COCA Now: Children with Congenital Zika Virus Infection Face Serious Challenges as They Age

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Children with Congenital Zika Virus Infection Face Serious Challenges as They Age

Zika Morbidity and Mortality Weekly Report (MMWR) Button

First report to show severe impairments become more evident over time

Children born with microcephaly – small head size for age – and evidence of congenital Zika virus infection face severe health and developmental challenges at ages 19-24 months, according to results from a new investigation led by the Centers for Disease Control and Prevention (CDC) in collaboration with the State Health Secretariat of Paraíba and the Ministry of Health of Brazil.

The report, published on December 15, 2017 in the  Morbidity and Mortality Weekly Report (MMWR), is the first to describe the health and developmental effects of congenital Zika virus infection in children with microcephaly through 2 years of age. Most of the children had severe motor impairment, seizure disorders, hearing and vision abnormalities, and sleep difficulties. Many of the children faced challenges in multiple areas.  

Although previous publications described the health effects in infants born with microcephaly during the Zika outbreak, this is the first investigation to characterize the health and development of these children as they age. The findings give a more complete picture of the lifelong challenges that will affect children born with microcephaly during the Zika outbreaks in Brazil and elsewhere, who will require specialized care from clinicians and caregivers as they age. 

ZODIAC: Long-term follow-up of children born with Zika-related microcephaly

Zika Outcomes and Development in Infants and Children (ZODIAC) investigation is a collaboration between the CDC and the Ministry of Health of Brazil. The investigation took place in northeastern Brazil, where Zika affected thousands of children born during 2015 to 2016. ZODIAC investigation compiled a comprehensive description of the health and development of 19 children with microcephaly and laboratory evidence of congenital Zika virus. ZODIAC data were collected through clinical evaluations, caregiver interviews, and review of medical records. Investigators found that, of the 19 children:

  • Eleven had indications of possible seizure disorder;
  • Ten had sleep difficulties;
  • Nine had feeding difficulties, such as trouble swallowing;
  • Thirteen children had hearing problems and 11 had vision problems, such as not responding to the sound of a rattle and not being able to follow a moving object with their eyes;
  • Fifteen children had severe motor impairments, including inability to sit independently;
  • Fourteen children had at least three of these challenges, complicating their care; and
  • Eight had been previously hospitalized, with bronchitis/pneumonia being the most commonly reported reason for hospitalization (6 of the 8).

The results provide important information to help the United States, Brazil, and other countries prepare for the unprecedented challenges posed for children affected by Zika virus infection. As they children age, they will continue to require specialized care from clinicians and caregivers. These results allow for anticipation of medical and social services needs of affected children and families, such as early intervention services, and planning for resources to support these families in healthcare and community settings.

For the most current information about Zika virus, visit http://www.cdc.gov/zika/ and https://www.cdc.gov/pregnancy/zika/data/pregnancy-outcomes.html.

See a searchable database of specialists who care for infants with congenital Zika virus infection in several U.S. states, the U.S. Virgin Islands, and Puerto Rico at: http://www.zikacareconnect.org/.