Physicians at the Santa Casa de Misericordia and researchers from the Institute of Biomedical Sciences at University of São Paulo describe the case of a baby born with Zika infection in January 2016, who remained infected by the virus even two months and one week after birth.
This is the first reported case of prolonged Zika infection in newborns.
The baby was born with 3 kg, 48 cm in length and the head perimeter of 32.5 cm, slightly smaller than the 33cm recommended by WHO. At first, doctors did not detect signs of any neurological abnormality: the analysis of the cerebrospinal fluid and the exams of the eyes and the ears showed normal results. Images taken by MRI, though, showed a reduced brain parenchyma, foci of calcification in the subcortical area and compensatory dilation of the supraventricular system. These results and the fact that the mother's symptoms of Zika infection appeared in the seventh month of pregnancy - when it is thought that the damage to the fetus is less severe than when the infection occurs earlier in pregnancy - led to a first diagnosis of mild microcephaly.
After 54 days of life, the baby showed no illness or neurological impairment. However, at six months, doctors noticed delayed psychomotor development, with an abnormal increase in the muscle tone and reduced muscle stretchability. Also, spastic hemiplegia (cerebral palsy) was detected. These characteristics imply a more serious condition than diagnosed before.
The baby's father traveled to the Northeast of Brazil and showed symptoms of Zika before his wife. It may indicate that the virus could have been sexually transmitted. Serological tests confirmed the infection in both parents.
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Prolongued Shedding of Zika Virus Associated with congenital infection
NEJM.org
Authors:
Danielle B. L. Oliveira1, Flávia J. Almeida2, Edison L. Durigon1 and others.
1- University of São Paulo
2- Santa Casa de Misericórdia of São Paulo
Journal
New England Journal of Medicine