Nineteen babies in Northern Brazil born with abnormally small heads as a result of being infected by Zika while in the womb had severe health and development issues as they aged, a long-term government study found.
The condition, known as microcephaly, led to babies having difficulties sitting up by themselves as well as difficulties with sleeping and feeding. They faced hearing and vision problems and had seizures.
It is the first study that assesses how babies with microcephaly caused by the Zika virus are faring as they reach age 2. The long-term prognosis for these children is unknown as they age. For children who have microcephaly because of other causes, the prognosis carries similar uncertainty.
Dr. Brenda Fizgerald, director of the Centers for Disease Control and Prevention, said the children would need to continue to be monitored.
“Children severely affected by Zika virus are falling far behind age-appropriate developmental milestones, and their challenges are becoming more evident as they age,” she said.
The findings were published Thursday in the CDC’s Morbidity and Mortality Weekly Report, and showed that eight babies had been previously hospitalized, six of whom went to the hospital because they had bronchitis or pneumonia. Fourteen children had at least three of the symptoms they tracked.
The investigation was led by the CDC with Brazil’s Ministry of Health and the State Health Secretariat of Paraíba. Scientists are planning to continue long-term follow-up of the 19 children in an investigation known as the Zika Outcomes and Development in Infants and Children, or “ZODIAC,” by conducting physicals, reviewing medical records, and interviewing caregivers.
Scientists noted that long-term care likely would be needed because of the difficulties babies were having.
“As children born affected by Zika virus grow up, they will need specialized care from many types of healthcare providers and caregivers,” said Dr. Georgina Peacock, director of CDC’s Division of Human Development and Disability. “It’s important that we use these findings to start planning now for their long-term care and stay vigilant in Zika prevention efforts in the United States and around the world.”
In Brazil, Zika affected thousands of babies born during 2015 and 2016. Zika is a virus typically spread through mosquitoes but can also be spread through sex. For the vast majority of adults, the symptoms of infection are mild, if they have any at all. The risks involved with infection, however, are high for pregnant women. In some cases, babies were stillborn; others were born with microcephaly.
Zika infections in the continental U.S. reached 2,311, the majority of which were because of traveling to places that had high transmissions. Numbers reached 4,621 in U.S. territories, however, and the virus was particularly widespread in Puerto Rico. In all, CDC data show, 5,544 pregnancies in the territorial and continental U.S. were “completed,” which carries a full range of meaning that could include abortion, miscarriage or being born with or without birth defects.
Zika infections appear to have largely subsided, an outcome scientists have attributed to herd immunity, a term used when a large proportion of people appear to have developed protection against infection. Because a large number of people became infected in 2015 and 2016, they were not infected again, which prevented the virus from spreading as quickly as before.
Scientists have also said, however, that they are watchful for another outbreak because mosquito-borne viruses tend to return, sometimes in other parts of the globe.
