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Congenital Zika Syndrome in Puerto Rico, Beyond Microcephaly, A Multiorgan Approach.
Leticia Gely-Rojas1, Lourdes García-Fragoso2, Juanita Negrón3
1Neonatal-Perinatal Medicine Resident, Neonatology Section, Department of Pediatrics, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
Puerto Rico Health Sciences Journal
|December 22, 2018
Summary
Zika virus (ZIKV) infection in Puerto Rico led to the study of congenital Zika syndrome. Even normocephalic infants showed ocular issues, highlighting the need for thorough evaluations of infants exposed to ZIKV.
Area of Science:
- Infectious Diseases
- Pediatrics
- Public Health
Background:
- The 2015 Zika virus (ZIKV) outbreak in Puerto Rico necessitated understanding its impact on intrauterine exposed infants.
- Congenital Zika Syndrome (CZS) presents a spectrum of neurological and developmental abnormalities.
Purpose of the Study:
- To characterize the clinical manifestations and laboratory findings in infants with intrauterine ZIKV exposure.
- To assess the prevalence of microcephaly and other anomalies in infants born to ZIKV-positive mothers.
Main Methods:
- Retrospective review of medical records for infants born to mothers with confirmed ZIKV infection during pregnancy (January 2016-June 2017).
- Inclusion criteria: infants admitted to UPH Neonatal Intensive Care Unit or referred to UPH High Risk Clinics.
- Data collection included head sonograms, brain MRIs, and auditory brainstem response tests.
Main Results:
- 191 infants were born to ZIKV-positive mothers; 7.8% presented with microcephaly.
- 73% of microcephalic infants showed head sonogram calcifications and severe brain MRI anomalies.
- Ocular findings were present in 50% of microcephalic infants and 31% of normocephalic infants.
Conclusions:
- While microcephaly is a severe CZS manifestation, ocular findings in normocephalic infants suggest a broader spectrum of ZIKV effects.
- 31% of normocephalic infants exhibited ocular manifestations, and 7% had abnormal head sonograms.
- Detailed neonatal evaluations are crucial for all infants exposed to ZIKV in utero.
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