title: Description of 13 Infants Born During October 2015-January 2016 With Congenital Zika Virus Infection Without Microcephaly at Birth - Brazil.
abstract: Congenital Zika virus infection can cause microcephaly and severe brain abnormalities (1). Congenital Zika syndrome comprises a spectrum of clinical features (2); however, as is the case with most newly recognized teratogens, the earliest documented clinical presentation is expected to be the most severe. Initial descriptions of the effects of in utero Zika virus infection centered prominently on the finding of congenital microcephaly (3). To assess the possibility of clinical presentations that do not include congenital microcephaly, a retrospective assessment of 13 infants from the Brazilian states of Pernambuco and Ceará with normal head size at birth and laboratory evidence of congenital Zika virus infection was conducted. All infants had brain abnormalities on neuroimaging consistent with congenital Zika syndrome, including decreased brain volume, ventriculomegaly, subcortical calcifications, and cortical malformations. The earliest evaluation occurred on the second day of life. Among all infants, head growth was documented to have decelerated as early as 5 months of age, and 11 infants had microcephaly. These findings provide evidence that among infants with prenatal exposure to Zika virus, the absence of microcephaly at birth does not exclude congenital Zika virus infection or the presence of Zika-related brain and other abnormalities. These findings support the recommendation for comprehensive medical and developmental follow-up of infants exposed to Zika virus prenatally. Early neuroimaging might identify brain abnormalities related to congenital Zika infection even among infants with a normal head circumference (4).
authors.forename: Vanessa
authors.initials: V
authors.lastname: van der Linden
authors.forename: André
authors.initials: A
authors.lastname: Pessoa
authors.forename: William
authors.initials: W
authors.lastname: Dobyns
authors.forename: A James
authors.initials: AJ
authors.lastname: Barkovich
authors.forename: Hélio van der Linden
authors.initials: HV
authors.lastname: Júnior
authors.forename: Epitacio Leite Rolim
authors.initials: EL
authors.lastname: Filho
authors.forename: Erlane Marques
authors.initials: EM
authors.lastname: Ribeiro
authors.forename: Mariana de Carvalho
authors.initials: MC
authors.lastname: Leal
authors.forename: Pablo Picasso de Araújo
authors.initials: PP
authors.lastname: Coimbra
authors.forename: Maria de Fátima Viana Vasco
authors.initials: MF
authors.lastname: Aragão
authors.forename: Islane
authors.initials: I
authors.lastname: Verçosa
authors.forename: Camila
authors.initials: C
authors.lastname: Ventura
authors.forename: Regina Coeli
authors.initials: RC
authors.lastname: Ramos
authors.forename: Danielle Di Cavalcanti Sousa
authors.initials: DD
authors.lastname: Cruz
authors.forename: Marli Tenório
authors.initials: MT
authors.lastname: Cordeiro
authors.forename: Vivian Maria Ribeiro
authors.initials: VM
authors.lastname: Mota
authors.forename: Mary
authors.initials: M
authors.lastname: Dott
authors.forename: Christina
authors.initials: C
authors.lastname: Hillard
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Moore
mesh_terms: D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008831:Microcephaly / Q000453:epidemiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012189:Retrospective Studies; D000071244:Zika Virus / Q000302:isolation & purification*; D000071243:Zika Virus Infection / Q000151:congenital* / Q000175:diagnosis*