In order to address the generalized public anxiety that the arrival of Zyka provoked in the USA last year, some mendacious mandarins of the mass media quickly labelled it as just a microcephaly that affected mostly folks living in dire poverty. Even though microcephaly is common, infants may have a normal head size at birth, but develop postnatal microcephaly or other neurologic symptoms at six months. We should top calling it microcephaly as it is bigger than that.
The Zika virus is trophic—attracted—to the neural stem—precursor—cells; the first clinical reports of prenatal infection came form Brazil in January 2016. In the USA, the Aedes Agypti mosquito vector is present throughout the year in Texas and Florida but expands seasonally to many more states. We have limited ways to stop an emerging pathogen but we have the technical tools—like polymerase chain reaction and genome sequencing—to quickly identify it in order to set up the necessary Public Health measures.
Dr. Amilcar Tamauri et al, from the Federal University of Rio de Janeiro, observed 11 infants with congenital Zyka infection from gestation to six months in the state of Paraíba. Seven of the infants were female and the median maternal age of delivery was 25 years; three of the infants died. The virus was identified in the amniotic fluid, placenta, cord blood, and neonatal tissues collected post-mortem in the three babies that died after delivery. All the patients had signs of brain damage and severe neurologic impairments.
Dr. Dobins et al. studied 57 cases of the congenital Zyka syndrome and presumed or proven Zika exposure during pregnancy in Fortaleza. About half of the children had a bony protuberance of the occipital bone, dubbed as the occipital shell. When the fetal brain cannot grow, it shrinks. The frontal and parietal bones, but not the occipital bone, collapse. Fifty one children had diffuse subcortical or sub-cortical calcifications in CT Scan.All the patients had enlarged extra-axial space and ventriculomegaly.
Infants exposed to the Zika virus should receive a comprehensive medical and developmental evaluation, for which a surveillance system is mandatory.
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