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Case Reports
. 2016 Apr;106(4):598-600.
doi: 10.2105/AJPH.2016.303115.

Initial Description of the Presumed Congenital Zika Syndrome

Demócrito de Barros Miranda-Filho  1 , Celina Maria Turchi Martelli  1 , Ricardo Arraes de Alencar Ximenes  1 , Thalia Velho Barreto Araújo  1 , Maria Angela Wanderley Rocha  1 , Regina Coeli Ferreira Ramos  1 , Rafael Dhalia  1 , Rafael Freitas de Oliveira França  1 , Ernesto Torres de Azevedo Marques Júnior  1 , Laura Cunha Rodrigues  1
Affiliations
Case Reports

Initial Description of the Presumed Congenital Zika Syndrome

Demócrito de Barros Miranda-Filho et al. Am J Public Health. 2016 Apr.

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We provide an overview of a published case series of 35 cases, a clinical series of 104 cases, and published and unpublished reports of clinical and laboratory findings describing cases diagnosed since the beginning of the epidemic of microcephaly in Brazil.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

FIGURE 1—
FIGURE 1—
Newborn Microcephaly and Arthrogryposis in Legs and Arms
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