Miranda-Filho Demócrito de Barros, Martelli Celina Maria Turchi, Ximenes Ricardo Arraes de Alencar, Araújo Thalia Velho Barreto, Rocha Maria Angela Wanderley, Ramos Regina Coeli Ferreira, Dhalia Rafael, França Rafael Freitas de Oliveira, Marques Júnior Ernesto Torres de Azevedo, Rodrigues Laura Cunha
Demócrito de Barros Miranda-Filho, Ricardo Arraes de Alencar Ximenes, Maria Angela Wanderley Rocha, and Regina Coeli Ferreira Ramos are with the University of Pernambuco, Recife, Brazil. Celina Maria Turchi Martelli, Rafael Dhalia, Rafael Freitas de Oliveira França, and Ernesto T. A. Marques Júnior are with The Research Center Aggeu Magalhães (CPqAM)/Oswaldo Cruz Foundation (Fiocruz), Recife. Thalia Velho Barreto Araújo and Ricardo Arraes de Alencar Ximenes are with the Federal University of Pernambuco, Recife. Laura Cunha Rodrigues is with the London School of Hygiene and Tropical Medicine, London, UK.
Am J Public Health. 2016 Apr;106(4):598-600. doi: 10.2105/AJPH.2016.303115.
To provide an initial description of the congenital syndrome presumably associated with infection by Zika virus compared with other syndromes including congenital infections of established etiologies.
We provide an overview of a published case series of 35 cases, a clinical series of 104 cases, and published and unpublished reports of clinical and laboratory findings describing cases diagnosed since the beginning of the epidemic of microcephaly in Brazil.
About 60% to 70% of mothers report rash during pregnancy; mainly in the first trimester. Principal features are microcephaly, facial disproportionality, cutis girata, hypertonia/spasticity, hyperreflexia, and irritability; abnormal neuroimages include calcifications, ventriculomegaly, and lissencephaly. Hearing and visual abnormalities may be present.
Preliminary data suggest that severe congenital abnormalities are linked to Zika virus infection. Cases have severe abnormalities, and although sharing many characteristics with congenital abnormalities associated with other viral infections, abnormalities presumably linked to the Zika virus may have distinguishing characteristics. These severe neurologic abnormalities may result in marked mental retardation and motor disabilities for many surviving offspring.
Affected nations need to prepare to provide complex and costly multidisciplinary care that children diagnosed with this new congenital syndrome will require.
与包括已知病因的先天性感染在内的其他综合征相比，初步描述可能与寨卡病毒感染相关的先天性综合征。
我们概述了已发表的35例病例系列、104例临床系列，以及自巴西小头畸形流行开始以来已发表和未发表的关于临床和实验室检查结果的报告，这些报告描述了确诊病例。
约60%至70%的母亲报告孕期出现皮疹；主要发生在孕早期。主要特征为小头畸形、面部比例失调、皮肤褶皱、张力亢进/痉挛、反射亢进和易激惹；异常神经影像包括钙化、脑室扩大和无脑回。可能存在听力和视觉异常。
初步数据表明，严重先天性异常与寨卡病毒感染有关。病例存在严重异常，虽然与其他病毒感染相关的先天性异常有许多共同特征，但可能与寨卡病毒相关的异常具有独特特征。这些严重的神经异常可能导致许多存活后代出现明显的智力迟钝和运动障碍。
受影响国家需要准备好为诊断患有这种新先天性综合征的儿童提供所需的复杂且昂贵的多学科护理。
