Congenital Zika syndrome (CZS) may look similar to other infections, but experts have identified several characteristics that set it apart.
The virus can cause anomalies of the skull, brain, eyes and joints and can impair development.
“Recognition of this phenotype by pediatric clinicians will help ensure appropriate and timely evaluation and follow-up of affected infants,” authors wrote in the review article “Characterizing the Pattern of Anomalies in Congenital Zika Syndrome for Pediatric Clinicians” (Moore CA, et al. JAMA Pediatr. Nov. 3, 2016, http://jamanetwork.com/journals/jamapediatrics/fullarticle/2579543).
Zika virus has spread to more than 45 countries in Central and South America and is being transmitted by mosquitoes in the Miami area.
There have been 4,128 cases of Zika virus reported in U.S. states and 30,178 in U.S. territories. Those include 1,005 pregnant women in the states and 2,263 in territories.
Authors of the study, who include Centers for Disease Control and Prevention (CDC) experts, reviewed 34 published reports describing clinical features of CZS.
“Although many of the components of this syndrome, such as cognitive, sensory, and motor disabilities, are shared by other congenital infections, 5 features differentiate CZS from other congenital infections: (1) severe microcephaly with partially collapsed skull; (2) thin cerebral cortices with subcortical calcifications; (3) macular scarring and focal pigmentary retinal mottling; (4) congenital contractures; and (5) marked early hypertonia with symptoms of extrapyramidal involvement,” they wrote.
The report details each of these areas. However, the authors noted more research is needed on co-occurrence of these components and whether any are required for a diagnosis.
Studies show infants have contracted congenital Zika during each trimester, but late first trimester and early second trimester appear to be most common. Researchers are studying the potential relationship between of the timing of the infection and the severity of the resulting anomalies.
For infants with congenital Zika infection, CDC guidance recommends an array of tests and follow-up with appropriate specialists.
The CDC asks that health care professionals report all suspected Zika cases to their state, local, tribal or territorial health officials. For congenital cases, they also should provide clinical information to the U.S. Zika Pregnancy Registry or Puerto Rico Zika Active Pregnancy Surveillance System through age 1 year so the CDC can monitor outcomes and adjust recommendations accordingly.
