, Ricardo Arraes de Alencar Ximenes, Maria Angela Wanderley Rocha, and Regina Coeli Ferreira Ramos are with the University of Pernambuco, Recife, Brazil. Celina Maria Turchi Martelli, Rafael Dhalia, Rafael Freitas de Oliveira França, and Ernesto T. A. Marques Júnior are with The Research Center Aggeu Magalhães (CPqAM)/Oswaldo Cruz Foundation (Fiocruz), Recife. Thalia Velho Barreto Araújo and Ricardo Arraes de Alencar Ximenes are with the Federal University of Pernambuco, Recife. Laura Cunha Rodrigues is with the London School of Hygiene and Tropical Medicine, London, UK.

Correspondence should be sent to Demócrito de Barros Miranda-Filho Rua Arnóbio Marques, 310, Santo Amaro, Recife, PE, Brazil. CEP: 50100130 (e-mail: demofilho@gmail.com). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints” link.

CONTRIBUTORS

D. B. Miranda-Filho, C. Maria Turchi Martelli, R. Arraes de Alencar Ximenes, T. Velho Barreto Araújo, and L. Cunha Rodrigues contributed to the concept and design or analysis and interpretation of data. All of the authors contributed to the drafting or revision of the article and approved the final version.

Peer Reviewed

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ABSTRACT

 

Objectives. To provide an initial description of the congenital syndrome presumably associated with infection by Zika virus compared with other syndromes including congenital infections of established etiologies.

Methods. We provide an overview of a published case series of 35 cases, a clinical series of 104 cases, and published and unpublished reports of clinical and laboratory findings describing cases diagnosed since the beginning of the epidemic of microcephaly in Brazil.

Results. About 60% to 70% of mothers report rash during pregnancy; mainly in the first trimester. Principal features are microcephaly, facial disproportionality, cutis girata, hypertonia/spasticity, hyperreflexia, and irritability; abnormal neuroimages include calcifications, ventriculomegaly, and lissencephaly. Hearing and visual abnormalities may be present.

Conclusions. Preliminary data suggest that severe congenital abnormalities are linked to Zika virus infection. Cases have severe abnormalities, and although sharing many characteristics with congenital abnormalities associated with other viral infections, abnormalities presumably linked to the Zika virus may have distinguishing characteristics. These severe neurologic abnormalities may result in marked mental retardation and motor disabilities for many surviving offspring.

Policy Implications. Affected nations need to prepare to provide complex and costly multidisciplinary care that children diagnosed with this new congenital syndrome will require.

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