Status: Funded - Open
The impact of congenital zika infection on infants and young children
Isabel Hurtado, MD
BACKGROUND: During the recent outbreak, Brazil health authorities reported an increased incidence of microcephaly. Epidemiological and clinical data suggest that microcephaly cases observed in Brazil are secondary to Zika infection during pregnancy, with transplacental passage of the virus resulting in congenital infection. Currently, Colombia is going through an outbreak of zika virus infection, and we expect 500 cases of microcephaly in the upcoming months.
GAP: The incidence of congenital infection among infants born to mothers with zika during pregnancy is not known. Furthermore, the clinical spectrum of this congenital infection and its physical, neurological or cognitive impact during infancy or early childhood is not fully known.
HYPOTHESIS: Zika infection during pregnancy leads to physical and neurocognitive sequela. The most affected infants will manifest in–utero and in the newborn period, while an unknown proportion of infants will develop neurocognitive manifestations in the first two years of life.
METHODS: We propose a prospective, descriptive study of infants born to mothers with molecular diagnoses of Zika during pregnancy. Using information from the state health department, we will identify women with molecular diagnoses of Zika during any trimester of pregnancy. We will follow their newborns for the first 2 years of life or until the end of the study period to document demographic, anthropometric and clinical data. We will perform neurocognitive testing at 12 and 24 months of life.
RESULTS: We evaluated 41 patients from mothers with zika during gestation. We found microcephaly in 2.4% of the study population. Other neurological alterations in the physical examination were present in 19%, musculoskeletal alterations in 4.8%, auditory alterations in 14.2% and ophthalmic abnormalities In 13.3%. These data is compatible with other series. So far our sample size is small and we have not finished monitoring patients so a causality can not be determined.
IMPACT: Describing the frequency of congenital malformations and neurocognitive sequela manifested by infants born to mothers infected with zika during pregnancy will allow us to determine support treatment and rehabilitation needs for these infants in future epidemics, and during year-round circulation in endemic areas.
Centro de Estudios en Infectología Pediátrica