Postnatal Zika and Dengue Infection and their Effects on Neurodevelopment Among Children Living in Rural Guatemala

Area of Science:

• Pediatric Neurodevelopment
• Infectious Diseases
• Virology

Background:

• Prenatal Zika virus (ZIKV) exposure is known to cause microcephaly and neurodevelopmental issues.
• The impact of postnatal ZIKV infection on infant brain development remains largely unknown.
• This study investigated neurodevelopmental outcomes in children with postnatal ZIKV exposure during an epidemic.

Purpose of the Study:

• To assess the neurodevelopmental effects of postnatal Zika virus (ZIKV) infection in young children.
• To evaluate the association between flavivirus serostatus and neurodevelopmental outcomes.
• To compare outcomes between infants and older children exposed to ZIKV and Dengue virus (DENV).

Main Methods:

• A prospective cohort study followed 1371 infants and children (aged 0-3.5 years) in Guatemala for 12 months.
• Neurodevelopment was assessed using the Mullen Scales of Early Learning (MSEL).
• ZIKV and DENV infections were detected via PCR and serological testing (focus reduction neutralization test).

Main Results:

• No PCR-confirmed ZIKV infections were detected; however, one-third of older children were ZIKV-seropositive, indicating likely postnatal infection.
• Dengue virus (DENV) infection was confirmed in 5.8% of participants, primarily DENV-3.
• No significant neurodevelopmental differences were observed in infants based on ZIKV or DENV serostatus. DENV seropositivity in older children correlated with lower MSEL scores and microcephaly.

Conclusions:

• Postnatal Zika virus (ZIKV) infection was not associated with adverse neurodevelopmental outcomes in this cohort.
• Dengue virus (DENV) seropositivity in children was linked to an increased risk of microcephaly and poorer neurodevelopmental outcomes.
• Findings highlight the distinct neurodevelopmental impacts of ZIKV and DENV in early childhood.