Congenital Zika syndrome

Congenital Zika syndrome
Congenital Zika syndrome
SpecialtyPediatrics
SymptomsSmall head, visual problems, contractures, stiffness[1]
Usual onsetNewborn baby[2]
CausesZika virus[2]
Risk factorsZika virus infection in mother[2]
Diagnostic methodHistory, symptoms, blood/urine tests, medical imaging[2]
Differential diagnosisCongenital toxoplasmosis, congenital syphilis, congenital varicella syndrome, parvovirus B19, congenital rubella, congenital cytomegalovirus infection, congenital herpes simplex, Aicardi-Goutières syndrome[2]
PreventionAvoiding mosquito bites, mosquito control, birth control education[3]
TreatmentSupportive care[3]

Congenital Zika syndrome presents as birth defects in a newborn baby of some mothers infected with Zika virus during pregnancy.[1] Symptoms typically include a small head, visual problems, contractures, and stiffness.[1] Less frequently heart problems, ambiguous genitalia, undescended testes, bowel problems, difficulty swallowing, hearing problems, or a small baby may occur.[2] Complications may include miscarriage or stillbirth.[2]

The cause is infection by the Zika virus, a type of flavivirus, during pregnancy.[2] Most infected mothers and their babies have no or mild symptoms.[4] Congenital Zika syndrome can occur regardless of whether the mother had symptoms.[3] Diagnosis is supported by detecting the virus in the mother, particularly if there are symptoms or a history of travel to an area with the Aedes mosquito.[3] Blood tests may confirm the diagnosis and distinguish Zika from Dengue.[3] Ultrasound may detect symptoms in the unborn baby.[2] MRI of the brain of the baby may show a collapsed skull and small brain.[2]

Treatment of Zika infection is supportive, with rest and hydration.[3] Prevention is by avoiding mosquito bites, mosquito control, and birth control education.[3]

Congenital Zika syndrome affects around 10% of babies born to mothers who had Zika infection during pregnancy.[3] The link between Zika and microcephaly was first documented in 2015 in Brazil.[2] The following year Zika was declared a Public Health Emergency of International Concern by the World Health Organization.[2] Limitations to diagnosis include the high cost of testing for Zika.[2] The Zika virus was first isolated in 1954 in Nigeria.[2]

Signs and symptoms

Symptoms typically include a small head, visual problems, contractures, and stiffness.[1] Less frequently heart problems, ambiguous genitalia, undescended testes, bowel problems, difficulty swallowing, hearing problems, or a small baby may occur.[2] Other abnormal nerve development consequences include, dystonia, tremors, mental disability, and hearing loss.[4]

In the eyes there may be scarring in the eyes and underdevelopment of the optic nerve.[4]

  • Finger deformities
    Finger deformities
  • Clubfeet
    Clubfeet
  • Knee dislocation
    Knee dislocation
  • Knee contracture
    Knee contracture
  • Joint contractures
    Joint contractures

Diagnosis

Testing is recommended by the CDC for all babies born to mothers who test positive for Zika, and all babies with symptoms of Zika virus.[4] This is typically by RT-PCR and antibody testing on blood, and ZIKV RT-PCR on urine.[4]

  • MRI- bilateral dislocation of hips, epiphyseal core (small arrow), and dysplastic acetabulum (large arrow)
    MRI- bilateral dislocation of hips, epiphyseal core (small arrow), and dysplastic acetabulum (large arrow)
  • X-ray knees
    X-ray knees
  • CT hips
    CT hips
  • X-ray- dislocation of hips
    X-ray- dislocation of hips

See also

References

  1. 1 2 3 4 "Congenital Zika Syndrome & Other Birth Defects | CDC". Centers for Disease Control and Prevention. 22 April 2022. Archived from the original on 12 June 2023. Retrieved 8 September 2023.
  2. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Freitas, Danielle A.; Souza-Santos, Reinaldo; Carvalho, Liege M. A.; Barros, Wagner B.; Neves, Luiza M.; Brasil, Patrícia; Wakimoto, Mayumi D. (15 December 2020). "Congenital Zika syndrome: A systematic review". PLoS ONE. 15 (12): e0242367. doi:10.1371/journal.pone.0242367. ISSN 1932-6203. Archived from the original on 9 June 2022. Retrieved 9 September 2023.
  3. 1 2 3 4 5 6 7 8 "Zika virus". www.who.int. World Health Organization. Archived from the original on 26 January 2023. Retrieved 12 September 2023.
  4. 1 2 3 4 5 Hills, Susan L.; Woodworth, Kate R. (2022). "92. Zika virus disease and congenital Zika virus disease". In Jong, Elaine C.; Stevens, Dennis L. (eds.). Netter's Infectious Diseases (2nd ed.). Philadelphia: Elsevier. pp. 556–561. ISBN 978-0-323-71159-3. Archived from the original on 2023-09-13. Retrieved 2023-09-12.
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