Clinical Features and Neurodevelopmental Outcomes for Infants with Perinatal Vertical Transmission of Zika Virus, Colombia (original) (raw)
Lancet (London, England), 2016
In November, 2015, an epidemic of microcephaly was reported in Brazil, which was later attributed to congenital Zika virus infection. 7830 suspected cases had been reported to the Brazilian Ministry of Health by June 4, 2016, but little is known about their characteristics. We aimed to describe these newborn babies in terms of clinical findings, anthropometry, and survival. We reviewed all 1501 liveborn infants for whom investigation by medical teams at State level had been completed as of Feb 27, 2016, and classified suspected cases into five categories based on neuroimaging and laboratory results for Zika virus and other relevant infections. Definite cases had laboratory evidence of Zika virus infection; highly probable cases presented specific neuroimaging findings, and negative laboratory results for other congenital infections; moderately probable cases had specific imaging findings but other infections could not be ruled out; somewhat probable cases had imaging findings, but t...
Journal of Clinical Medicine, 2018
Introduction: The recent Zika virus(ZIKV) epidemic in Brazil was characterized by a range of different clinical presentations, particularly microcephaly, Guillain-Barré syndrome, and death. In this context, we determined the causal relationship between fatal microcephaly cases and ZIKV infection. Methods: Twelve fatal cases of neonates, whose mothers were infected with ZIKV during pregnancy, were examined; cases included nine neonatal deaths due to microcephaly, one miscarriage, and two stillbirths. Tissue samples were obtained from all cases at necropsy and were submitted for virological investigation (RT-qPCR and virus isolation) and/or histopathology (hematoxylin and eosin staining) and immunohistochemical assay for the detection of ZIKV antigens. Results: ZIKV antigens and/or ZIKV RNA were detected in tissue samples of all 12 cases examined. ZIKV was recovered in one case. Results of the virological and immunohistochemical analyses, as well as the anatomic abnormalities and hist...
Zika Virus Disease [Working Title]
Dengue, Chikungunya and Zika are arboviruses transmitted by Ae. aegypti with significant public health impact. In the first trimester of 2015, autochthonous Zika transmission was reported in Mexico. The state of Yucatan is an endemic region where pregnant women with acute infection and related congenital abnormalities in fetus and newborns were observed. We describe results from a cohort of pregnant women and their babies followed up in Yucatan during the first Zika transmission outbreak (2016-2018). Clinical manifestations of acute ZIKV infection, persistence of viral RNA in pregnant women, as well as congenital abnormalities were observed. In addition, we describe the phenotype of newborns from confirmed or suspected ZIKV prenatal infection.
Postmortem Findings for 7 Neonates with Congenital Zika Virus Infection
Emerging infectious diseases, 2017
Postmortem examination of 7 neonates with congenital Zika virus infection in Brazil revealed microcephaly, ventriculomegaly, dystrophic calcifications, and severe cortical neuronal depletion in all and arthrogryposis in 6. Other findings were leptomeningeal and brain parenchymal inflammation and pulmonary hypoplasia and lymphocytic infiltration in liver and lungs. Findings confirmed virus neurotropism and multiple organ infection.
Severe Neurologic Disorders in 2 Fetuses with Zika Virus Infection, Colombia
Emerging infectious diseases, 2017
We report the results of pathologic examinations of 2 fetuses from women in Colombia with Zika virus infection during pregnancy that revealed severe central nervous system defects and potential associated abnormalities of the eye, spleen, and placenta. Amniotic fluid and tissues from multiple fetal organs tested positive for Zika virus.
Congenital Zika Virus Infection
JAMA Neurology, 2016
IMPORTANCE Recent studies have reported an increase in the number of fetuses and neonates with microcephaly whose mothers were infected with the Zika virus (ZIKV) during pregnancy. To our knowledge, most reports to date have focused on select aspects of the maternal or fetal infection and fetal effects. OBJECTIVE To describe the prenatal evolution and perinatal outcomes of 11 neonates who had developmental abnormalities and neurological damage associated with ZIKV infection in Brazil. DESIGN, SETTING, AND PARTICIPANTS We observed 11 infants with congenital ZIKV infection from gestation to 6 months in the state of Paraíba, Brazil. Ten of 11 women included in this study presented with symptoms of ZIKV infection during the first half of pregnancy, and all 11 had laboratory evidence of the infection in several tissues by serology or polymerase chain reaction. Brain damage was confirmed through intrauterine ultrasonography and was complemented by magnetic resonance imaging. Histopathological analysis was performed on the placenta and brain tissue from infants who died. The ZIKV genome was investigated in several tissues and sequenced for further phylogenetic analysis. MAIN OUTCOMES AND MEASURES Description of the major lesions caused by ZIKV congenital infection. RESULTS Of the 11 infants, 7 (63.6%) were female, and the median (SD) maternal age at delivery was 25 (6) years. Three of 11 neonates died, giving a perinatal mortality rate of 27.3%. The median (SD) cephalic perimeter at birth was 31 (3) cm, a value lower than the limit to consider a microcephaly case. In all patients, neurological impairments were identified, including microcephaly, a reduction in cerebral volume, ventriculomegaly, cerebellar hypoplasia, lissencephaly with hydrocephalus, and fetal akinesia deformation sequence (ie, arthrogryposis). Results of limited testing for other causes of microcephaly, such as genetic disorders and viral and bacterial infections, were negative, and the ZIKV genome was found in both maternal and neonatal tissues (eg, amniotic fluid, cord blood, placenta, and brain). Phylogenetic analyses showed an intrahost virus variation with some polymorphisms in envelope genes associated with different tissues. CONCLUSIONS AND RELEVANCE Combined findings from clinical, laboratory, imaging, and pathological examinations provided a more complete picture of the severe damage and developmental abnormalities caused by ZIKV infection than has been previously reported. The term congenital Zika syndrome is preferable to refer to these cases, as microcephaly is just one of the clinical signs of this congenital malformation disorder.
Medicine, 2017
A major epidemic of Zika virus (ZIKV) infection occurred in French Guiana and West Indies. French national epidemiological surveillance estimated that 1650 pregnant women contracted the ZIKV during epidemic period from January 2016 to October 2016 in French Guiana. ZIKV infection during pregnancy is a cause of microcephaly and birth defects. In this report, we describe 2 children with proven in utero ZIKV exposure. Their mothers were both symptomatic and ZIKV infection occurred early in pregnancy. Ultrasonography monitoring in utero did not show any abnormality for both patient. They were born at full-term, healthy, without any birth defects and no sign of congenital ZIKV infection. ZIKV was neither found on placenta fragments nor children blood and urine at birth. Their neurodevelopment outcomes in early-life fitted the expectations. As recommended in national guidelines, we performed cerebral MRIs at 2 months old, showing severe brain abnormalities, especially of white matter area...
A Short Compilation on Zika Virus Transmission and Its Complication During Pregnancy
Journal of Drug Delivery and Therapeutics, 2016
Zika virus is an emerging arthropod borne virus (arbovirus) transmitted by Aedes (Stegomyia) mosquitoes. The virus belongs to the genus Flavivirus, family Flaviviridae, and is closely related to other Flavi viruses such as dengue, yellow fever and West Nile viruses. Zika Virus is an RNA virus containing 10,794 nucleotides encoding 3,419 amino acids. Zika Virus was first isolated from a rhesus monkey in the Zika Forest of Uganda, in 1947. 1 Zika Virus was first isolated from humans in 1968, in Nigeria. Zika Virus has been considered as emergent since 2007.In 2007, an outbreak of Zika Virus occurred on YAP, the western state of Micronesia. There was 49 conformed and 59 probable cases of Zika identified. Roughly 73% of the 11,241 population was infected according to the CDC. In November 2013, an outbreak occurred in the islands of Western Polynesia, including Tahiti. As of January 13, 2014 the number of confirmed Zika cases was 361, while the number of suspected cases was over 35,000. In February 2014, New Caledonia reported 49 cases, 30 were cases imported from French Polynesia, some cases were confirmed to be autochthonous. 2 Clinical Manifestations: The first well-documented report of human Zika Virus disease was in 1964 when Simpson described his own occupationally acquired Zika illness at age 28. It began with mild headache. Next day, a maculopapular rash covered his face, neck, trunk, and upper arms, and spread to his palms and soles. Transient fever, malaise, and back pain developed. By the evening of the second day of illness he was a febrile, the rash was fading, and he felt better. By day three, he felt well and had only the rash, which disappeared over the next 2 days. Zika Virus was isolated from serum collected while he was febrile. 3 In 1973, laboratory-acquired Zika Virus illness in a man was reported with acute onset of fever, headache, and joint pain but no rash which was isolated from serum collected on the first day of symptoms; the man's illness resolved in 1 week. Of the 7 Zika Virus case-patients in Indonesia, all had fever, but they were detected by hospital-based surveillance for febrile illness. 4 Other manifestations included anorexia, diarrhea, constipation, abdominal pain, and dizziness. The outbreak on Yap Island was characterized by rash, conjunctivitis, and ABSTRACT Zika virus, a mosquito borne flavivirus transmitted primarily by Aedes aegypti mosquitoes is a pathogen affecting humans. These vectors also transmit dengue and chikungunya virus and are found throughout much of the world, including parts of the United States. An estimated 80% of persons infected with Zika virus are asymptomatic. Microcephaly is the greater risk for the infant born from the Zika Virus infected pregnant mother. This virus also causes neurological syndromes. Zika virus disease can often be diagnosed by performing reverse transcriptase-polymerase chain reaction (RT-PCR) on serum.
PLOS Neglected Tropical Diseases, 2021
Objective To analyze adverse fetal and neonatal outcomes of Zika virus infection by the timing of infection during pregnancy. Method: Cohort study of 190 pregnancies with 193 offspring with a positive RT-PCR test for Zika virus (March/2016 to April/2017). Results Death or defects related to congenital Zika virus infection were identified in 37.3% of fetuses and newborns, and microcephaly in 21.4% of the newborns. The proportion of small for gestational age newborns was 21.9%. Maternal symptoms in the first trimester were significantly associated with the birth of newborns with microcephaly/cerebral atrophy, small for gestational age and with the deaths (one abortion, one stillbirth and the two neonatal deaths). Maternal infection during the second trimester was further associated with asymptomatic newborns at birth. The study showed that 58.5% of the offspring with microcephaly and / or cortical atrophy were small for gestational age, with an evident decrease in symptomatic offsprin...