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
“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.