Infectious causes of microcephaly: epidemiology, pathogenesis, diagnosis, and management
Delan Devakumar1, Alasdair Bamford2, Marcelo U Ferreira3
1Institute for Global Health, University College London, London, UK.
Abstract:
Microcephaly is an important sign of neurological malformation and a predictor of future disability. The 2015-16 outbreak of Zika virus and congenital Zika infection brought the world's attention to links between Zika infection and microcephaly. However, Zika virus is only one of the infectious causes of microcephaly and, although the contexts in which they occur vary greatly, all are of concern. In this Review, we summarise important aspects of major congenital infections that can cause microcephaly, and describe the epidemiology, transmission, clinical features, pathogenesis, management, and long-term consequences of these infections. We include infections that cause substantial impairment: cytomegalovirus, herpes simplex virus, rubella virus, Toxoplasma gondii, and Zika virus. We highlight potential issues with classification of microcephaly and show how some infants affected by congenital infection might be missed or incorrectly diagnosed. Although Zika virus has brought the attention of the world to the problem of microcephaly, prevention of all infectious causes of microcephaly and appropriately managing its consequences remain important global public health priorities.
Insights
Microcephaly, a sign of neurological issues, can stem from various infections beyond Zika virus. Preventing all infectious causes and managing consequences are crucial global health priorities.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- Microcephaly is a critical indicator of neurological malformation and a predictor of future disability.
- The 2015-16 Zika virus outbreak highlighted the link between Zika infection and microcephaly.
- Zika virus is one of several infectious agents capable of causing microcephaly.
Purpose of the Study:
- To review major congenital infections causing microcephaly.
- To detail the epidemiology, transmission, clinical features, pathogenesis, management, and long-term outcomes of these infections.
- To address classification challenges and diagnostic issues in congenital infection-related microcephaly.
Main Methods:
- Comprehensive literature review of congenital infections associated with microcephaly.
- Synthesis of data on epidemiology, transmission, clinical presentation, and pathogenesis.
- Analysis of current management strategies and long-term consequences.
Main Results:
- Identified cytomegalovirus, herpes simplex virus, rubella virus, Toxoplasma gondii, and Zika virus as significant infectious causes of microcephaly.
- Highlighted variability in occurrence contexts and potential for misdiagnosis.
- Emphasized the substantial impairment caused by these infections.
Conclusions:
- While Zika virus gained attention, numerous infectious agents cause microcephaly.
- Effective prevention of all infectious causes and management of consequences are vital public health goals.
- Accurate diagnosis and classification of microcephaly due to congenital infections require further attention.
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