Lessons Learned at the Epicenter of Brazil's Congenital Zika Epidemic: Evidence From 87 Confirmed Cases

dc.creatorMeneses, Jucille do Amaral
dc.creatorIshigami, Ana Catarina
dc.creatorMello, Luisa Medeiros de
dc.creatorAlbuquerque, Luciano Lira de
dc.creatorBrito, Carlos Alexandre Antunes de
dc.creatorCordeiro, Marli Tenório
dc.creatorPena, Lindomar José
dc.date2018-03-22T12:22:48Z
dc.date2018-03-22T12:22:48Z
dc.date2017
dc.date.accessioned2023-09-26T20:18:23Z
dc.date.available2023-09-26T20:18:23Z
dc.identifierMENESES, J. DO A. et al. Lessons Learned at the Epicenter of Brazil’s Congenital Zika Epidemic: Evidence From 87 Confirmed Cases. Clinical Infectious Diseases, v. 64, n. 10, p. 1302–1308, 15 maio 2017.
dc.identifier1537-6591
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/25449
dc.identifier10.1093/cid/cix166
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8853821
dc.descriptionA LJP é apoiada por doações do CNPq e da FACEPE (Fundação de Ciência e Tecnologia do Estado de Pernambuco).
dc.descriptionCongenital Zika virus infection has stimulated great international concern. A prospective case series of 87 infants with laboratory-confirmed congenital Zika syndrome (CZS) at the epicenter of the Brazilian Zika epidemic in Pernambuco state is presented. Mothers were interviewed for symptoms of possible Zika virus (ZIKV) infection during pregnancy, and fetal ultrasounds were obtained. Infant cerebrospinal fluid (CSF) samples were tested for ZIKV-specific antibodies, and sera were screened for other congenital infections. Neuroimaging and ophthalmologic evaluations were also performed. Sixty-six mothers (76%) reported symptoms of ZIKV infection during gestation. Fetal ultrasounds were available from 90% of the mothers, and all demonstrated brain structural abnormalities. All of the CSF samples tested positive for ZIKV immunoglobulin M. The majority of infants (89%) were term; the mean birth weight was 2577 ± 260 g, and the mean head circumference was 28.1 ± 1.8 cm. Severe microcephaly, defined as head circumference 3 SD below the mean for sex and gestational age, was found in 72 (82%) infants. All infants had an abnormal neurological exam, and 18 (20.7%) had arthrogryposis. The main abnormalities detected in computed tomography scans were calcifications (99%), followed by ventricular enlargement (94%), cortical hypogyration (81%), and less commonly, cerebellar hypoplasia (52%). Unilateral diaphragm paralysis was identified in 3 infants. Maternal young age, term infant, small for gestational age, and the presence of ophthalmologic abnormalities were significantly associated with a smaller head circumference Z score. Our findings, based on laboratory-confirmed ZIKV infection, add valuable evidence for the understanding of CZS.
dc.description2043-03-22
dc.formatapplication/pdf
dc.languageeng
dc.rightsrestricted access
dc.subjectVírus Zika
dc.subjectsíndrome congênita do zika (CZS)
dc.subjectParalisia do diafragma
dc.subjectImunoglobulina M.
dc.subjectMicrocefalia
dc.subjectZika virus
dc.subjectCongenital Zika syndrome (CZS)
dc.subjectdiaphragm paralysis
dc.subjectImmunoglobulin M.
dc.subjectMicrocephaly
dc.subjectAnticorpos virais / sangue
dc.subjectAnticorpos virais / líquido cefalorraquidiano
dc.subjectArtrogripose / epidemiologia
dc.subjectArtrogripose / virologia
dc.subjectCérebro / anormalidades
dc.subjectCérebro / virologia
dc.subjectBrasil / epidemiologia
dc.subjectCerebelo / anormalidades
dc.subjectCerebelo / diagnóstico por imagem
dc.subjectCerebelo / virologia
dc.subjectDeficiências do desenvolvimento / diagnóstico por imagem
dc.subjectDeficiências do desenvolvimento / epidemiologia
dc.subjectDeficiências do desenvolvimento / virologia
dc.subjectEpidemias / estatística & dados numéricos
dc.subjectFêmea
dc.subjectDoenças Fetais / epidemiologia
dc.subjectDoenças fetais / virologia
dc.subjectIdade gestacional
dc.subjectHumanos
dc.subjectImunoglobulina M / sangue
dc.subjectImunoglobulina M / líquido cefalorraquidiano
dc.subjectInfantil
dc.subjectMicrocefalia / diagnóstico por imagem
dc.subjectMicrocefalia / epidemiologia
dc.subjectMicrocefalia / virologia
dc.subjectMães
dc.subjectMalformações do Sistema Nervoso / diagnóstico por imagem
dc.subjectMalformações do Sistema Nervoso / epidemiologia
dc.subjectMalformações do Sistema Nervoso / virologia
dc.subjectNeuroimagem
dc.subjectGravidez
dc.subjectComplicações na Gravidez Infecciosa / epidemiologia
dc.subjectComplicações na Gravidez Infecciosa / virologia
dc.subjectEstudos Prospectivos
dc.subjectParalisia Respiratória / diagnóstico por imagem
dc.subjectParalisia Respiratória / epidemiologia
dc.subjectParalisia Respiratória / virologia
dc.subjectUltrassonografia
dc.subjectVírus Zika / imunologia
dc.subjectVírus Zika / isolamento e purificação
dc.subjectInfecção pelo vírus Zika / congênita
dc.subjectInfecção pelo vírus Zika / epidemiologia
dc.subjectInfecção pelo vírus Zika / virologia
dc.titleLessons Learned at the Epicenter of Brazil's Congenital Zika Epidemic: Evidence From 87 Confirmed Cases
dc.typeArticle


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